Category: lithium

Mental Health Medication And Dangerous Side Effects In The Heatwave by Eleanor

~ Eleanor Segall ~ 8 Comments

(image: Roman Odintsov)

In the words of Motown singers Martha Reeves and the Vandellas,

‘Just like a heatwave
Burning in my heart
Can’t keep from cryin’
It’s tearing me apart’

Temperatures yesterday here in the UK reached 40 degrees celsius, the hottest day here on record ever! Some people love the heat- ‘Oh it reminds me of being on the beach on holiday’, ‘It’s not that hot- just put a cold flannel on your face’ and ‘Why are people moaning, we go abroad to get this weather?’ are things i have heard this week. However, for people like myself who take strong mental health medication, in a country not used to these temperatures, this weather is quite literally no picnic.

Firstly, my parents and sister are redheads with pale skin. I am the same and am not built for the heat or humidity. Then, we can add in the fact that I have bipolar disorder and take daily medication- which if not managed correctly can send my blood and body toxic. This has never happened as I stay indoors, don’t do strenuous exercise and drink constantly (and eat enough) in the heat. Yesterday though was a big risk as it became SO hot.

(image: Karolina Grabowska: Pexels)

The risks of Lithium, a mood stabilising medicine, in the heat are fairly well known. It is a natural salt, dehydrating the body so if you don’t drink enough water or eat enough salt, the level of Lithium in the blood saturates and becomes too high- toxic.

Signs of lithium toxicity include: nausea and vomiting, abdominal pain and diarrhea, confusion, drowsiness, slurred speech, increased thirst and lack of coordination of muscles. Severe toxicity signs are: blurred vision, severe muscle spasms, seizures and coma. It is no joke. So trying to cope with Lithium in 40 degree weather and in most places, lack of air con, meant I was confined to my home as I didn’t want to feel like I was melting or run out of water. Thankfully, I didn’t go toxic!

Additionally, I take the anti psychotic Quetaipine which stops me developing mania and psychosis. This and another such medications can impair the body’s ability to regulate it’s own temperature. I am therefore at risk of developing hyperthermia- excessive body temperature- which can be fatal. (scary right??)

So you can imagine that when I hear we are having a heatwave, I instantly think ‘stay indoors, cool showers, ice lollies, sit by air con unit, drink lots and lots’ . I worry about commuting or travelling in the heat. I still can be out in some heat- but 40 degrees was too much!

Something that has troubled me as i wrote this blog is this. My employers have been amazing and let me work from home yesterday. I am able to hydrate myself and eat and keep myself cool. But for those who are ill and unable to, I imagine many were rushed to A and E with the above symptoms yesterday. As a vulnerable adult, my GP didn’t even call to check on me or highlight the side effects of my meds… I only know all this from Dr Google!

There is still a long way to go with proper care for those of us living with (as termed by my doctor) ‘severe mental illness’ whether we live in remission/recovery or whether we have a support network…..I may be 34, not 94- but I could be at risk and they wouldn’t know.

I hope by writing this blog and highlighting these side effects that more people will be aware of this too- which affects people with bipolar, schizophrenia/ schizoaffective disorder, psychosis, depression and other illnesses where anti psychotic meds are used.

One positive- when the heat broke last night and the summer rain fell as Rob and I watched on our balcony.. it reminded me of being in India during monsoon season and in Ghana having a shower in the rain so I suppose not all bad! I admitted I cheered when I saw the rain.

Lastly, I can’t finish this blog without highlighting we had a family bereavement yesterday- a cousin (but more like an uncle) passed away after illness. I will miss him terribly but learnt so much from him- kindness, humility and faith.

Stay safe in this heat! Do your meds affect you?

Love,

Eleanor

xx

Taking Lithium for Bipolar Disorder: Side Effects by Eleanor

~ Eleanor Segall ~ 5 Comments
Pre Lithium in 2010 (skinny minny)

Post Lithium (on my wedding day in 2019)

I first heard about Lithium carbonate, a natural salt and the ‘gold standard’ medicine for bipolar disorder, when I was in my teen years. My dad was taking it to help his bipolar episodes- Lithium is known to stabilise mood and stop mania and depression from occurring or lessening their impact. I knew then that it was quite a strong drug, that you would need blood tests and that it caused weight gain. But it really helped my dad with his illness.

Fast forward to 2004, I was just 16 and had been diagnosed with bipolar in hospital. My brain was still growing and both I and my psychiatrist were reluctant to try Lithium at that stage, so I was started on Carbamazepine, another mood stabiliser. It was only when this medicine stopped working about 10 years later in 2014, when I was struggling with suicidal depression and anxiety (which then turned into a manic episode that I was hospitalised for), that I seriously considered taking Lithium to help me, like it helped my dad.

