Dear Jaime. My heart goes out to you. I went to medical school and trained in psychiatry partly to understand my father's bipolar illness. He was delusional and manic for years until Lithium became available in 1970's. I fully believe in neurochemical and genetic determinants of emotional illness and in the critical need to treat such 'brain' conditions with proven medical interventions. Over the years I treated many of my patients with Lithium, some of whom developed serious nephropathy after many years of treatment. I've switched them to Lamictal or Latuda with equally good results. (I avoid Depakote because of many side effects and risk to fetus in pregnancy). Good luck on your journey....your story is shared by many.
9
What a brilliant description of your life; it is so helpful to so many. Thank you for sharing this.
6
While Lithium seems to be helping me control my mania, obviously it is not a panacea. Furthermore, I do not think it is appropriate, in the vast majority of cases of delusional thinking, to force someone physically to take it. For many people being forced to take medication can be traumatic and counterproductive. Personally, I think that is the case with 99% of people who have been forced. Most people don't like anything that has been forced on them, whether medicine, food, sex, ideologies, beliefs, violence, religion etc...
3
Thank you Ms Lowe--your courage in opening speaking about the realities of a manic episode will enlighten some and validate others.
After experimenting with every possible non-medicinal intervention (meditation, yoga, physical exercise, talk therapy...), a wise psychiatrist suggested lithium. With one manic episode which lasted an entire night (with my husband and mother keeping vigil), I gladly took Lithium. It was immediately clear I had to do anything to protect my mind.
I still have my personality but it is not shattered into a million fractals. I am able to sit on meditation cushions now, practice and teach yoga and exercise for pure pleasure. I have my life back (for 25 years now) and it is just the one I wanted.
After experimenting with every possible non-medicinal intervention (meditation, yoga, physical exercise, talk therapy...), a wise psychiatrist suggested lithium. With one manic episode which lasted an entire night (with my husband and mother keeping vigil), I gladly took Lithium. It was immediately clear I had to do anything to protect my mind.
I still have my personality but it is not shattered into a million fractals. I am able to sit on meditation cushions now, practice and teach yoga and exercise for pure pleasure. I have my life back (for 25 years now) and it is just the one I wanted.
5
I love that this article shows the good and the bad of taking this medication, and what a complicated and necessary choice it is. Thanks for sharing. Lithium saved my life, but I'm glad I transitioned onto other medication. It turned off the suicidal thinking like a light switch but it also left me in a fog. I'd also like to point out the bit about how the doctors said she had a "decreased need" for sleep during the mania... When I read about bipolar symptoms that description always bothers me. We need our sleep more than most people. There is a difference between a need to sleep and a physical inability to do so. We need to sleep when we are manic, but we can't. Sleep deprivation is at least half the battle when it comes to our sanity. I'd love to see a followup article on that from this brilliant writer.
4
Beautiful and relatable writing. I hate that fear of "am I going to become a crazy person?" Arm your loved ones with the list of manic symptoms and the authority to hospitalize you if they come to visit. It will be ok.
My mother, too, viewed lithium as her salvation, although she was never quite stable on it. Then she developed kidney damage, high blood pressure and congestive heart failure. A review of her medical records showed both her internist and her leading-neuropharmacologist psychiatrist had failed to follow up on elevated BUN and cretanine levels 6 months earlier.
Switched to Clozaril, she because a much more even-keeled until she died of CHF 7 years later at age 55. When I got my own diagnosis, lamictal probably saved my life. There are other choices for you out there. Good luck.
My mother, too, viewed lithium as her salvation, although she was never quite stable on it. Then she developed kidney damage, high blood pressure and congestive heart failure. A review of her medical records showed both her internist and her leading-neuropharmacologist psychiatrist had failed to follow up on elevated BUN and cretanine levels 6 months earlier.
Switched to Clozaril, she because a much more even-keeled until she died of CHF 7 years later at age 55. When I got my own diagnosis, lamictal probably saved my life. There are other choices for you out there. Good luck.
3
Unlike you, I was diagnosed much later in life, mid forties, and I was very fortunate to get immediate and good care. I had spiraled into manic blogging, delusional anxiety with a sense of impending doom, and an annoying habit of thinking every conversation was an opportunity to show my skill at creating metaphors and similes. I ended up picking depakote since my mom and her sister died from kidney disease (her sister was on Lithium for bi-polar). The depakote has worked pretty well for the past few years. It definitely helps me sleep well, but it also leaves me a little tired during the day. Daily exercise has helped a ton and I haven't noticed any weight gain. A little hair loss at first as the liver stabilized, but then it stopped. Anyway, it has worked for me and I hope it works for you. Thanks for the article.
