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What to Do if Someone with Bipolar Refuses Treatment

Even once a person with bipolar disorder knows he's sick, he might still refuse treatment. Here's what a loved one can do for a bipolar refusing treatment.

Bipolar disorder is a scary illness, but sometimes even scarier is the idea of treatment. Logically, going to the doctor, getting a diagnosis and getting help doesn’t sound scary, but if you’re the one faced with psychiatrists, personal, probing questions, destroying what you know and treatments that might make you feel worse before you feel better, you might find the concept daunting.

But what do you do if you’re a loved one of a person with bipolar (or another mental illness) who is refusing treatment?

Why Do People Refuse Bipolar Treatment?

People refuse treatment for many reasons. As I mentioned, one of them is fear of treatment and fear of the unknown but there are other reasons too, such as:

  • Fear of doctors
  • Lack of trust or belief in medical treatment
  • Fear of side effects
  • No wanting to lose the mania of bipolar disorder
  • Fear of labeling and stigma

What’s a Loved One to Do About Bipolar Treatment Refusal?

And sometimes, when faced with this wall of reasons not to get treatment, it can seem absolutely hopeless to get the person to see reason. But here’s the thing, this wall of reasons basically comes down to only one thing: fear. And bipolar education creates knowledge and that knowledge dispels fear.

Offer Facts About Bipolar Treatment

So my best advice is to take a very logical approach with a loved one and deal with each fear one at a time. Sit down and ask the person why they are refusing treatment. Only he or she knows for sure, so make sure you at least understand his perspective as it’s absolutely real and valid.

And then start dealing with the fear. If the person is afraid of doctors, this is perfectly reasonable. You can help by researching what will happen in the appointment ahead of time. You can help by researching doctors in the area and finding the best one. You can help by facilitating and going to the appointment. You can help by supporting the patient’s wishes during the appointment. Doctors absolutely can be scary but what a patient really needs is someone on his side so that he doesn’t feel “out-gunned” by someone in a position of authority.

If the fear is lack of trust or faith in medical treatment, this is understandable too. Then it’s time to do research on treatments and find success stories for the person to read.

In short, calm, rational conversation can often pinpoint exactly why a person is refusing help and doing some research on your part can help assuage whatever fear the patient may have.

But What if They Still Refuse Bipolar Treatment?

Okay, but what if you’ve done all that and the person still refuses treatment?

Well, then you might want to remind them of what the problems are and what treatment can do. People only need help for a mental illness once the mental illness becomes a problem in their lives like when a person loses a job, or does poorly in school, or destroys relationships and so on. It’s then that help is needed and so it’s entirely appropriate to remind the person of these problems and talk about how something needs to be done to address them.

And if not treatment, then what? Does the person want to live without being able to work? Does he not want personal relationships? Does he want to flunk out of school? Probably not. And treatment is the way to address all these issues.

And if you do all that and you’re supportive and you try your best and the person still refuses to budge, then you need to respect his opinion. I know it’s hard to hear when you love someone, but unless the person is a minor or unless he’s a danger to himself or others, the person absolutely has the right to refuse treatment. We’re adults. We get to make choices and then live with the ramifications thereof, even if our loved ones disagree.

(And once that choice is made, you, as a loved one, have your own choices to make, many of which can be very hard, but that will have to wait for another article.)

You can find Natasha Tracy on Facebook or GooglePlus or @Natasha_Tracy on Twitter.

Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate and author of Lost Marbles: Insights into My Life with Depression & Bipolar.

Find Natasha Tracy on her blog, Bipolar Burble, Twitter, Google+ and Facebook.

66 thoughts on “What to Do if Someone with Bipolar Refuses Treatment”

  1. Hi natasha. My wife had undergone bariatric surgery and wanted to loose weight so she started a keto diet that helped her loose more weight in less days.. till today she has lost around 75 kilos . The surgeon always rejected the idea of her keto diet as she needs enough food to be taken in regular intervals but she did not listen, now she has multiple deficiencies like vitamin D vitamin A protein albumin copper iron etc… she has now become totally unstable mentally and due to nutritional deficiencies she is getting very weak and has developed a muscle disease in her legs and has become less mobile physically. She would get physically violent for me to complete her duties at home and also threatened me with a knife. .. as of now she is not eating for the past 35 hours and refuses medical help… she hates my parents and has had a fight with her brother too who was trying to intervene and get her to go to a therapist. . Her brother and father live in a different country and so I literally have no help around. .. she has lost consciousness 3 times where I have called the hospital and managed to get her back to consciousness. . I can’t see her die this way. .

