My depression spiraled out of control over the last week or so. I’m talking horrendous fights with J in which I brought up things we fought about in our first three months dating. I’m talking staying in bed sobbing until 1 pm. I’m talking not tending to my ADL’s (for those of you out of the mental health circuit, nevermind). It’s been bad. This is particularly bad news given that I’m on two antidepressants, one of which is at its highest prescribed dose.
So I went in for my monthly appointment with my psychiatrist this morning. He said, “Have you been on Lithium?”
Have I been on Lithium? Have I been on Lithium?
Yes. I’ve been on Lithium.
In fairness, I’ve done my research. My feelings about Lithium are not rational. Lithium was the best option for bipolar treatment when I was a teenager. However, its side effects are, well, not nice. In mood stabilizing doses, regular blood test are required to make sure that the liver is not being affected negatively. It behaves very much like salt, so it’s possible to retain water. When I was 17 I gained 20 pounds the month I was on Lithium. And then there’s the part I conveniently forgot to mention to my doctor today…
Lithium is what I took the one time I overdosed. Probably should have mentioned it to the pdoc, but honestly, I forgot about it.
Before I go on, I should say that I have only been truly suicidal the one time in my life, that fall of 1996, when I was 17. As bad as my depression has been in the years since, and it’s been very, very bad, I’ve never actually had a plan.
But, I did overdose and I did carry on as if nothing were wrong and I did go to school in a stupor and no, nobody noticed. My pdoc of the time said that four more pills would have killed me. It wasn’t long after that that he took me off Lithium.
I know that the Lithium taste that will inevitably come back into my mouth along with the perpetual thirst will be a solid reminder of that horrid time in my life. I know that drinking water will not just be a luxury now, it will be very necessary to keep me from getting dehydrated because of this medicine. My psychiatrist says that the dose he’s prescribing will not be enough to affect any real weight gain and I won’t even have to take the blood tests, but it sure won’t help me lose the weight I’ve already got.
But, as my pdoc said today, “Would you rather be alive or not quite so pretty?” (His euphemism for fat.)
I asked about clinical trials. He said we aren’t there yet. I said something about my depression being hard to treat. He said to wait until I’ve been under ECT (electroconvulsive therapy) three times before I talk like that. He was actually very encouraging, though, reminding me to reward myself in some small way mentally for each active thing I do these days.
I’m just pitching a temper tantrum here in writing, I know, about the Lithium. I know it’s not nearly as bad as it was when I was on a mood stabilizing dose. My pdoc will see me again in two weeks, at which time he hopes we can stop the Lithium altogether. He doesn’t mean for me to stay on it forever, thank God.
But it still scares me. The memory scares me a lot, that memory of what those extra little pills could have done 15 years ago.
And I dread, dread, dread being thirsty all the time. That part will happen this go-round.