3
I witnessed this behavior with a family member and Lithium worked for him. Loved the article but would love to read more about drug-resistance bipolar treatment.
4
Thank you for this. You have shown everyone who can read what mania can be like. As a psychiatrist, your story is familiar to me, but a lot of people will be instructed in a thoughtful way by your work here.
1
My mom is bipolar and was for my entire childhood, only getting diagnosed in the early 90s, when I was almost out of the house. Her manic episodes didn't include delusional behavior (or at least not to the extreme Ms. Lowe experienced), and she was able to hold down a job (just barely). So her illness flew under the radar.
Our lives were never predictable. Sometimes my mom would be amazingly loving and smother us with kisses, hugs, homecooked meals, home-baked cookies, etc. She would take us shopping and buy hundreds of dollars-worth of clothes and toys that we had been told previously we couldn't afford. (And, in fact, we couldn't afford it, and my father would have to take everything back to the store later.) Other times she would be furiously angry and scream and break things and sulk for days if someone left a bowl in the sink, instead of putting it in the dishwasher. Then she would descend into depression, and for days she couldn't get out of bed. She would sob and talk about killing herself. Then the cycle would start over. The mania never lasted the same length of time, nor did the depressive episodes. We just never knew what would happen, or how long it would last, or what to expect.
Lithium and other drugs were a Godsend not just for my mom, but for our whole family. My mom would be dead now, if not for the drugs. I'm thankful for psychiatric medications. They have allowed me to know my mother as she really is, and not the person the illness makes her into.
Our lives were never predictable. Sometimes my mom would be amazingly loving and smother us with kisses, hugs, homecooked meals, home-baked cookies, etc. She would take us shopping and buy hundreds of dollars-worth of clothes and toys that we had been told previously we couldn't afford. (And, in fact, we couldn't afford it, and my father would have to take everything back to the store later.) Other times she would be furiously angry and scream and break things and sulk for days if someone left a bowl in the sink, instead of putting it in the dishwasher. Then she would descend into depression, and for days she couldn't get out of bed. She would sob and talk about killing herself. Then the cycle would start over. The mania never lasted the same length of time, nor did the depressive episodes. We just never knew what would happen, or how long it would last, or what to expect.
Lithium and other drugs were a Godsend not just for my mom, but for our whole family. My mom would be dead now, if not for the drugs. I'm thankful for psychiatric medications. They have allowed me to know my mother as she really is, and not the person the illness makes her into.
5
I just wanted to say thank you for writing this piece. You're scientific and poetic and weave in topics like history, chemistry, and psychology effortlessly and this was just a pleasure to read. I think my favorite part was tying in astronomy with past-present-future comparisons and the awe that this element has been around since the dawn of the universe. And then the grand sweeping universe-scale statements are balanced by a very personal story of someone grappling with identity and stability and the fear of it being taken away. Just a wonderful piece and you're a fantastic writer.
My thoughts are with you and I hope you'll pull through okay, hope the knowledge that some random person out there is thinking of you and rooting for you helps! Looking forward to reading more of your work.
My thoughts are with you and I hope you'll pull through okay, hope the knowledge that some random person out there is thinking of you and rooting for you helps! Looking forward to reading more of your work.
5
Nice job on your 20 year struggle with bi-polar disorder as reported in the New York times Magazine of June 25, 2015. One of our children was and still is afflicted with that disorder. She is now 57 years old and is a sucesful business woman. She too has problems with the existence of God.
You spent a lot of time on how lithium helped you, but very little on why you don't believe in God. Why not?
Would love to hear your reply. Read my book "God Seeks Us". It might help.
Shalom, Salaam ,Peace of the Lord God
Bill Parrott
You spent a lot of time on how lithium helped you, but very little on why you don't believe in God. Why not?
Would love to hear your reply. Read my book "God Seeks Us". It might help.
