Mental illness and the problems with treatment adherence

  I have posted here about my battles with bipolar disorder and it's role in my life. I have always had good adherence to the treatment of my disorder and good awareness of it's impact on my life and others should I not be diligent in my self-management. Perhaps this comes from being raised by two parents with mental illnesses so I was aware of it and it's existence from an early age. When I began to have some issues with this illness I was not unprepared for the symptoms and also was aware of the impact an uncontrolled illness had on one's family and social circle.
   The number one reason that individuals with mental illness are not adherent to treatment is because of Anosognosia or an unawareness of being sick. It is due to damage to the part of the brain in which we think about ourselves. People with Anosognosia will come up with many, many reasons for their behaviors and symptoms rather than knowing they have a serious mental illness.
   The problem with non-adherence is devastating. Non-adherence is the number one reason for relapse, re-hospitalization, job loss, homelessness and other problems like incarceration for crimes committed while under the influence of rampant symptoms.
    The number two reason is concurrent drug abuse which can be used as self-medicating and can hide symptoms behind a mask of drug-induced behaviors. Many of those with mental illness use drug and alcohol as a way to either dampen or heighten their symptoms. A person who is depressed might take a stimulating drug as a way to deal with that. Someone who is having hyper active symptoms such as mania may use sedatives as a way to control that internal feeling.
    Another reason, and this is seen in bi-polar individuals primarily, is that you want the "high" that being hypomanic or manic provides. Being able to go without sleep, be more socially dynamic, more productive and more creative can certainly have it's lure. However untreated mania can cause havoc for people. The processes of the mind that have to do with impulse control and decision-making are dampened and can lead someone to do some dangerous things such as commit crimes, be promiscuous, overspend money, drive recklessly or engage in other damaging acts. 

    For me I believe it is not my fault I was born with a chemical problem which creates mood problems and symptoms however if I am aware of my illness and am just defiant in adhering to my treatment then it becomes my problem. I should not subject my friends, family and co-workers to the actions of an uncontrolled mood disorder when there are proven treatments for it. Constant mood crisis and acting out tires and overwhelms our family and friends. It is unfair of us once we are both aware we have an illness, and are given a way to manage it, to defy that treatment and be a roller coaster of out-of-control behaviors and constant crisis that we make others deal with for us.

           “It took me far too long to realize that lost years and relationships cannot be recovered. That damage done to oneself and others cannot always be put right again.”
― Kay Redfield Jamison, An Unquiet Mind: A Memoir of Moods and Madness