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