Bye, bye lithium

When I was first diagnosed with Bipolar Disorder it was so long ago it was called Manic Depression and I think that it’s a much more vivid name. It conjures up the extremes in words that people understand without masking the reality in clinical cleanliness. In the past 19 years much has changed for me except the almost ever presence of lithium.

I was prescribed lithium as a base drug back in 1994 and it worked very quickly for me; silencing the white noise that had been in my head for so long I thought everybody had it, calming intrusive thoughts, tempering reactions and overreactions, soothing the itchiness in my mind.

From the start the problems as well as the solutions existed and, for a while at least, the problems were worth putting up with. Along with the relative ease of mind it gave me it also gave me an almost unquenchable thirst, a raging and out of control desire for food (I put on so much weight I went from a size 10 to a size 18 in a year) and shakes that meant at times I couldn’t sign a cheque because my writing was unrecognisable. These are big side effects and it’s a constant internal battle to keep on taking something that, though it can do enormous good, takes such a toll on your body.

What you also have to endure is regular blood tests which are there to make sure that your kidneys and thyroid are ok (lithium can destroy the thyroid) and to measure the amount of lithium in your blood. Too much lithium and it poisons you, too little and it doesn’t work. It’s a balancing act within the balancing act of keeping your moods stable.

The physical act of taking lithium is something I have struggled with constantly. The tablets are chalky and begin to disintegrate on on touch with liquid making them difficult to swallow. The liquid tastes a bit like hell would if hell had a taste. I go through phases where I have difficulty swallowing and have to resort to a liquid diet and find it almost impossible to swallow lithium in any form.

Lately I’ve been find it harder to take lithium. I’ve been using the liquid diluted in squash but a combination of loathing and a dodgy memory means that I’ve been barely compliant. I’ve had blood tests more frequently of late because of this and they show that my kidneys are beginning to drop in function due to age and the level of lithium in my blood stream no longer falls within the levels that are considered to have therapeutic value. There is little lithium in my system and, due to a combination of coping mechanisms and a fantastic support network, my mood levels are easier to cope with; they can still be devastating but I cope with them better.

A few years back when I was quite ill and my bipolar memory problems were particularly bad I registered Lasting Power Attorney (LPA) with the Office of the Public Guardian. This means that should I become unable to make decisions for myself for whatever reason then my health, welfare and finances are looked after by, in my case, two nominated people.

Quite naturally I discussed this loathing of lithium with them several times over the past few years and I used them as a sounding board recently. I put it to them that since the lithium in my system was below a therapeutic level and my moods where remaining relatively stable then I was taking a potentially poisonous and particularly obnoxious drug for no reason. Calculating the pros and cons of taking lithium it emerged that the cons were overwhelmingly outweighing the pros. I suggested to the friends that hold LPA that it was maybe time to stop taking lithium and I received their support.

I talked to my GP this morning outlining and summarising the problems and my proposed solution. He has agreed that it would be a worthwhile experiment stop taking lithium. An experiment because there is the chance of a relapse and we won’t know until I try to live without it. I am keeping a store of lithium in just in case but I’m optimistic that I won’t need it. By this time next week I’ll have taken my last dose and five days later it will be out of my system. Then we wait and see.

After 19 years this could be it, I could be free of the tyrant that has both ruled and restored my life. Bye, bye lithium it’s not been that nice knowing you.

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