Taking pills when it’s difficult to do so

arrowhearts said to realsocialskills:
I was wondering if you knew of any tips or resources for taking (pill-based) medications daily when for a variety of reasons (anxiety, forgetfulness, bad taste, fear, etc) it is difficult to do so? Also thank you so much for the time and thought you have put into this blog! It has been very useful and informative to me!

realsocialskills said:

There are some potentially useful reminder/tracking apps for iOS, Android, and Apple Watch:

  • Mango Health, which is gamification-based and offers rewards/badges for taking your pills every day. (It’s not very flexible.) It also has notifications and reminders.
  • (If you like gamification, HabitRPG may also be helpful).
  • Medisafe, which is in no way gamified and isn’t trying to make you have fun or like anything. It’s just an app that tracks medications, gives reminders, and has a few other features. 

Getting help remembering from someone else:

  • Some people find it helpful to have someone remind them to take pills.
  • Or ask them whether they’ve taken a pill.
  • Or to bring them the pills.
  • (Both medication apps allow you to link another person to your pill-taking records, if you want to.)
  • This can also backfire, and isn’t the right option for everyone.
  • (One way it can backfire is that if you ask people for help remembering, they may think that it’s their job to *make* you take it, whether you want to or not.)
  • (Needing help with the logistics of pill-taking doesn’t mean that you need someone else to take over your medical decisions, but a lot of people think it does).
  • Some people also find that their anxiety skyrockets when others pay attention to their pill-taking.
  • Sometimes this is less of a problem if it’s mutual (where you remind someone about their pills, and they remind you about yours.)

Help can also be more occasional:

  • Some people need occasional help figuring out the logistics, or overcoming anxiety or other barriers. It can help to have people you can ask for occasional help, along the lines of:
  • “I need to take my pill, but I need to eat before I can take it, and I have no food. Can you help me figure out how to eat?”
  • “I can’t make myself take my pill, can you tell me to go do it?”
  • “Can you remind me that it’s ok to take pills and that I’m not being lazy or something?”
  • “I’m having trouble with the pharmacy’s online refill system, do you know how it works?” 
  • tl;dr: Needing help doesn’t mean needing others to take over, and it doesn’t necessarily mean needing supervision or ongoing daily assistance. 

If the problem is that the pills taste disgusting or are hard to swallow:

  • Sometimes this is a problem that goes away over time.
  • Sometimes if you keep tasting a particular taste regularly, it become less disgusting.
  • Similarly, many people who initially find swallowing pills difficult find it much easier as they get more practice.
  • You can also put the pill in a spoon of something like applesauce, yogurt, or pudding. That can mean that you taste and feel the pudding and not the pill, which can make swallowing easier for some people.
  • Some people find it helpful to chase pills with a liquid they like.
  • (A caveat about that:
  • If  the taste/sensation makes you feel sick to your stomach or like you’re going to throw up, it may not be a good idea to drink/eat something you really like right after. 
  • Because you can end up associating that feeling with the thing you like, and then develop an aversion to that too.
  • But if the nasty-tasty pills *don’t* make you feel sick, washing the taste away with something you do like can work really well.)

If the problem is irrational or mostly-irrational anxiety:

  • Reminding yourself that the anxiety is irrational can help.
  • Reminding yourself what the pill does and why you want to take it can also help.
  • And once you get used to taking the pills regularly, the anxiety may go away.
  • Some people find it helpful to think things like “This is scary, but I can do it, and it won’t always be this scary.”
  • One reason that taking pills can be scary is that it can be an unpleasant reminder that you need the pills. 
  • If that’s a barrier, it might help to remind yourself that you need the pills whether you take them or not. 
  • Or you might know that it causes side effects you hate.
  • It also might help to complain about this to yourself, along the lines of “I really !#$!$# hate having to take this pill”.
  • (Having to take pills can suck, and it’s ok to have feelings about it.)

