Tag: 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

Taking Mental Health Medication Doesn’t Make You ‘Weak’: Fighting the Stigma by Eleanor

~ Eleanor Segall ~ 4 Comments
(image: Matthew Ball for Unsplash)

Disclaimer: All medication must only be prescribed by a psychiatrist or GP dealing with you individually. Advice from medical professionals must be sought before taking any medication., Never take someone elses medication or try to cure yourself!

This week, I had a conversation with someone about being on mental health medication, in this case, anti depressants for clinical depression. We reminisced that as teenagers, we just weren’t taught properly by school or in society about mental illness. It wasn’t talked about here in the UK back in the 2000s and everything was really hushed up, cloak and dagger, as if you had to be ashamed of it. As if anything to do with our mind was shameful- no one really had much education, unless it happened in your family.

I know that for many people, even in 2022, taking medication for their mental health carries this sense of shame.

For me personally, I was so ill that there really was no choice for me as a 15 year old, but to be started on medication. My symptoms of bipolar disorder first appeared at the age of 15 with depression and anxiety episodes, followed by mania and psychosis. So, I was on anti psychotic medications as well as what is known as a mood stabiliser, a medicine for mood disorders that stabilises moods (in this case, the bipolar poles). I also took regular anti depressants and anti anxiety medications and still do daily. My medicine regime is pretty intense but it means that my bipolar is well controlled and in remission- and that I am stable. My family has a hereditary illness that can be severe- so medication was the right choice for me.

However, for those without a severe mental illness like bipolar or schizophrenia, you may be recommended to try anti depressants first. There are varying different types which work on seretonin reuptake in the brain and help to balance brain chemistry.(although scientists cannot pinpoint the cause for depression fully yet). These can be used in combination with therapy and exercise to help treat depression and anxiety.

Some families and cultures hold great shame to be seen taking mental health medication and so hide it from loved ones. Others stop taking it, believing they are stable and well because the medication has balanced them out- and then crash into depression. For some though, anti depressants are a shorter term thing. The point is, its all so individual and there is no one size fits all medicine- you must do what is right for your recovery but definitely do not suddenly stop them.

In my family, my Dad was already on mental health medication- Lithium for bipolar, when I became ill. So, I was lucky that I had a loving supportive and accepting family, including plenty of medical professionals who understood. It was a steep learning curve for everyone though. And yes, as a teenager, I did hold some shame for taking medicines because I just wanted to ‘fit in’ and be a ‘normal’ teen. Coupled with the fact no one openly talked about mental illness at school or in general (this was just before social media!) and I felt this overwhelming sense of shame that my brain chemicals had let me down. I never once skipped taking medication though.

The thing is with mental health is that you can’t see it. But, you can absolutely feel when something is wrong and when you feel chemically depressed or other mental illness. This is usually depression unlinked to a life event- you wake up with it and you know its back, you feel despondent and unable to cope.

Yet, because you can’t see it- shame is even greater because how do you explain it to others? And are you ‘weak’ or ‘crazy’ to need medication to function?

The answer is No. To have to take the correct prescribed medication for you daily is an effort. You have to commit to it and to seeing how some medicines go. To go through episodes of mental illness makes you stronger and more resilient, surviving each day. You are not weak, your brain just needs help (like helping diabetes or a heart problem) and the words ‘crazy’ or ‘unhinged’ just serve to reinforce stigma. There is no need to be afraid or filled with shame or self loathing- but it is valid to feel this way as you are human!

In 2017, it was estimated that 792 million people worldwide lived with a mental health disorder (one in 10 globally). 46 million of those had my disorder, bipolar. However, this is the tip of the iceberg because mental illness is often underreported due to stigma. So- you are not alone. There is treatment out there to help you.

Remember not to be ashamed of needing medication to cope with life’s challenges (alongside therapy etc). The stigma is slowly falling and I will continue to write and share to this end.

You are not weak! You are powerful beyond comprehension .

Do you take medication? Does it help you?

Love,

Eleanor x

Reflecting on a New Year 2022: Be Your Own Kind of Beautiful by Eleanor

~ Eleanor Segall ~ 2 Comments
(image: Neon Filter)

When I was a child, growing up in Hertfordshire, my biggest dream (other than being a wife and mummy one day, because yes even then I dreamt of that) was to be an actress in the West End. I could think of nothing more exciting than standing on a stage, performing and I wanted to go to drama school from age 11. I went in the end at age 23 to do my masters degree at Royal Central in London, after doing a 3 year degree featuring Drama at Goldsmiths. I was so excited to have achieved a dream of mine, even though for many reasons I decided not to act professionally.

