I once asked someone who suffered from manic-depression (or bipolar disorder) to describe his experience of the difference between mania and depression. In his words, "When I'm manic, I'm God, and when I'm depressive, I'm Satan." That explanation really brought home to me the challenges of managing a mental illness such as bipolar disorder.
The drug lithium is the drug of choice in treating bipolar disorder (and some other mood disorders). People who suffer from bipolar disorder experience profound changes in mood, as described above. The manic state can include anger and irritability in addition to the false sense of euphoria that is more commonly thought of as mania. The depressive state is primarily a feeling of hopelessness and sadness writ larg.
While the mechanism of how lithium works to counteract bipolar disorder remains somewhat of a mystery, it is known to work upon the central nervous system and to interact with a variety of neurotransmitters and receptors.
Here are a few things to know about the drug lithium:
- Lithium is taken orally via capsule (including a slow-release capsule), syrup or tablet (including a slow-release tablet).
- It takes 2-3 weeks to reach the level of lithium in one's system where results will be experienced. Additionally, the levels may need to be adjusted so as to achieve optimum effect. This means that the patient needs to be patient (no pun intended!) in waiting to achieve the desired results.
- The dosage required to affect mood disorders is only just below a dosage amount that can be toxic. Thus blood levels of lithium must be closely monitored during treatment, along with kidney and thyroid function.
- Lithium must be taken exactly as directed, which will be on a daily basis in regularly spaced doses, as prescribed by a physician. This way, the amount of lithium in the blood will remain constant.
- Because lithium affects the regulation of sodium and water levels in the body, it is important to drink 2-3 quarts of water or other fluids daily so as to avoid dehydration.
- Losing too much water and salt from one's body can lead to serious side effects from lithium. Thus, extra caution must be taken in hot weather and during any activities that cause heavy sweating (i.e. exercise or saunas). Additionally, a significant change in diet (especially the sodium content in one's diet) or any illness that causes sweating, vomiting or diarrhea may affect lithium levels. You should always err on the side of checking with your doctor under these circumstances.
- Never take diuretics while on lithium. Let your doctor know all medications that you take.
- Indications that the body has too high of a level of lithium include diarrhea, upset stomach (including nausea or vomiting), appetite loss, drowsiness, muscle weakness, slurred speech, lack of coordination, tremors and disorientation.
- Lithium should be taken after eating so as to reduce stomach upset and a possible laxative effect.
- While at one time lithium treatment was considered unsuitable for children, more recent studies indicate its usefulness in treatment of early-onset bipolar disorder.
If you are in a position of having been prescribed lithium, chances are that you have experienced some extreme ups and downs in your life. Please recognize that lithium may offer you the opportunity to gain control of your emotions and thus be able to move forward in your life in a way you have never before experienced.
Some who have been prescribed lithium shy away from taking it because the potential side effects can seem daunting. I urge you to look at your diagnosis in the same way that someone diagnosed with diabetes might. Yes, it would be preferable not to have the condition in the first place, and there will be challenges to managing it, however appropriate treatment can change your life for the better. Lithium offers to you the possibility of being the master of your emotions instead of having your emotions rule you.