Shalom, Salaam ,Peace of the Lord God
Bill Parrott
I suffer from Bipolar II, in which mania is not present, and the cycle is from depression to hypomania, which, for me, is as close to normal as I an able to feel. I, too, took lithium carbonate starting in 1991 and, while it seemed to work on my mood swings, it had other, non-palliative effects, including uncontrollable trembling of my hands. When I was misprescribed a large dose which was life-threatening, I switched to Depakote. I had traded one medication which was damaging to my kidneys for one which threatening my liver. At one point, I was taking 2500 mg of Depakote daily, and was seriously advised by a physician to avoid Tylenol, which can be threatening to a dodgy liver.
In October 2012, in a very foolish move which others with bipolar illness have done, I ceased taking Depakote and Lexapro, an antidepressant. I became unpleasant to be around, and was pretty much a mess.
July 2014, I began taking Lamictal (lamogritine), which has a very slow titration; I started taking 25 mg/day, then 50, then 75, then 100, then 150, then 200, then 250, then 300, then 350, then 400 mg/day, over 5 months. I am currently at the 400 mg/day dosage. It is not a miracle drug by any means, but it is the first psychiatric medication in 25 years that I have felt actually helped me.
This is a lifelong illness, and has been a lifelong struggle for me. I am hopeful that my improvement so far will be lasting.
In October 2012, in a very foolish move which others with bipolar illness have done, I ceased taking Depakote and Lexapro, an antidepressant. I became unpleasant to be around, and was pretty much a mess.
July 2014, I began taking Lamictal (lamogritine), which has a very slow titration; I started taking 25 mg/day, then 50, then 75, then 100, then 150, then 200, then 250, then 300, then 350, then 400 mg/day, over 5 months. I am currently at the 400 mg/day dosage. It is not a miracle drug by any means, but it is the first psychiatric medication in 25 years that I have felt actually helped me.
This is a lifelong illness, and has been a lifelong struggle for me. I am hopeful that my improvement so far will be lasting.
6
Hi Jaime- Thank you for an incredible description of the journey a bi polar person experiences. Having lived with a man on and off for the last 15 years with frequent and similar experiences of mania an depression, I can say you're RIGHT ON!
He too had to discontinue lithium that caused diabetes insipidis and took depakote among other drugs. When he lost his job and became seriously depressed, his psychiatrist gave him Latuda. Well he spent last year in a wheelchair, hospital, rehab and neurologist specialist as he developed parkinson symptoms that lasted for 8 months. It was a true nightmare. Luckily those symptoms had finally subsided and guess what- he became manic in December and has since moved out. My heart breaks for him and all who suffer this illness. Your story shines a light on it and hopefully, more will educate themselves after reading about you. Thanks for your genius writing of your hopeful story. Please continue to keep us informed. Good Luck and God Bless.
He too had to discontinue lithium that caused diabetes insipidis and took depakote among other drugs. When he lost his job and became seriously depressed, his psychiatrist gave him Latuda. Well he spent last year in a wheelchair, hospital, rehab and neurologist specialist as he developed parkinson symptoms that lasted for 8 months. It was a true nightmare. Luckily those symptoms had finally subsided and guess what- he became manic in December and has since moved out. My heart breaks for him and all who suffer this illness. Your story shines a light on it and hopefully, more will educate themselves after reading about you. Thanks for your genius writing of your hopeful story. Please continue to keep us informed. Good Luck and God Bless.
4
I took lithium as a mood stabilizer. It's amazing to me how I think I can accomplish more than in my sane mind. this shows that medication is necessary. the author needs to take her pills, like I do or anyone with a mental dis ability. she stopped pills taking and this shows her symtoms return returning. if she was more honest with herself and stop thinking it will fix itself; she puts herself through years of pain. lithium was a good pills, until the levels showed a little kidney damage, so they took me off of it, and I i put myself on a semi kidney diet, to bring my function back to normal. I believe in God, and her comment that a pill, manufactured in pill factory is her god, sounds like a drug addict. I'm amazed at how people move to NY act like they renounce God because they think the city is exciting with big eyes like . I was born here, so no Pollyanna view of NY except it's good and it's bad. i'd give her five years to be living in the city to be disillusioned by how people are. the selfishness and the rudeness. the pills being her god is unnatural(pun) and illogical . what happens if they discontinued, then she's going back being depressed ? she needs a better life philosophy.