However, sometimes, long held dreams, things that are part of the core of our being, of our inner identity, can be a little harder to achieve. Sometimes, we find ourselves on the less travelled path, we feel different from our friends and family because our lives, for whatever reason, are different. We have to consider our health in a unique way. We have to try and surrender our fears to the universe and hope that everything will work out OK.

When I was diagnosed with bipolar disorder at 16, I was still a child and I didn’t know what it would feel like to be an adult, needing a cocktail of medication daily in order to have stable brain chemistry. And how this medication might affect my body and mind- and considering children in the future as a woman with bipolar and all that brings- discussions with psychiatrists, difficult decisions to be made, do I carry my own baby, what will make things safer for me?

As I look ahead to 2022, I know that our dreams are there to be fulfilled. I know that I must trust and have faith that whatever happens, whatever 2022 brings to us, I will always have hope and I know my husband will too.

Wishing you all a happy and healthy 2022 – may all our dreams manifest for the good.

Eleanor x

Believe In Progress, Options, Laughter and Recovery: Some Thoughts on Bipolar and Life.

~ Eleanor Segall ~ 5 Comments

(image: Hannah Blum)


Hi everyone,

I havn’t done a personal blog for a while because things have felt pretty…. the same. We are all going through such a difficult year where we feel in limbo, stuck with the dark, cold nights and little to distract ourselves- we can’t travel, go on holiday, see friends indoors in person . It can all feel bleak and frustrating with Covid 19 and this new world we find ourselves in.

I am lucky that my mental health hasn’t taken a nosedive, although there have been days where I have felt low, anxious and overwhelmed. I love my work for the Body Shop and my writing, but there are times when I just want a break. We were planning on maybe going away somewhere in the UK, but then Tier 3 restrictions hit London, so we will be at home over the Christmas break. Instead, I have made sure I have taken time for myself and rested- so that things don’t get too much.

I opened my book Bring me to Light this morning- I don’t often read it as I wrote it. But, it fell on this page- a poem about Bipolar that a fellow friend and patient wrote when we were on the hospital day unit in 2014. She also had bipolar disorder and was in there for her recovery.

It said,

Believe

In

Progress

Options

Laughter

and

Recovery

She kindly let me keep her poem- at the time, I needed hope, healing and faith- that I could get better. That Bipolar wouldn’t ruin my life.

I did get better. I have been so much better on my new medication. I met an amazing man who is now my husband. I found a career I am able to do with my PTSD and new friends and a team of people around me who are wonderful. Life is good.

However, a small part of me is scared. Scared to get ill again or be hospitalised. Scared of the psychosis that wrecked my life. Scared of whether or how I can become a mother whilst on Lithium or whether we will need to look at surrogacy as the meds can cause birth defects and there is a strong risk of post partum psychosis and pre or post natal depression for me with my bipolar. I am scared that if I carried my own child, I could end up on a hospital ward again- but a mother and baby one. I don’t want that to happen.

In my book Bring me to Light I wrote, ‘ Sometimes I still feel like the scared sixteen year old, sitting in that psychiatry room at the Priory North London, being given a diagnosis of bipolar disorder. …I have learnt that thanks to Lithium and therapy, bipolar disorder does not have to be my life.’

But knowing Lithium’s impact on my physical body too is scary. Weight gain. Acne. Water retention. Potential issues with kidney function/diabetes in future. Not being able to breastfeed on it or possibly carry a baby due to the severe risk – I have the most acute form of Bipolar and become very ill without medication.

These issues are so personal and I and Rob have been processing them for a while. We lost Robs dad to brain cancer in July and I didn’t feel able to blog about children before now. But, when the time is right and we speak to a perinatal psychiatrist and plan for a child, I want to write about it- maybe even a new book.

In the mean time, I am excited for new births in our family and I am just living and enjoying being well, being healthy.

I never see myself as someone with a disability- I always look for the Light. But, there are limitations and drawbacks to having this illness, even when it is in remission. It is biological and impacts on things I never realised when I was diagnosed in 2004. At the age of 32, these are becoming more real than ever and its scary. But, I want to smash the stigma and so I will write about what I can.

I wish you all a wonderful , relaxed festive season with good mental health- Happy Chanukah and Christmas.

Love,

Eleanor x

9 Years Undiagnosed: My Life with Bipolar Disorder, for Time to Talk Day: Guest blog by Mike Segall

~ Eleanor Segall ~ 8 Comments

timetotalkdaydad1

(image: Time to Change)

*Trigger warning: discusses thoughts of suicide and mania, please read with care *

This blog has been courageously written by my Dad, Mike, about his journey with bipolar disorder and the hurdles he faced in getting a diagnosis. For those of you who have read my book, you’ll know some of this. This is the first blog that Mike has written for us and I want to share it on today, Time to Talk Day by the charity Time to Change.  So here is Mike’s story….

