Whether changes in brain chemistry are a cause or an effect of certain mental health conditions, regulating them is often a critical part of treatment. Genetics, environment, neurobiology and other factors may all play a role in a person’s symptoms and their experience of mental health conditions. Finding the right psychiatric medication requires a highly personalized treatment approach. You may have to try a couple of different combinations before you settle on the ones that work for you, and communication with your prescriber throughout your treatment is critical. If you run into any problems that keep you from doing so, you should get in touch with your prescriber right away.

In this blog post, we’ll discuss medication adherence and some barriers that prevent people from taking their prescriptions as directed.

What is medication adherence and why is it important?

Medication adherence is how closely you follow your prescriber’s instructions for taking your medication. It’s not an all-or-nothing matter but a spectrum of nonadherence to partial and complete adherence. If you have good medication adherence, you take your medication at the proper frequency and at the time of day your prescriber recommends. You’ll also follow instructions about taking it with meals or specific foods and avoiding any foods, substances or other medications your prescriber has told you to avoid. 

Medication adherence is important because it affects how well your medication works. It can also help you minimize unwanted side effects — for example, your prescriber might tell you to take your medication before bed to avoid daytime drowsiness. 

8 common barriers to medication adherence in mental health treatment

During medication management appointments with your psychiatrist or nurse practitioner, you’ll need to give your care provider an accurate idea of how your medication is affecting you and what side effects you’re noticing. Your dosage, the time of day that you take your medication, other medications you’re taking, and other factors may impact your experience. To receive the best care possible, you’ll need to give them any information that may be relevant and follow their exact instructions. 

If something is getting in the way of your medication adherence, you should talk about it with your prescriber. There are solutions for most issues that people run into with psychiatric medication. 

The following barriers may make it hard to take your medication exactly as directed:

• Cost of medications — Being unable to afford psychiatric medication is a hard obstacle to overcome. It can be hard to talk about financial setbacks, but taking the right medication may make a big difference in your ability to support yourself. You may be able to find a patient advocate who can help you find affordable insurance or a medication savings program. 
• Misunderstanding — You need to be 100% sure you understand your doctor’s instructions on when and how to take your medication. Don’t make any assumptions, and don’t adjust your medication regimen on your own. Ask as many questions as you need to until you feel comfortable and confident taking your medication as prescribed. 
• Forgetfulness — If you have a condition that affects your memory, or if your medication makes you forgetful, that can make it difficult to take your medication at the right time and the right frequency. There are some practical solutions for this, like using a daily pill organizer or setting a reminder on your phone (there are a lot of apps that can help with this). 
• Judgments and stigma around medication use — Some individuals are reluctant to take medication because they think they “should” be able to handle their problems without it. They might see medication as a crutch or a “band-aid” that will hold them back from finding long-term solutions. If you don’t agree with your doctor’s advice, it’s more than OK to get a second opinion. You should also know that there are many cases when people need psychiatric medication to reduce their symptoms and perform daily functions. Taking medication doesn’t make you “weak,” and relying on medication isn’t necessarily a bad thing.
• Risk of unwanted side effects — It’s fairly common for people who are new to mental health medications to say, “I don’t feel like myself when I’m taking medication.” Medication management is critical when you’re starting, stopping or making any changes to any medication regimen. If you experience side effects like brain fog, weight gain or sexual dysfunction, discuss them with your prescriber promptly. They may adjust your dosage or suggest alternative medications to improve your comfort and adherence.
• Not feeling like you need your medication anymore — This is especially common with mood stabilizers you might take for bipolar disorder, anxiety disorders or depression. After a few weeks or months of medication and therapy, some people feel so much better that they want to stop taking their medication. However, stopping medication suddenly can lead to withdrawal symptoms or a return of symptoms. Talk with your prescribing doctor before you stop taking any medications.
• Some medications are habit-forming — It’s true that some psychiatric medications can carry a risk of physical dependence or misuse. Your prescribing doctor should let you know about any risk of dependency with the medications they recommend and how to limit these effects. Let your doctor know if you’ve had a substance use disorder. Ask them about other alternatives and strategies for managing your symptoms in the long and short term. When it’s time to discontinue a habit-forming medication, your prescribing doctor should guide you through the process to minimize any withdrawal effects.
• Not wanting to take certain medications — Some people may not want to take certain medications because of their specific effects. It may be that the person doesn’t believe they have a certain condition. Or it may be that particular medication’s reputation. Medications that people sometimes refuse for various reasons include lithium and antipsychotics.

Your individual brain chemistry affects your moods, thoughts and behavior. All of these things can impact your ability to follow your prescriber’s instructions. It can be difficult to follow a new medication regimen when you’re dealing with symptoms that make it hard to function. In these cases, the stable and supportive environment of a Residential Treatment Center (RTC) or a Partial Hospitalization Program (PHP) may help you make the transition. At Lightfully, our compassionate staff psychiatrists are available to help clients in these programs.

When you do find the right medication, it can only help you if you take the right dosage at the right time. You and your psychiatrist or nurse practitioner should work as a team to find a regimen that’s easy for you to follow. Honesty and trust are important aspects of your relationship with these care providers. If you don’t feel heard or understood, it may be time to consider a second opinion.

Are you struggling to find a medication regimen that works for you? Let’s talk about it. Contact us today with questions about medication adherence and medication management.