1
As a bipolar with extreme mania I blew through lithium like a Mack truck through tissue paper. I was put on Tegretol and that kept me on planet earth for 25 years now. Just wanted to share that for people not reaponding to other alternatives to lithium.Side effects have been minor, slight tremor and sedation in the morning.
Good luck to all bi polars and their families.
Good luck to all bi polars and their families.
3
Good luck -- I hope you find a med or combination that works for you.
3
Beautifully written...........brutally honest......I am unable to put in words like the author has how striking and informative his plight ........I will remember Jaime Lowe and look forward to any future thoughts on any thing ......thank you and so looking forward to seeing you write on any subject matter whatsoever..........
That is a wondeRfully wRitten and fascinating aRticle.
when i tapeRed off lithium in 1998 (12 yeaRs afteR staRting it), i got a bone cRushing depRession, as delusional and hoRRid as the 5 episodes which pREceded it. i always was suRE i would lose eveRything and eveRybody, and that i was the lowest chiggeR in the univeRse. i couldnt sleep and lost weight. woRst of all, i was scaRed of eveRyone and eveRYthing, people and places i usually felt comfoRtable in. I went back on lithium.
my kidney function is now less than 50%. my high blood pRessuRE is contRolled by BP medication.
I have kidney disease independent of lithium, called "thin basement membRane disease" felt to be a disoRdeR of collagen IV and genetic in oRigin.
foR me, lithium nephRopathy gets confounded with this otheR condition . I have kidney cysts consistent with lithium kidney damage, but i have anotheR pRocess which may lead to kidney failuRe going on. foR me, nephRologists had a knee jeRk tendency towaRd blaming all kidney damage on lithium. One nephRologist staunchly Refused a kidney biopsy, as if my autoimmune condition oR family histoRy of kidney disease could not possibly have caused any of the damage.
If biopsy has not yet been done, you have the option of Requesting this, to insuRe you do not have anotheR, possibly tReatable kidney condition.
Must you be without a medication which has genuinely helped?
when i tapeRed off lithium in 1998 (12 yeaRs afteR staRting it), i got a bone cRushing depRession, as delusional and hoRRid as the 5 episodes which pREceded it. i always was suRE i would lose eveRything and eveRybody, and that i was the lowest chiggeR in the univeRse. i couldnt sleep and lost weight. woRst of all, i was scaRed of eveRyone and eveRYthing, people and places i usually felt comfoRtable in. I went back on lithium.
my kidney function is now less than 50%. my high blood pRessuRE is contRolled by BP medication.
I have kidney disease independent of lithium, called "thin basement membRane disease" felt to be a disoRdeR of collagen IV and genetic in oRigin.
foR me, lithium nephRopathy gets confounded with this otheR condition . I have kidney cysts consistent with lithium kidney damage, but i have anotheR pRocess which may lead to kidney failuRe going on. foR me, nephRologists had a knee jeRk tendency towaRd blaming all kidney damage on lithium. One nephRologist staunchly Refused a kidney biopsy, as if my autoimmune condition oR family histoRy of kidney disease could not possibly have caused any of the damage.
If biopsy has not yet been done, you have the option of Requesting this, to insuRe you do not have anotheR, possibly tReatable kidney condition.
Must you be without a medication which has genuinely helped?
1
Thank your for writing this. I wish I had half your bravery.
4
Thank you for this article. Another in a long series of de-stigmatizing bipolar one would hope. Balancing mental health with physical health is difficult. We decided against lithium for my adopted daughter precisely because of the long-term side effects involved which played out in her biological grandmother. However, the ramping on and off trying to find something that works (and that insurance will pay for) is difficult. I understand that they are doing research with stem cells at the University of Michigan in an effort to pin point the medication that is most effective for each individual. Let's hope there are breakthroughs for this next generation.
4
Thank you so much, Jaime.
My father had bi-polar disorder. After 5 years of constant struggle he finally killed himself.
His body could never tolerate Lithium, so he had to always rely on alternative treatments.
As part of his first 'episode' was confessing his multiple infidelities to my mother - dating back to the years prior to their marriage - they divorced immediately. As I am his oldest son, it was on me to take care of treatments.
What made it really hard was that absolutely NOBODY in our closest circles had NO IDEA WHAT BI-POLAR DISORDER IS.
When seeking help and advice with doctors and hospital staff I often ended up more frustrated and sad for the lack of knowledge and procedures to deal with manic episodes.