    1. Hi Gb,

      I’m sorry to hear you are in that situation. Sometimes weight loss can be like a drug. That’s when it becomes an eating disorder.

      I am not an expert in eating disorders, but I have two suggestions for you:

      Perhaps you might like to read the book “You Need Help”? It outlines ways of getting a loved one to get help. (I have no affiliation with this book and nor does HealthyPlace): https://www.amazon.com/You-Need-Help-Step-Step/dp/1616491485/ref=sr_1_1?s=books&ie=UTF8&qid=1511119387&sr=1-1&keywords=you+need+help

      You may also want to hold an intervention with her loved ones. Interventions are typically used for people with addictions, but there is no reason why they can’t be used for a person with an eating disorder. You can read more about an eating disorder intervention here: https://www.healthyplace.com/eating-disorders/articles/intervention-to-help-someone-with-bulimia/

      I hope that helps.

      – Natasha Tracy

  2. Our family is struggling with a mother who is 66 years old and bipolar. She has struggled with this illness for the majority of my life but in the past few years has stopped visiting a doctor and has stopped taking her medication.
    This has caused her to become extremely abusive and hostile (verbally) towards my father, her sister (and husband). She has also stopped taking care of herself physically with a complete disregard for her hygiene, not wearing corrective eyewear, and erosion of her teeth. The family home has become a hoarder’s paradise.
    While my mother is not a serious physical threat to herself, she is causing a serious strain to those closest to her.
    My father is 71 years old and handles his wife’s deteriorating health by suffering in silence. He refuses to leave her for more than an hour or two as he feels “things will only get worse if he leaves”. It has had a toll on him physically & mentally.
    It has caused anxiety in my aunt, who lives next door with shutters permanently drawn and doors locked.
    My brother does not feel comfortable having his son over for any period of time. I am not comfortable having my wife over.

    The only people who can do no harm in her mind are her long dead parents, and her two children (myself and my brother).

    Most of my visits involve me rotating between confronting my mother about her abusive & irrational behavior or trying to ignore her so I can hang out with my father.
    It has come to the point where we as a family would be better off without her. Everyone hates her. I hate her.

    What do we do?

    1. Hi Fred,

      I’m sorry you’re in that situation. I used to have a very sick father who refused help too.

      In my opinion, I would suggest an intervention. I know that interventions are typically for people with addictions, but it could work in this case, too. See how to run one here (not affiliated with HealthyPlace): https://www.mayoclinic.org/diseases-conditions/mental-illness/in-depth/intervention/art-20047451\

      Also, you may be able to contact elderly protective services and they may be able to help you further.

      At that point, all of you need to declare clear boundaries. In the end, as an adult, if she wants to destroy herself, that is her right. I know that’s hard to hear, but it’s what I had to accept too.

      I hope that helps.

      – Natasha Tracy

      1. Thank you. I did not know an intervention was possible for mental health issues affecting the family.
        Have you had any experience of it working in other situations?

  3. My girlfriend is bipolar and doctors have always had a team hard time finding a vein to draw blood. Because of this, they put her on lithium without doing blood work.
    Years later she started having kidney problems. That’s when they discovered that she had been prescribed a dose like 10 times the amount she should’ve been prescribed which has put he on the verge of needing dialysis.
    They practically destroyed her kidneys. She still has to desk with the BD but her body can’t handle the treatment meds. This is s real problem. Any suggestions?