 

My experience of Bipolar 1 Disorder was that I was undiagnosed for 9 years. I was never sent to a psychiatrist and was put on the wrong medication (I hadn’t heard of mood stabilisers and seemingly neither had my doctor).

So- What is Bipolar Disorder? (formerly known as Manic Depression)

To me, Bipolar symbolises the two extreme poles of mood- mania and depression. The North Pole is Mania. Mania is wonderful for me- you think you can be anyone, you think you can do anything, achieve anything, You are flying. You think ‘why can’t everyone be like this and experience everything?’. You are much more uninhibited. You may shop more, you spend more money, You think you can FLY!

But you can’t fly and you fall, you fall off a cliff into varying degrees of  deep, dark depression, which can last for months.

Bipolar disorder is  a chemical imbalance in the brain that causes periods of depression and periods of abnormally elevated mood, mania. The elevated mood is significant, known as mania or hypomania depending on its severity and whether symptoms of psychosis are present. Psychosis means when your mind lose touch with reality, with delusions or hallucinations.

During mania, someone feels abnormally, happy, energetic, irritable and not requiring sleep they often appear to be bouncing off the walls, starting new projects, trying to achieve too much. In some cases, addictions during mania may also present.

During depression, someone with bipolar disorder may be crying, experiencing negative thoughts and giving poor eye contact. You will notice this if you ever have a conversation with someone who is depressed. They may also be suicidal or talk about self harm.

My Story:

My first manic episode occurred in 1991 and I went to the doctor and was prescribed Valium (an anti anxiety calming medication), which was handed out like sweets in those days.

The Valium didn’t do me any harm but they certainly didn’t do me any good. In the next 9 years, I had three manic episodes followed by three increasingly devastating depressive and suicidal episodes, the last of which lasted 5 months.

In my first manic episode I was going out a lot late at night to clubs and bars and spending too much money. My second and third manic episodes were much more controlled as I recognized what was going on but I was still much more outgoing than usual and spending too much money.

My depressive episodes were serious and eventually suicidal and lasted 3, 4 and 5 months respectively. I often stood on the edge of a London Tube platform thinking about ending it all. I would drive down the motorway at speed not turning the corners until the last possible moment. I would stand in the bathroom with hands full of tablets thinking about overdosing and ending my life. Mostly, I was at home in bed doing nothing but sleeping , eating and surviving.

The person you would meet today is not the person you would have come across at that time.

Looking back there was no real connection made between these episodes and I wonder 1. Why I was never hospitalised and 2. Why I wasn’t diagnosed more quickly.

First of all, 30 years ago far less was known about Bipolar Disorder so the doctors weren’t quick to diagnose it. Secondly, it was only after 9 years that my GP reviewed my file and noticed that I had never been referred to a psychiatrist.

This was the breakthrough that changed and saved my life.

I went to The Priory hospital to see a psychiatrist, describing my episodes. Within 45 minutes I had a diagnosis,

”You have a mental illness. It has a name, It is Bipolar 1 Affective Disorder. You have it for life and it is treatable with the drug Lithium.”

Lithium balances out the chemical imbalance so you end up between the poles and mood is then stabilised. I am pleased to say that in the past 20 years, the medication has worked for me and has stabilised my bipolar disorder, so I no longer get episodes of mania or depression.

I am also pleased to say that as quite an emotional person I still experience the normal feelings and emotions that come with everyday life.

Starting on Lithium is not easy as you have to be weaned onto it. There are side effects, the most common being weight gain and you have to have regular blood tests to make sure the level of Lithium in your bloodstream is correct (non toxic) and it is not affecting your kidneys.

I do wish that I had been diagnosed earlier and not had to suffer manic and depressive episodes as I did.

These are the 4 takeaways I would like you to have from reading this, this Time to Talk Day:

1. With mental health it’s good to talk about it , It’s good to fight stigma and it’s good for your own healing.

My journey started in 1991 and I would hear things like ”you’ve got a weakness. Why don’t you pull yourself together?”, which were unhelpful

2. Think about how you can help people in your community by recognizing the signs that someone has depression or mania.

3.  Live a positive life- I am an example of a bipolar sufferer who can maintain a positive life. Bipolar is an illness that needs treating. It is treated with medication but it can take time for the medication to be right as each person has individual brain chemistry.

4. Listen to those who are struggling. Most of us listen to reply. If you watch two people deep in a conversation or you are in one yourself your focus will be very much on the other person and you will be listening at 90%.

But if you are listening to understand and you are feeling and sharing their emotions then you are truly listening at 100%. Check out the Samaritans help line too.

 

mikesegall

(image: Mike Segall)

Mike Segall is a professional speaker and mental health advocate, sharing his lived experience with bipolar disorder to groups in the UK. He is also the father of the founder of this blog, Eleanor.