To this day, I doubt anyone in our family still understands what happened. My mother (a psychologists) still believes that medication is useless. In talking about it with my brothers (years ago, as this is a topic that rarely comes up) they have made it very clear: no medication and institutionalization.
This is an issue that should have increased public exposure. The more quality information and insight we can all access, the easiest it will be for the next generations that have to deal with this.
Great articles like yours are exactly what we need.
My father had bi-polar disorder. After 5 years of constant struggle he finally killed himself.
His body could never tolerate Lithium, so he had to always rely on alternative treatments.
As part of his first 'episode' was confessing his multiple infidelities to my mother - dating back to the years prior to their marriage - they divorced immediately. As I am his oldest son, it was on me to take care of treatments.
What made it really hard was that absolutely NOBODY in our closest circles had NO IDEA WHAT BI-POLAR DISORDER IS.
When seeking help and advice with doctors and hospital staff I often ended up more frustrated and sad for the lack of knowledge and procedures to deal with manic episodes.
To this day, I doubt anyone in our family still understands what happened. My mother (a psychologists) still believes that medication is useless. In talking about it with my brothers (years ago, as this is a topic that rarely comes up) they have made it very clear: no medication and institutionalization.
This is an issue that should have increased public exposure. The more quality information and insight we can all access, the easiest it will be for the next generations that have to deal with this.
Great articles like yours are exactly what we need.
21
I was wondering if you are familiar with the book, An Unquiet Mind: A memoir of moods and madness by Kay Redfield Jamison. She helped write an important textbook on bipolar illness, but this book is about her own experiences. One of the things I remember describing was how when a person becomes 'stable' on medication, the world becomes a little more gray, especially in comparison to a manic phase when a person experiences the world much more intensely. You see, hear, taste, feel things more directly, with less filtering. So she describes forgetting to take meds now and then, and at some point, begins to believe, "hey, I don't need to take these meds anymore; there is nothing the matter with me," and then it is off to the races. She talks about finding the right psychiatrist who she could trust, who could tell her when she was started to elevate, and because of the trusting relationship, together they could do something to prevent a full blown manic episode.
I think the layman, particularly in the form of family, friends and other loved ones, has difficulty in understanding how someone with a history of bipolar illness would ever stop taking meds. Ms Jamison's words helped me to understand how this could happen. I am wondering if you could comment on this and whether you have someone like that in your life.
Great essay!
I think the layman, particularly in the form of family, friends and other loved ones, has difficulty in understanding how someone with a history of bipolar illness would ever stop taking meds. Ms Jamison's words helped me to understand how this could happen. I am wondering if you could comment on this and whether you have someone like that in your life.
Great essay!
8
Jaime thanks for sharing your own experience of bipolar and lithium with such candor. It's been a lifesaver for so many people, as powerful as this element is, one also needs to acknowledge as you have that it may cause severe side effects. Its ability to maintain the myelin sheathing of the nervous system is one therapeutic aspect that has doctors prescribe it for severe brain damage, as a counterweight to its deleterious effects.
5
Brilliant article. This should be read by everyone who believes that we have complete free will about how we live our lives. We are all neurochemical UNIQUE entities, and each of us experiences thoughts, sensations and emotions the only way we can.
However, the title, using the word believe twice, is a bit misleading, if necessary to pique the reader's interest. Your narrative shows that you repeatedly experimented with taking and abstaining from medication, and those experiments led to a scientific proof of the effect of lithium on your consciousness. There is no proof, one way or the other, of the existence or non-existence of God, or gods, which is why we have belief or non-belief in one or many gods.
Again, a great article. I can't prove the truth of it but I do believe every word of it.
However, the title, using the word believe twice, is a bit misleading, if necessary to pique the reader's interest. Your narrative shows that you repeatedly experimented with taking and abstaining from medication, and those experiments led to a scientific proof of the effect of lithium on your consciousness. There is no proof, one way or the other, of the existence or non-existence of God, or gods, which is why we have belief or non-belief in one or many gods.
Again, a great article. I can't prove the truth of it but I do believe every word of it.
2
If you're stuck between a rock and very hard place, there is no harm in trying prayer to that God you're sure is less powerful than lithium. Just saying.
2
Praying is fine, but it's not going to help mental illness.