If the issue is reluctance or reservations about the pills:

  • I’m somewhat uneasy about mentioning this, because logistical difficulty is often dismissed as unwillingness to take pills.
  • That said — sometimes the problem really is that someone is trying to force themself to take pills that they don’t really want to take.
  • Everything is harder when you don’t want to do it.
  • There are all kinds of reasons that people might not want to take medication. (Some good reasons, some bad reasons).
  • Eg: Some people feel ashamed of needing medication, or feel like they should be able to somehow will themselves to not need it.
  • Eg: Sometimes the side effects really suck. Sometimes side effects mean that a given treatment needs to be reconsidered.
  • Eg: Sometimes people take pills that don’t seem to be working, and that can be demoralizing.
  • Eg: Sometimes people are misdiagnosed, and prescribed medication that isn’t appropriate, (or suspect that they were misdiagnosed).
  • Eg: Sometimes things that seem like a good idea in the doctor’s office don’t seem like a good idea in day-to-day life.
  • Eg: Sometimes when people have been taking a pill for a while, they forget what it was like without the pill — but keep noticing the side effects. This can make it hard to feel that the pill is still worthwhile.
  • Eg: Sometimes people come under intense pressure from others to believe that a particular pill will fix things. This can get complicated if the pill isn’t actually the right solution.
  • (And there are any number of other reasons).
  • Sometimes the solution to this is changing your attitude towards your medication, and sometimes the solution to this is changing your treatment plan. (And sometimes it’s a combination of both). 
  • So it might be worth asking yourself: How do you feel about taking this medication, Is this a pill you want to take?
  • Why are you taking it? Why was it prescribed? Do you agree with the reasons?
  • Are you having side effects that suck? Are you questioning whether the side effects are worth it? 
  • Is there another option you want to consider, or does this seem like the best choice for now?
  • If you really are reluctant, err on the side of taking that seriously. You may have a good reason, and it may lead to needed changes.
  • If you think about it and decide that your reluctance is irrational, that can also be very helpful.
  • Either way, if the problem is reluctance, thinking through things and getting to a point where you feel confident that you’re making the right choice can help a lot.
  • *All that said*, it’s important to remember that taking pills can be hard for all kinds of different reasons.
  • Some reasons it can be hard to take pills have absolutely nothing to do with how you feel about them. 
  • Wanting to take pills doesn’t always make it possible to take pills.

Sometimes pills are easier to take if you associate them with an action you do every day rather than with a time. Eg:

  • If “take nighttime pill at 11pm” doesn’t work, “take nighttime pill when I brush my teeth” might.
  • If “take morning pill at 8am” doesn’t work, “take morning pill after I eat breakfast” or “take morning pill when I get into my car/bus to go to work/school” might work.
  • Or “I’ll take my pills when my kids come home from school and I’ve given them theirs”.

Sometimes changing where/how your pills are stored can make a big difference, for instance:

  • Keeping pills in the medicine cabinet can make it easier to take them when you brush your teeth
  • Keeping pills next to your bed can make it easier to take them when you get up and/or when you go to bed
  • If you frequently forget to take your medication, keeping some in your purse/ backpack/etc can make it easier to take it once you realize you forgot.
  • If you need to take medication when you eat, keeping the pills near your food might help.
  • Some people find pill sorters really helpful. They’re clear box-things with a box for each day, and at the beginning of each week you put a week’s worth of pills in them. This can also be a way to tell whether you’ve taken a given dose or not.
  • Sometimes you can get pills packed in blister packs, with a compartment for each day. 
  • (Birth controls are usually packed this way, and some pharmacies can pack any kind of pill this way).

If part of the issue is privacy:

  • Sometimes not wanting other people to know can complicate taking medication.
  • This is a common issue for birth control pills — and there are cases you can get for birth control packs that look like little makeup cases. (So you could keep it in your purse and it would just look like you have makeup).
  • (If you’re in a situation in which it’s unsafe for others to know that you’re using contraception, birth control pills may not be the best option. An IUD or Depo-Provera shots might be better. Planned Parenthood can help you consider options.). 
  • Similarly, it might help to keep pill bottles inside little containers that don’t look like pill things (eg: Claire’s has coin purses that are a good size for this).
  • Or to get a lockable toolbox and keep the key on your keychain.
  • Or to keep pills in your gym back if you have one — most people are going to assume there are gross sweaty clothes in there and be reluctant to look.
  • If you’re in college and don’t want your roommate to know about your pills, it might work to keep your pills with your shower stuff, and take them when you shower.
  • Or to keep pills in your backpack, go to the bathroom after class, and then take the pills there

If part of the issue is that they’re hard to afford:

  • If you’re taking a name-brand drug, look online for a coupon. A lot of companies offer them.
  • If you’re taking something insurance isn’t covering, GoodRx can often save you a LOT of money. (It tells you about coupons, and shows you which pharmacy near you has the lowest price.)

Anyone else want to weigh in? What are some strategies you know of for dealing with pills?