What to Do When Your Loved One With Bipolar Disorder Refuses Treatment

If someone is refusing treatment, resist the urge to walk away. This is someone you care about, so continue to provide support as long as it makes sense for your own wellness. Listen to what they have to say about treatment and their reasons for refusing. You may find that when you sit back, listen, and just provide support, your loved one will open up and give you some clues that could help you push treatment more effectively.

For example, consider the story shared by Mark K., who eventually agreed to residential treatment for his bipolar disorder after being pushed by family:

“For a while my family thought that I just didn’t realize I was sick. I always knew something wasn’t right. The truth was that I hated the idea of having a label, of being mentally ill. I did not want to go to treatment, because it meant admitting that there was something wrong with me, so I denied it for a long time.

My brother really pushed me, and it only made me push back. My mom listened, though. She stopped pushing and just asked me questions. She listened, and that made such a big difference. One day when we were talking, I just broke down. And while I felt like a failure and weak at first, getting that off my chest also felt like a relief. She talked to me about experiences she had with depression when she was younger. I had no idea, and it really made me feel less alone. That was the real push I needed to get help.”

Just listening to the person you care about can reveal some real but surmountable roadblocks to treatment. The fear of stigma, struggling to accept the label of mental illness, hesitation to take medications, bad experiences with past treatment, and worries about not being able to work or go to school are all valid concerns, but ones you can reason with and work around.

As long as your loved one is still in a position to have a rational conversation about treatment, you can engage them and have a serious discussion. Talk about the benefits treatment could bring. For example, if your loved one is struggling to live the life they want to, talk about how treatment can help them make changes and set and achieve goals.

Hone in on specific things about their life that they don’t like. Maybe your loved one has a hard time maintaining a long-term relationship or keeping a job they enjoy. Talk about how untreated bipolar disorder is probably getting in the way of achieving a healthy relationship and a rewarding career.

It also helps to have a plan already in place when you start this conversation. Be prepared with a few options for rehab, therapy, and treatment plans. This makes it easier for your loved one to take the concrete step to get help, but also gives them a choice and a say in where their treatment goes from here.

Bipolar disorder is a complicated illness that touches every area of a person’s life and that usually requires time to adjust to and benefit from therapy and medication. Outpatient care can help, but for your loved one, push residential care to get the best outcome. Residential treatment will provide them with the time and safe environment in which to really focus on learning how to live well with this chronic illness.

There are several things a residential treatment center can offer that outpatient treatment cannot necessarily provide:

• A multi-disciplinary staff with several areas of expertise
• Several types of therapy
• Around-the-clock supervision with medical care
• Individualized treatment plans
• Alternative therapies and support services
• Life and job skills training
• Aftercare services

A residential program will also provide a thorough evaluation at intake that may uncover other issues that need to be addressed, like substance use disorder or another mental illness. The best treatment includes all mental health issues in care, so this is an important step for informing the treatment plan.

When someone you care about continues to refuse treatment, when their mental health issues are causing serious problems, or if they can’t see or admit that they have bipolar disorder, a more drastic push may be useful. Interventions are well known in the cases of substance use disorders and can be effective. Loved ones come together to show support but to insist on treatment. If the person in question refuses, there are consequences such as taking away financial support.

If you choose to try an intervention, there are some risks. It is best to work with a mental health professional to plan, practice, and initiate this strategy. An intervention for a mental illness like bipolar disorder can be riskier than that for an addict. Take care and be prepared for denial, hostility, even aggression. Have a plan in place and don’t try to do this without professional assistance.