6
This article is a gift. I recently reviewed Denice Turner's memoir, Worthy - in it she writes about the pain and mystery of being mothered by a woman with undiagnosed bi-polar disorder. The mother was diagnosed with "fibromyalgia" and blamed as a narcissist. At the time of her death she was on seven psychoactive meds and intravenous morphine. I talked with Denice before I wrote the review and told her I believed her mother had severe bi-polar disorder - as did my mother. Denice said, "I thought that was what was going on." Here is the review: http://knau.org/post/knaus-southwest-book-review-denice-turners-worthy
2
I do believe in God, and I do believe in lithium. For me, that's why humans are who we are. So we can use our God-given talents and drive and the world around us to help relieve suffering in all its forms. Thank you for the honest, thoughtful, and very informational article, Jaime Lowe.
3
What a stunningly fine writer - this piece reads like music.
10
I feel for the author, her struggle with bipolar disorder and the havoc trying to stay aflo has wrought on her system. I wish her the best with her new meds as well as the physical ordeal that may be ahead.
I've recently had to admit (only) to myself (so far) that the dark daemons that have befallen me year in and out without fail since I was a child could not be other than bipolar disorder and after having tried to keep them in check with a long list of SSRIs that were only sporadically helpful, I've been put on Seroquell, which I'm hoping will give me more leeway to cope because I'm on course towards Lithium if they don't...
What I was wondering is if the alternative is less potentially harmful than its ancestor? (Not that I'd stop taking it otherwise as long as it works, and until it harmed me irrevocably. Living without meds is just inconceivable)
Long live the author, and I will look for some follow-up...
I've recently had to admit (only) to myself (so far) that the dark daemons that have befallen me year in and out without fail since I was a child could not be other than bipolar disorder and after having tried to keep them in check with a long list of SSRIs that were only sporadically helpful, I've been put on Seroquell, which I'm hoping will give me more leeway to cope because I'm on course towards Lithium if they don't...
What I was wondering is if the alternative is less potentially harmful than its ancestor? (Not that I'd stop taking it otherwise as long as it works, and until it harmed me irrevocably. Living without meds is just inconceivable)
Long live the author, and I will look for some follow-up...
7
I have been diagnosed with bipolar II for over 11 years, and on lithium for 10 of those years. My one concern with this essay, as well as medical instruction and popular press articles, is that much of the focus is on the mania experienced by those with bipolar disorder. It is recognized that depressive (and mixed) episodes are far more common during the life course of the illness. I find that discussion regarding treatment does not adequately discuss maintenance for bipolar depression and the increased risk of suicide when moving from a (hypo)manic to a depressive episode.
A significant number of people eventually diagnosed with bipolar spectrum disorders initially present with depression, not mania. Overlooking a complete mood disorders assessment is very common, and can have disastrous consequences when antidepressants are prescribed, as I personally experienced. I would like to see more widespread discussion of depression in the context of bipolar disorder. The image of bipolar disorder=mania that has persisted in the common media (and within medicine) continues to do a disservice to those who wish to successfully manage their illness.
A significant number of people eventually diagnosed with bipolar spectrum disorders initially present with depression, not mania. Overlooking a complete mood disorders assessment is very common, and can have disastrous consequences when antidepressants are prescribed, as I personally experienced. I would like to see more widespread discussion of depression in the context of bipolar disorder. The image of bipolar disorder=mania that has persisted in the common media (and within medicine) continues to do a disservice to those who wish to successfully manage their illness.
25
The ONLY medication combination that lifted my treatment-resistant bipolar depression was lithium and the often-maligned MAOI (monoamine oxidase inhibitor) Parnate/tranylcypromine. If you do research you will find small-but-convincing studies done in the 1970's. This combination has been called the "last resort" for bipolar depression. I tried over twenty meds until this incredible duo eradicated my debilitating bipolar depression. The MAOI dietary restrictions have been totally worth it!
5
EXactly my reaction, as I also have had bipolar 11 for 30 years. As in any illness there are so many variations from "typical.' Blpolar does imply a shift from manic, or "hypomanic,"--much more subtle than described here--to (often devastating ) Depression. I believe the less "typical" the illness is, the more difficult to treat. Lithium, along with the other drugs mentioned here did not work for me, though I definitely have a form of bipolar illness. ECT, and finally the right drug, and wonderful therapy, plus correct diagnosis by a psychiatrist helped to modify my symptoms. Plus, much good luck, including education and ability to afford all this help. Medication: there is no worse side effect than not trying any treatment that might help: the common side effect of suicide, or for certain highly increased likelihood of heart and other diseases from the stress of mental illness.