Lithium was first found to have benefits for patients with bipolar disorder in the 1950s, with a discovery by psychiatrist John Cade. Even today, we still don’t know what causes the disorder, but it is believed that Lithium stabilises mood – particularly mania. The psychiatrist.com notes this,

‘The real breakthrough in lithium therapy came in 1952, when Erik Stömgren, a Danish psychiatrist and head of the Aarhus University psychiatric clinic in Risskov who had read Cade’s article, suggested to a staff psychiatrist at the hospital, Mogens Schou, that he undertake a randomly controlled study of lithium for mania. Random controls were just being introduced to psychiatric drug trials at that time, and Schou randomly assigned patients to lithium or placebo by the flip of a coin. His results were published in a British journal with the article concluding, “The lithium therapy appears to offer a useful alternative to [electr[electroconvulsive therapy] since many patients can be kept in a normal state by administration of a maintenance dose.”

For me personally, Lithium treatment has changed my life in a number of ways- both good and not so good. Lets start with the good, I havn’t had an episode of mania and psychosis or suicidal severe depression in 8 years, which is largely down to medication helping my bipolar brain chemistry. It has worked for me- which is amazing- and I never thought I would find an effective treatment to help me. I have bipolar 1, the most severe type and although Dad has the same and was helped, I never thought it would lead me to remission. In fact, in 2014 when I was under the home treatment team after hospital, one of the nurses asked me to consider whether Lithium might not work for me and I might have to live with episodes… needless to say I cried as was very fragile and asked her to leave! She was wrong, thankfully.

On to the bad things: Lithium in combination with an antipsychotic Quetaipine has caused me to put on a lot of weight, as it slows metabolism. I also have to have 3 monthly blood tests to check my lithium level is within the correct range as too much is toxic to the body. Thankfully, I drink enough water and eat enough salt so I have never had a toxic reading but its a very careful balance..I have to always look after myself. Another bad side effect is skin sensitivity and acne- Lithium causes spots- so I have had to adapt my skincare regime and diet accordingly. Sometimes certain foods plus Lithium can trigger this too. Again, I have to pay more attention to my physical health as a result of taking Lithium and Quetaipine

The weight gain in particular has been a worry for me and is something I am working on., especially as diabetes runs in my family. Then there is the Lithium thirst…

Lithium as mentioned is a salt, and as it metabolises in the body, makes you incredibly thirsty. You have to be careful not to get dehydrated. Hence my love affair with Robinsons squash and the occasional ice cold fruit juice. No matter how much I drink, I can never fully quench my thirst, even if well hydrated. Lithium thirst is not the easiest… but Robinsons is my friend as its lower in calories and more delicious than plain water! And now I am thirsty again… haha

So I have a love-hate affair with Lithium. Brilliant for my mental health, not so great for my physical health at times. There is also a concern because over time Lithium can cause kidney and thyroid issues, which is why I have blood tests too. So its not perfect, but it really helps me to live my life and have stable mental health. Over time, its important i am monitored. I have been on it 8 years, but it could start causing problems at some point.

Additionally, when I please G-d get pregnant one day, my lithium levels will need to be monitored (but thats a blog for another time).

I don’t have nausea or trembling on Lithium which is good, but the other side effects (particularly weight) have not been so pleasant. I am so grateful though to have a medicine that keeps me well and out of hospital, able to live a life that some others take for granted.

Thanks to all who voted for this blog. If theres anything else you’d like to know, just ask a question and I will respond.

Eleanor x

What It’s Like To Go Through Severe Depression as a Bipolar Episode: Looking Back by Eleanor

~ Eleanor Segall ~ 14 Comments
(image of Eleanors book Bring me to Light: Eleanor Segall/ Trigger and Welbeck publishing)

TRIGGER WARNING- DISCUSSES SUICIDAL IDEATION, SELF HARM AND BIPOLAR DISORDER. PLEASE READ WITH CARE

This weekend, I went home to my mums to celebrate the Jewish festival of Pesach (Passover) and have some quiet, family time. It was wonderful and because our religious laws mean we don’t use the internet, our phone on our festivals, it meant I had time for digital detoxing and switching off. But with that silence, came space. To think and reflect.

Something you may not know about me is that as well as being a writer, throughout the years I have been a prolific diary (journal) writer. The act of putting pen to paper and type to keyboard has always been therapeutic for me in my darkest moments. I found a diary I had written in 2013, when I was living with depression, suicidal ideation and self harm thoughts and actions.

