Managing Bipolar Disorder

Dear Dr. B,

I’ve heard that people with bipolar disorder, like my brother, often go off their medications even though they need them, why?

Confused But Concerned

Dear Concerned,

Individuals with bipolar disorder have a chemical imbalance which affects mood, motivation, sleep, energy, libido, creativity, and other day to day functioning. Medications are frequently prescribed to help regulate the chemical imbalance.

One of the most difficult aspects physicians face in treating bipolar disorder is exactly what you mentioned: patients often discontinue taking their medication. This often happens primarily for one of two reasons. First, when medications are working, patients feel good so they often think they don’t need their medication anymore rather than appreciating that the reason they feel better is because the medication is doing what it is supposed to do.

Secondly, for some patients, as the medications begin to regulate their neurochemistry, their energy level is regulated and so is their creativity, so they are often less productive than when they are experiencing the more manic or hypomanic side of bipolar disorder. They often don’t like this, so they will discontinue their medication in order to experience the euphoria, extreme energy, or creativity that the medication may dampen.

The concern is that going off any such medication without close medical supervision can be very dangerous.

I can appreciate your concern. You love your brother and want the best for him. Perhaps you might offer to accompany him to his next doctor’s appointment so that you can ask his physician similar questions in order for your brother to hear the doctor’s responses for himself, rather than hearing them from you and perceive you to be a nagging sister who doesn’t know what she is talking about.

Remember that when you do express your concerns to your loved one, to speak the truth but in love.


Just as God’s kindness is what leads us to repentance, our words spoken in love and gentleness will be more likely to be received well than in anger and frustration.

Your RX When Speaking the Truth in Love

Hope Prevails,

Dr. B

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