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My brother has bipolar but refuse to understand that he is sick. How can you give someone medication if he believes he does not need it?

my brother has bipolar but refuse to undestand that is sick.he believe that is just a bit depressed and went to the doctor yestarday and refused the monthly injection but is still taking lithium.
Is that possible that someone because of the condition the brain can not process that is sick?
How can you give someone medication if he believe he does not need it?
Is there a way to convince him that he has bipolar ?
Asked On : Fri, 19 Apr 2013
Answers:  4 Views:  37
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  User's Response

A patient experiencing a manic or hypomanic phase of Bipolar illness has no insight regarding his or her illness and therefore does not realize that he or she is ill.

At least he is taking Lithium which is a good thing because Lithium is a very effective Mood stabilizer which can not only control his depressive or manic phase but can also prevent the future manic / depressive phase of Bipolar illness. Most patients are willing to take medicines once their symptoms are under control and they realize that they need help to control these symptoms.

You can discuss with his doctor about the option of increasing the dose of Lithium if you think that his symptoms are not under control.

Once he started responding to medicine his doctor can explain to him the sign and symptoms of Bipolar illness.

Please feel free to discuss further if you have any other doubt.

Kind regards


Answered: Fri, 19 Apr 2013
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Psychiatrist Dr. Nehal Shah's  Response
thanks for using health care magic.
In bipolar mood disorder, patient dose not have insight regarding their illness many times that is the reason why they do not believe.
Lithium is gold standard treatment for bipolar mood disorder.
If he is not improving with lithium, we need to add/switch to divalprorex or olanzapine or risperidone. all these drugs have the formulation that can be mixed into the food out of knowledge of patient. that should be used after advise of your psychiatrist.
Insight oriented psychotherapy may be of some help to convince him
Answered: Fri, 19 Apr 2013
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Psychiatrist Dr. Seikhoo Bishnoi's  Response
Dec 2014
Welcome to HCM

Bipolar disorders consists of episodic mania and depressive illnesses. In mania episode individual may refuse to accept that he has some illness. He may even refuse to take medicines, loss of insight is common in them. If he is refusing the medicines then you can give medicines by mixing with food. He is taking lithium by will. A lot of other medicines used in bipolar disorder are available in syrup forms which are odorless and tasteless. These can be mixed with food without intimating the patent. Medicines like Olanzapine, Resperidone etc can be used. After taking medicine for about 1 month he may start complying to treatment.

Dr. Seikhoo Bishnoi, MD
Answered: Fri, 19 Apr 2013
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Psychiatrist Dr. Gourav Monga's  Response
Welcome to health care magic
I can understand your situation. I appreciate your effort to seek online support.
In cases of bipolar disorder, specially mania, patient don't have insight into the condition. That's why patient refuse to believe the illness. Once patient gets adequate treatment and starts improving, he gains partial insight into the condition, starts believing the illness and take treatment by his own.
You can give medication in form of sprinkles or liquid and mix it in food/juice/milk etc. You can also give depot injections (monthly/biweekly).
Hope it helps
Good luck
Dr. Gourav Monga
Consultant Psychiatrist
Answered: Fri, 19 Apr 2013
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