The journal was covered in butterflies- always my symbol of hope. I don’t want to trigger anyone so I will say this carefully- essentially, I was so unwell that for me, my symptoms were: sleeping until the afternoon with a slight break for a meal or tablets, not socialising, finding it hard to wash due to increased anxiety and lethargy, feeling like I didn’t want to wake up the next day and wanting to harm myself in various ways- but being so frightened by these thoughts (because i knew they weren’t really Eleanor) that i had to vocalise them to my family and psychiatrist to keep myself safe. Thats what I did and its why I am still here today, in recovery.

I lived with this depression for about 6 months- my psychiatrist was encouraging me to try Lithium to stablise the bipolar but I wasn’t ready and wanted to see if Quetaipine could halt that. As we know, I became hospitalised for mania soon after in 2014 which led me to recovery and writing my book Bring me to Light.

When you live with an illness like bipolar disorder, you can sometimes forget the nuances of all the details of how you were when you were unwell. For me, I always felt that I handled the depressive episodes ‘better’ than the mania- just because I was able to keep myself as safe as possible by telling my family and doctor and changing medication. My psychiatrist had to come out to see me at home with a nurse as I was so unwell and I wrote out how I felt for him to know.

So many people live with terrible episodes of depression so this blog is just looking back and giving you some knowledge of how it manifested for me. Essentially, depression is a slowing down of the mind towards inactivity, darkness, misery, anxiety, agitation and it is often triggered due to changes in hormones and brain chemistry (if you have a family history its more likely to happen). Depression is not just low mood. Its paralysing. Its not wanting to be in the world and being in so much emotional pain. You may think of ways to harm yourself and you may dream of not being in the world. Or you may be ‘high functioning’. I somehow managed to go to friends weddings during this time despite spending the other days in bed til 5pm- I have no idea how- anti depressants and support helped greatly. However, my depression was dark and invasive.


Now, I had forgotten a lot of these finer details. For me, I never truly wanted to die- I wanted the uncontrollable bipolar to go! The suicidal ideation was my bipolar brain chemistry but also an expression of not coping with life and the bipolar moods I had been given- I was 24 and I couldn’t enjoy life- i was wracked with anxiety too. My mental health was fragile and unstable and it is no way to live- but what saved me, was being hospitalised and finding medication and therapy that has helped me to live in remission (thank God) for 7 years now.

I can say now that my brain chemistry is balanced and even if i ever get sad or frustrated, I don’t have those awful thoughts and if they ever come up, I can deal with them. I have such a supportive partner and family- my family and psychiatrist saved me as well as me trying to save myself- I frightened myself with my thoughts and I had some semblance of being able to keep myself going, which is not possible for everyone. It helped that my Dad has bipolar and could really understand what was going on for me too- he understood exactly how I was feeling but he knew it was the illness and not Ellie. I feel so lucky for that because not everyone has this. My mum, step dad and sister and wider family also were so supportive and never blamed me for being unwell. That helped too. My faith also has helped me dearly,

(Me at 25 when I was going through depression. This photo was a selfie taken when I was dressed up to go to a friends wedding and my sister had done my make up. There were no photos with messy hair or red eyes and tears. I never looked this good when I was in bed til 5pm most days in my PJs).

If youve got this far thank you for reading. My mission is to help others with these conditions feel less alone, through sharing my own experiences. I have been careful not to reveal what certain thoughts were here so I don’t trigger anyone.

If you live with depression and a host of other issues, you can recover again. Hold on. You will not feel like this forever and you can find a level of happiness and stability again. Reach for help, someone you trust, a help line, a psychiatrist and don’t give up.

Mental Health Chat With Penny Power OBE and Thomas Power of Business Is Personal with Myself and my Dad Mike Segall. Our Journey With Bipolar Disorder and Anxiety.

~ Eleanor Segall ~ Leave a comment


Yesterday, 9th Feb, my dad Mike and I were honoured to be interviewed by his friends of many years, Penny Power OBE and Thomas Power of Business is Personal- live on Linkedin, Youtube and Facebook.

They asked us to come on their weekly show to talk about our hereditary journey with bipolar disorder and anxiety and shed light on all things mental health.

It was a real pleasure to talk all about our lives and how my Dad was diagnosed with bipolar just 4 years before me.

Trigger warning: discusses suicidal ideation and psychosis.

Thanks Penny and Thomas! We hope it battles stigma around this much misunderstood illness. Watch here:

https://www.youtube.com/watch?v=Fghp8RNTvX0