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

To have a loved one with bipolar disorder is challenging, especially when that person refuses to get treatment. There are many reasons they may refuse care, including being unable to see they have a problem. This very serious mental illness that causes depression and mania cannot be managed without professional care. It is essential that family and friends push and do what they can to ensure a loved one with bipolar disorder gets the help they need.

Bipolar disorder is a serious mental illness that affects about 2.6 percent of the U.S. population. Characterized by periods of depression and mania, an episode of high energy and activity, racing thoughts, exaggerated self-confidence, and even psychotic symptoms, bipolar disorder causes significant dysfunction.

If someone you care about is struggling with this illness but doesn’t want to get treatment, there are things you can do. Be supportive, listen, reason with your loved one, present a plan for treatment, and if necessary consider staging an intervention with the help of a mental health professional.

Listen and Be Supportive

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.

Outline Benefits and Have a Plan Ready

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.

Push for Residential Treatment

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.

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A Mental Health Intervention

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.

Is Hospitalization Ever Necessary?

Involuntary commitment is a difficult decision to make. In general, adults have a legal right to refuse any kind of treatment. And taking away anyone’s freedom to refuse care is not a decision to be taken lightly. However, there are exceptions. These are generally for instances in which it is believed that the individual could cause harm to self or others.

Suicide is one important reason you may need to seek emergency care for a loved one. If involuntary commitment will save their life, it is worth doing. Of course, hospitalization to stabilize someone is not really treatment. Treatment cannot be forced for bipolar disorder, because it requires commitment and time from the individual being treated. But, sometimes in a crisis situation treatment begins with hospitalization.

Facing refusal of treatment for someone you care about is difficult. Their mental illness is likely holding them back in life and is probably interfering in your life and relationship. Learn more about bipolar disorder, listen to what your loved one feels and needs, and help make them see that treatment will make their lives better.

Bridges to Recovery offers comprehensive treatment for people struggling with mental health disorders as well as co-occurring substance use disorders. Contact us to learn more about our renowned Los Angeles programs and how we can help you or your loved one start on the path to lasting wellness.