Hi Ambulatory. It is definitely not an inappropriate question. Actually, it is an interesting one that gives many here something to really think about.

I more than willingly take medications now, but that was definitely not the case for many years in the past. The reasons I didn't in the past varied, but it was mostly because I thought the illness would go away and potentially not come back. I thought of my bipolar symptoms as almost a type of "flu". Other times, I simply thought I could fight symptoms myself using the power of my mind. Unfortunately, there came a time when I couldn't succeed with that plan. That's not to say that I think therapy is useless for bipolar disorder. To the contrary, I think therapy is very helpful at managing stress and even reducing symptoms, in various ways, but I don't yet think it can cure my mental illness. I don't think I am (or ever would be) capable of preventing all symptoms without the help of medication(s). Perhaps there are some people that can, but they either have a different "flavor" of bipolar disorder, or they have some power that I don't have. Sometimes circumstances in life overpower us.

I know that many people reject medications because of stigma. The topic of stigma could be discussed at length.

A lot of people have heard bad things about medications, so are not willing to try them. A lot of people actually have some bad experiences with medications, so decide to abandon them, sometimes without even giving other medications a chance. Sometimes a given medication gives people a rough start, but the side effects eventually ease. Patience and tolerance are things many people struggle with. I definitely did when I was younger. As I've aged and learned a few specific things, I've gained more tolerance and patience.

Very often when manic, one thinks that "nothing is wrong". In fact, things may seem to be wonderful or they believe their mood/behavior is justified, in some way. And then why on earth would one want to end "wonderful" or justified behavior? And yet things can definitely turn ugly with ramifications. Those that love a person with bipolar disorder often see something the afflicted doesn't. I think many people here are much more willing to seek medication treatment when depressed than when manic. Sometimes when depressed, one (or a family member) may say "You can snap out of it. Keep your chin up." Other times a person with bipolar disorder may think that by denying the problem, it doesn't exist. Denial is a real problem for many mental health challenges. It's a shame that so often people need a terrible crisis (bottom) in order to accept help. Some have such crises and still don't accept help.

I obviously don't know why your family member has given up on therapy and/or refuses medications. Maybe one of the above-mentioned reasons? Maybe some other one. I feel for them and also for you and your family member's other loved ones and friends. It's sad and frustrating to see a loved one ill, but not accepting help. I understand both sides of this.