# PTSD and refusing to take medication



## Talon (Jul 12, 2013)

Hello,

My husband is very kind and sweet when he's on his medication. But every once in awhile he decides to not take his medication.

For whatever reason, it can be simple as him "leaving" it in the car, etc, he would just go cold turkey.

After this he is very emotional, verbally abusive, and in general rebels against getting important stuff done. Recently his feet have developed a very bad case of athlete's foot or some sort of fungi. I have been asking him to make a doctor's appointment because it is getting worse and the medication we have isn't working. I started asking him a week or two ago. 

Before his feet looked just like they were really dry, with dead skin. But that was before, now his feet look like lizards feet..the soles look scaly and even have a tint of green.

For the past few weeks I've been feeding into his constant excuses of "my anxiety is high, I don't want to do this." He has been using this excuse with a lot of stuff. I am understanding to this. But today I've had enough of it. When I found out last night after he had a break down because he didn't want to call the doctor for his feet that he hadn't taken his pills again for apparently three days, I nearly wanted to snap.

I believe I laughed when he told me. It was like, "Here we ****ing go again." 

I don't understand..why does he do this? What is on his mind when he wants to stop taking his prescriptions? Is he trying to stay "sick" to delay him having to finish the PTSD program at the VA? Today I got so mad because I wanted him to call the doctor NOW, because I had a feeling if I didn't make him do it now he would just later forget. He got upset and said "They are on lunch", i told him to call any way. I'm tired of his excuses of why he can't do something now. We legit got in a huge argument, and he again played the victim like he tends to do when he doesn't take his prescriptions. At that point I just exploded and started insulting him(it wasn't good..I said horrible things). I was deeply hurt that I have to always wrestle with him over issues with his own health. 

What can I do? I'm really tired of this vicious cycle. This cycle always starts with him not taking his pills! I do not understand the logic behind this. I know PTSD is about avoidance, but he has to be sane at the start when he IS taking his pills. So why the hell does he just decide to not take them???? Why does he not want to do things for his health? I offer to help him, to take him to the doctor...but he still is nasty. 

I need some insight please, am I just taking this too personal? How do I stop internalizing his actions. How do I stop him from doing this just about every month and not taking his ****ING pills.


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## Anon Pink (Jan 17, 2013)

Hi Talon, 

That must be so frustrating for you! Do you mind telling me what medications he is taking for his PTSD?


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## Talon (Jul 12, 2013)

He takes seroquel and another medication that he is suppose to take it twice a day for his anxiety. I cannot remember it's name.


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## Runs like Dog (Feb 25, 2011)

Seroquel is tough stuff. Aytpical antipsychotic antischizophrenic. Used mostly for schizophrenia or major bipolar illness. It doesn't have the worst side effects but most drugs in this class can have some rather unpleasant side effects. Stopping taking them suddenly is even worse. Its claim to fame is it produces less tardive dyskinesia.

I would try to find out specifically WHY he doesn't like it and take that to the VA to try to get them to change it something else. Perhaps NOT an antipsychotic.


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## blessedhusband (Apr 10, 2016)

I can think of a few reasons why he potentially may be avoiding his meds:
1) He legitimately forgets, then immediately slips into a state of mind that makes it difficult for him to go back on.
2) He feels like the medication isn't helping. You may notice he seems better when he is on it, but maybe he doesn't notice.
3) He feels like he has recovered and no longer needs the medication. That happens to a lot of people for whom medication does work.
4) He is scared that he isn't ready for what comes next in his life after completing the VA program you mentioned.
5) He feels so hopeless, depressed, and worthless, that he doesn't see a reason to bother taking care of himself.
Try to stay calm when you talk to him about it. It is important that you find out why he is struggling to take his meds, and he isn't likely to tell you the real reason if he is afraid you will judge him or scold him. Be gentle and supportive. And ask specific questions. Instead of asking "Why don't you take your meds?" (may sound accusatory), ask more probing questions, like
1) "Do you feel like your meds are working for you?" 
2) "Do you feel like this VA program is working for you?"
3) "Do you see a light at the end of the tunnel?"
4) "Is there anything I can do to help you remember?"
Better understanding what is really going through his head may help you to avoid taking it personally or internalizing it. It is also important to make sure that you are maintaining healthy relationships with friends and family members and taking time out for yourself. Caring for a loved one with a mental illness can be exhausting and discouraging. They only way to do it successfully is to put your own oxygen mask on first. Taking care of yourself is not optional; it is a prerequisite to taking care of him. I speak from experience; my wife is currently in the hospital receiving treatment for a psychiatric condition.
Lastly, when you say he becomes verbally abusive, this is very concerning. Your responsibility to take care of him should never trump your responsibility to protect yourself. If you feel unsafe in any way, PLEASE talk to someone and get out of the situation immediately. If you feel you need to escape and don't know where to turn, just reply with what city you are in, and I or someone else on this board will gladly research to find available resources in your area. You are a valuable person who deserves to feel safe and cared for.


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## Homemaker_Numero_Uno (Jan 18, 2011)

Runs like Dog said:


> Seroquel is tough stuff. Aytpical antipsychotic antischizophrenic. Used mostly for schizophrenia or major bipolar illness. It doesn't have the worst side effects but most drugs in this class can have some rather unpleasant side effects. Stopping taking them suddenly is even worse. Its claim to fame is it produces less tardive dyskinesia.
> 
> I would try to find out specifically WHY he doesn't like it and take that to the VA to try to get them to change it something else. Perhaps NOT an antipsychotic.