  4. I hv same prblm actually my mom is now 65 yrs old nd suffering mentally disturbed from 8-9 months we provide medicine but it can’t help us because after taking medicine she going to sleep and when she awake again she’s talking nd walking unnessary without take a rest what I do , pls suggest me the meal which is help to recover her hyper depression nd stopped over thinks

  5. Hi, miss Natasha. I was diagnosed with bipolar disorder around 6 months ago. I have a reversed problem. I feel great while I take my meds, but, my family thinks that I’m weak by taking them and it’s all just my “lack of self discipline” that cause all of my mood swings. Mind you, they were all there when the doctor diagnosed me. I don’t know what to tell them. I feel frustrated since they get mad if my random outbursts happen but they don’t allow me to take my meds either. I talked to my psychiatrist about this and he already talked to my family about it and they acted as if I’m lying to them. I’m sorry for ranting but I just feel too frustrated

  6. My young bro has a mental problem but has refused to take the medicine in order,he says theys a pill that is strong on him and makes him to sleep alot’so am planning to put this pill in his tea so that the meducation will be taken in full order at the end.pliz help me and advise me on my plan dear.

    1. Hi Ssettenda,

      I can’t tell you what to do, but I think it would be better to convince your brother of the need for medication rather than trying to give it to him without his knowledge. I would recommend trying to educate him about his illness and the importance of treatment and hope that knowledge convinces him to take his own treatment.

      – Natasha Tracy

  7. My mother is an absolute nut! Normally your mother your supposed to love and care about, we’re at the point we’re we hope she would just die cuz it’s making my father want to die and even hopes for it, and the same for me! She’s abusive, EVERYTHING is hers!!! She’ll go from calm to being a demon in .2 seconds!!! Sorry but if I’m upset and someone bothers me I’m still upset I.don’t act like there’s nothing wrong! I myself have mental issues, ADHD, depression, also struggled with drugs in my earlier yrs mostly cuz of her! I would see all these other families with a normal mom and I envied that! My mom Nvr gave me the love and attention like a regular mom with two kids would! My little brother was and still is the golden.one! Him and I.could do the EXACT thing wrong and I’d get the heat for it whilst he got “go to your room!” Enough with the past, I’m not a dr. But if I was to diagnose her, after reading and even going you medical school, she has OCD, (which we can deal with) fairly certain she has ADD/ADHD(which would explain why I have it! And manic bi-polar!!! And I also believe she’s a sociopath, cuz it seems like she literally gets off on other ppls pain!-she’ll start fights with us just to make herself feel better! And also I’ll even go as far as saying spilt personality disorder! When she goes in public she “puts on a mask! ALL of my friends ive had over the yrs saw this and I became the butt of a lot of jokes, “over a, pair of boots” was something that happened that my mom went on a, war path about 15 yrs ago and it’s still brought up as a joke! (Because I didn’t wanna wear the new boots I got for Christmas my mom took them and got outta the bath just to throw out my boots! I look back and laugh at it but things like this have been going on for yrs now! And I’m scared that my dad is gonna have enough and suicide, he can’t take it no more! And she knows I can’t leave here cuz I have a felony record from about 10 yrs ago that needs to be expunged but I don’t have the right amount of time in and she knows this and uses this to her advantage! My father, myself and even my little brother the “goldenchild” all know all to well she needs help and WILL NOT go to a dr cuz she feels “there’s nothing wrong with me!!” “I don’t need a dr!!!” Well, YES you do, NO-ONE I know that is like this!!! I’m trying to see if there’s a law in New Jersey that whether or not a person needs help, that they’ll take them whether they wanna go or not!!! It’s prying this family apart and I’m afraid I’m going to lose my father cuz of her! He’s already said to me, that if something happens to me and he goes to the hospital he doesn’t want her there!!! And my bday is April 13th, on the 12th I tried to commit suicide, cuz after a day of my mother telling me I’m worthless, I’m a, waste of space, telling me to get outta her house! Etc! I’m other things that I’m sure u can think of, ive been taking my medicine and in feeling and doing much better, but if this keeps up who knows what can happen! PLZ HELP ME!!! Idk what to do, can we make her go to a,hospital?! Any help will be great!-thank you!

    1. Hi Steve,

      I’m so sorry you’re in that situation. I can’t say I know what that’s like, but I can say it must be very upsetting.

      I don’t know about the laws, personally, but you can look up the information about treatment without consent for your state here: http://www.treatmentadvocacycenter.org/browse-by-state

      I also suggest you get your hands on a copy of the book “I’m Not Sick, I Don’t Need Help” https://www.amazon.com/Someone-Mental-Illness-Treatment-Anniversary/dp/0967718937/ref=sr_1_1?s=books&ie=UTF8&qid=1500310063&sr=1-1&keywords=i%27m+not+sick+i+don%27t+need+help (not affiliated with me or HealthyPlace).

