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July 6, 2012
Pebbles, Potholes, and Perspective
The Act of Compliance
by Sarah Hancock

Life can be really difficult when dealing with a loved one who has an illness of any kind, especially if that loved one isn't following a treatment plan you deem necessary. When dealing with mental health issues, often a person who doesn't follow the prescribed medication regiment is labeled "noncompliant."

This sounds like something I heard as a child during the movie, Flight of the Navigator. The alien would follow an order and state robotically, "Compliance!"

One of my loved ones has juvenile diabetes. During my youth, I watched as her blood sugars ebbed and flowed. I watched as she had allergic reactions to medications, sat with her as she waited on hold forever to speak with nurses and doctors, and listened to her describe allergic reactions, watching in horror as those reactions became scary.

As a five-year-old, I tried cramming jelly in her mouth when she passed out because it was the only sweet thing my little five-year-old mind could identify. She had her great days and her not-so-great days, and I loved her through all of it.

During everything, I was always fully aware that she was doing her very best, everything she possibly could, to keep the blood sugar balanced. However, no matter how hard she tried, it wouldn't always balance. Heat, exercise, eating out, overworking herself at school, playing with other kids ? it just seemed as though she could never control all the factors. How could she? It was an impossibility. Did that stop her from trying? No.

I've been diagnosed with a mental illness since 1998. From the very beginning, when a doctor handed me a pill, I took it. Why? Because I had faith all doctors were as good as my friend's. I carried my medicine around with me. I set my watch alarm to remind me to take the medicine. I put the medicine in an obvious place so that I'd never leave the house without taking it. I put another one next to my bed so that I'd always take it before I went to sleep. As far as compliance is concerned, I was the ideal patient!

When my symptoms didn't fade after the 3-4 week waiting period, I'd talk to my nurse or doctor about what was going on. When I had horrific side-effects, I called the proper medical personnel and let them know. (Believe me, some of the side-effects from psychiatric meds are positively embarrassing!) When I had an allergic reaction and my hair started falling out, you guessed it, I called my doctor. When my white blood count was lower than a person on chemotherapy, my doctor called me.

Whatever it was, I talked to my doctor. Why? Because I'd grown up watching my friend have open conversations with her doctor. To me, doctors weren't scary. In fact, they were heaven-sent! Even if they were clueless, part of me had a flicker of faith that they could help me, like they had my friend.

I've had two separate psychiatric doctors. Both, bless their hearts, did the best they could. One I trust completely as a doctor, the other I don't. Why? Because one listened to me and the other didn't.

To me it seemed as though the second doctor was so caught up in trying to diagnose my reoccurring random symptoms that he was apparently frustrated because I didn't fit into an actual label. He stopped listening. Instead of listening to me, an individual person, it seemed as though he listened to an ever-evolving label, trying to make my medications fit the label of the day instead of trying to make the medications fit me.

Granted, sometimes I was able to communicate better than others, but my point is, why try to communicate if no one is listening?

Many people who have symptoms of a mental illness did not grow up with good medical experiences. If you have a doctor who doesn't listen, change doctors! If that means you have to go through several doctors, do it!

For those of you who have a loved one who has symptoms of mental illness, support him in patiently finding a doctor he can trust. Even when you might trust a particular doctor, if your loved one doesn't, keep looking! There's nothing worse than having to argue with your loved one about what the doctor ordered.

Let me explain something. If the doctor ordered it, the doctor will be seen as a dictator. However, when the doctor takes time to discuss options and give your loved one a choice in the matter, your loved one is much more likely to be "compliant" simply because the person with the diagnosis is making choices associated with the patient's plan. The physician is creating the plan the patient gets to follow.

Let's face it, if your doctor told you that in order to be released from the hospital you had to dye your hair bright pink, would you do it? Yes, simply to get out of the hospital! Then you'd dye it back to your normal color as soon as you could, not feeling comfortable with looking like you had a head full of cotton candy. Sometimes the treatment plans that doctors and counselors come up with make about as much sense to a person with mental illness as if the patient had been commanded to dye his hair.

To live healthfully, you must be involved with your own recovery. I know that it's important for a patient to feel in control of his treatment plan if only because everything else in his life feels out of control.

A person is more likely to achieve a successful recovery when he recognizes that he has a choice in the matter and feels empowered to make his own decisions. When a person believes his opinion makes a difference in his own recovery process, then he will do what he feels is necessary to enjoy life, because he believes it is within his power to do so. Compliance!

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