You are misinformed. This drug has different actions depending on the dosage. At low levels, it has strong antihistamine properties, is slightly sedating and has anti-anxiety properties. At slightly higher levels, it can be used for things like bipolar. At its higher dosage, i.e. 800 it is an antipsychotic. 

Taking say, 800 mg does not have a huge knock-out effect as compared to say 50 mg. That is, an 800 mg dose is not 16 times stronger than 50 mg (or mean a person is 16 times more mentally ill). It means they need it for a different reason. 

It is non-addictive. Depending on the dose, you can stop taking it, in particular lower doses, and while it's advised to consult with the doctor first, someone who is taking 50-300 mg who stops taking it might end up being sleep deprived and crabby but it's not going to turn them into a crazed psychotic killer. 

There are many approaches to PTSD treatment. Sometimes it takes experimentation on the part of the patient and the treatment team to discover what works. It is a unique condition, in that it is as unique as the patient, so treatment is going to be unique as well, and may change over time during the course of the treatment. 

So, going back to the main topic of this particular post, the Seroquel, it may be that he is not in the correct dose range, and should talk to a psychopharmacist or prescribing clinician about getting on the correct dose. Maybe patients don't understand the dosing of this class of drugs. They think it's like other drugs, which have a more direct correlation between action and dose. So patients may think I don't want to feel so sedated, I'll take a little bit less...or, I want to get more sleep/better sleep, I'll take a little bit more. If not wanting to be sedated, the time of dose can be changed. If wanting better sleep, maybe needing a sleep med or sleep training. Others hear they are not supposed to drink alcohol when taking the drug, so they skip a day or two on the weekend. Honestly, it's better to be honest with the prescribing clinician and to check the dose and find out what's safe, rather than to go without and think the alcohol will do the same thing as the drug (sleep, sedation, etc.) for a day or two - it doesn't. 

I'm not saying the drug isn't working for him. That may be the case, but there are all sorts of misunderstandings when it comes to this type of drug, mainly that it's not just used for an antipsychotic, although that's the FDA approval, it's used for all kinds of things. It happens to be a very kick-a** antihistamine at low doses. 

It can actually create tardive dyskinesia, this is why you need to go see a clinician to be evaluated for it. And get the blood tests. And stick with therapy and behavior modification and other treatment, because ideally you won't be on this drug forever. 

The VA gets a bad rap for prescribing, but I believe that the prescribing for PTSD is on the whole, accurate and within guidelines. Concurrent treatment of depression is essential and the rate is very high for that. 

Managing stress is extremely important. Environmental and emotional. 
But make sure the medication is being taken correctly, on schedule (same time every day) and is the correct dosage. 
It is a good medication, I can absolutely swear by it, and can also offer assurances that it is not a lifelong need. 
After a while the brain can learn to produce the exact same effects as the medication offers. It's hard to explain. But it does happen, if a person sticks with a program. I think it's that it gives the brain a rest and whatever mechanism is broken in there has a chance to heal and restore itself. I'm not a biochemist. But I do know it works. And at the dose its given for PTSD, it's not an antipsychotic.

Another reason people might not take it, besides wanting a drink, is that it makes you very tired and sometimes you can feel uncoordinated and not at the top of your game you were used to being at as a soldier. It makes you feel less of who you were trained to think you were. That is a huge ouch. And it tends to add a bit of weight, so keeping up with exercise and super healthy eating is a requirement, as well as taking good vitamins. For a solider to have to take a sedative, is a contradiction in terms. It is hard to learn how to truly relax. A change in mission plan, and an acceptance of that change, is critical. That is, a person needs to see that taking the treatment is their duty. It is a continuation of the mission that got them that way to begin with. But some people don't see it this way. They only look at their past. They don't see their current situation as just another hurdle, they see it as some kind of sidelining or end of the line. Which is not true at all. When other people see them as 'sick' this makes it even worse. It's funny soldiers use all kinds of technical assistance to do their jobs, and even take go/no-go pills to do their job and do all kinds of exercises that change their mental biochemistry (same as taking drugs, actually) but ask them to use a drug to help with damage control after the fact, to repair a #1 asset, the human being, and they have a big problem with that. The problem requires a change in thinking, they need to understand that they already gave their brain a big drug, for so many years. This drug was called military training and military duty. It already changed the brain chemistry. So of course, to change it again, either requires lots of training which won't happen in a random civilian world which is very chaotic and filled with people who don't understand the structure and 'therapeutic' interventions and environment needed, or drugs and therapy and some kind of self-advocacy in getting what they need from their environment through changing it. (And this doesn't mean yelling at it!)


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## Malpheous (May 3, 2013)

I had issues taking meds because they left me feeling like... 'not me'. It felt pointless int eh end because I just "was" but I "wasn't me".

I know some guys are just genuinely forgetful of it. Miss a dose or two. Think they "have it under control" and go farther into the hole. 

Some guys have TBIs that make them legitimately forgetful.

Sometimes you see yourself coming to the end of a timed program that's meant to assist you, and you get anxious that you're just not ready to complete that program. So you sabotage in the hopes of a reboot to gain more time.

It's frustrating for the ones around us.


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