      I’m sorry I can’t give you more specific recommendations, but I hope those resources help.

      – Natasha Tracy

      1. Nov 7, 2017 Hello, Almost sounds identical to my elderly mother who was (just) first diagnosed with bi polar 2 with psychosis…She’s been in the hospital 2 weeks now…she doesn’t recognize there is anything wrong because of never being treated for this disease it makes her disease much worse. Don’t know if she will ever be back. 🙂

        She is still saying nothing is wrong with her and hears what she wants to hear from people…says its me but friends, family and doctors all know. The way we got her to the hospital was just leaving her alone as much as possible until she did something stupid.. It happened once she was in hospital over night and 2 weeks later she did another something that ended her there again, this time they kept here for 72 hours and then 2 more weeks and now 30 more days. She is very sick 🙁

        She’s mean and then nice and mean and then nice.. Thinks she’s forgetting. She lies about everything and always has now that I look back and she’s even had a fake affair with a millionaire man for a year. Just lies and excuses and we all knew but now we have been to her house and looked around…we were right and she will not admit anything or she doesn’t think she is lying…either way I cry for her everyday.

        Her bank account is closed because she bounced so many checks buying things and she has been lying about everything.

        1. Also I don’t have POA and she won’t grant it even if she allows it, she thinks I wanna keep her there.. 🙁

          BTW she 75 years old and brilliant throughout her life.

  8. I have a mentally ill adult son that refuses treatment and I feel uncomfortable with him living with me. Am I a bad mother because I have gotten to the point to put him out of my home? He doesn’t like to bath, he chain smokes, he’s very disrespectful, he walks all night, in and out of the front door. I’ve been dealing with this behavior for 8 years now. I don’t want to see anything happen to him but at the same time I’m very uncomfortable in my own home. It’s like I’m walking on eggshells whenever I try to talk to him. Would I be a bad mother to put him out on the street?

    1. I’m in the same boat as you except I did put my son out. Like your son he paces constantly, day & night or at times he’ll lay in bed for days doing absolutely nothing. He is very volatile toward me, so for my own sanity I had to kick him out. I feel like a terrible mom, but what are you supposed to do? If they refuse treatment? So sorry you’re going through this cause I know exactly how hard it is. Will be praying for y’all.

    2. You have to do what you can to help him on the outside, if he can work maybe he will understand that working will pay for an apartment although you will probably have to pitch in…It would be worth it.

      Where does he get the money for smokes?

      Otherwise say good-bye and tell him when he gets on his meds you two can have lunch or something. Hard yes, Tough Love!

  9. My brother and I are struggling with a mother who is bipolar, 80 years old, and it expresses in the form of extreme abuse and hostility to us, her close family, while being effusive and ‘saintly’ to those outside (as if attempting to keep up appearances). Our father is infirm and depends on her for care. She will leave for days at a time, no food in the house. If we provide groceries she goes into a rage upon return, saying we are interfering. We can’t take it anymore.

  10. My daughter behave very agressive after her baby was born. She was having mental problems before ,but nothing like that! She is abusive and agressive toward me. It’s got so bad that I can’t visit my grandson anymore. Additional y to all it looks like her boyfriend also have mental issues. He is also abusive verbally toward me. My daughter doesn’t want any help. She is telling that she is ok. But I am crazy. I cut all connections with them. I can’t see my grandchild. I don’t know what to do !!!!

    1. I have the same problem. I have a sibling with bipolar disorder. He is very aggresive toward me and very nasty. Constantly puts me down then he asks for you to do things for him and if you say no he will make your life miserable. Im sorry your unable to see your grandchild but maybe just maybe for now its for the best. You have to take care of yourself. I cant stand the way my brother talks to my mother. She has always been good to him but we are all getting older and he refuses any kind of help or treatment.

      1. I am also in a very similar situation. I have an older brother who is mentally ill and refuses to get help. He is verbally abusive, especially to our mother, makes threats, and destroys the house. We tried to get him help, but he was sent back home, and it made things worse. At this point, safety is a number one priority. You can’t control others’ decisions, but you can make decisions of your own. It’s awful that that people experience these situations, but it is a relief to know that there are others that understand.

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