In the milder forms of manic-depressive disorders, many patients refuse to continue with lithium carbonate as a prophylactic agent for the following reasons: (1) Creative patients feel that the lithium carbonate acts as a "brake," preventing productivity and interfering with the earning of a livelihood. (2) The hypomanic phase is so enjoyable that rather than eliminate or limit it, they prefer to take their chances on the possibility that a depression will not recur. (3) Denial of the chronicity of the illness lies behind denial of the need to ingest lithium carbonate indefinitely.
Polatin P, Fieve RR. Patient Rejection of Lithium Carbonate Prophylaxis. JAMA. 1971;218(6):864–866. doi:10.1001/jama.1971.03190190050009
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