5
I know!
When mania blooms, there's often little incentive to keep it in check, as it feels like a well-deserved vacation from its literal downside, the "negative" pole.
For me, bi-polar is a misnomer as there are more than two stages in the cycle: there's the initial upward swing from depression (before the electric surge of uncontrolled urges becomes overwhelming) when life finally seems to be worth living, which is different from the next stage that feels (esp. in retrospect) like an altered state induced by psychedelic and stimulant drugs. There is also another phase in the mix that doesn't feel like depression, but rather an unfeeling state wherein I exist separately from the world (and to a certain extent, myself).
And the actual depressed state? As I continue to tumble downwards (like Alice in Wonderland) I know what awaits me but can't for the life of me do anything to change the course of things.
As it happens, my new psychiatrist has me rating my feelings twice daily to better assess my condition and so be better prepared for the changes... (Though with the new meds I am beginning to think I'm beyond the reach of the darkness now, invincible-like ;-) )
When mania blooms, there's often little incentive to keep it in check, as it feels like a well-deserved vacation from its literal downside, the "negative" pole.
For me, bi-polar is a misnomer as there are more than two stages in the cycle: there's the initial upward swing from depression (before the electric surge of uncontrolled urges becomes overwhelming) when life finally seems to be worth living, which is different from the next stage that feels (esp. in retrospect) like an altered state induced by psychedelic and stimulant drugs. There is also another phase in the mix that doesn't feel like depression, but rather an unfeeling state wherein I exist separately from the world (and to a certain extent, myself).
And the actual depressed state? As I continue to tumble downwards (like Alice in Wonderland) I know what awaits me but can't for the life of me do anything to change the course of things.
As it happens, my new psychiatrist has me rating my feelings twice daily to better assess my condition and so be better prepared for the changes... (Though with the new meds I am beginning to think I'm beyond the reach of the darkness now, invincible-like ;-) )
2
Much of your experience I share. 30 years on lithium. One suggestion to others. For me, manic episodes begin with tell-tale body changes, most notably, the decreased need for sleep you refer to. Also, I find myself with an outsized opinion of all my best qualities. After 30 years, it takes about one day to sense the mania coming on. I immediately focus on getting 8 hours sleep, stop my antidepressant, take tranquilizers as needed and, in this way, support the calming influence of lithium. I have nipped a number of manic episodes in the bud in this way. And have not spiraled out of control for a decade. My mantra is that self awareness is the best therapy out there. Of course, we are all different. But, in my case, the lithium sometimes needs a helping hand. And I find that in such instances, an ounce of prevention is worth a pound of cure.
25
"Some people who take lithium feel robbed of their natural personality"
I'd like to hear more from you regarding what you feel is 'natural personality'. it's an inquiry i have been making a long time through Buddhist and nondual paths.
and i hope the Times will keep publishing your honest and fearless handling of your life.
I'd like to hear more from you regarding what you feel is 'natural personality'. it's an inquiry i have been making a long time through Buddhist and nondual paths.
and i hope the Times will keep publishing your honest and fearless handling of your life.
3
Jaime, Your fluid, gorgeous, engaging, facile, eloquent, evocative writing style richly saturated with your sensory experience is lush and immensely pleasurable. From whence does that come? Does it ebb and flow with your 'moments' of 'flight'? Is it intertwined with your mood swings? Living in Brooklyn is a never to be fulfilled dream of mine yet you are there and extremely successful, in part, as a result of your emotional 'fluidity'. Wow! How could you give that up? Sid
1
I recall discussing the problem of lithium side effects with a psychiatrist who found some success in lowering dosages by combining it with a slow release benzodiazepine. However, given the elevated percentage of manic patients who have a history of self-medication with alcohol, most physicians are understandably wary of prescribing the benzo mix.
4
Thank you for your article - many similar experiences here, and you described yours beautifully. I also had long-term success with lithium (18 yrs) and eventual kidney problems. I tried Depakote for 2 years and felt fairly dead inside, so then switched to Tegretol and then Trileptal with more success. I wish you all the best in your switch, and hope you continue to write about your experience. Many people will be helped by it.
6
"Fieve says that lithium hasn’t been extensively tested as a treatment for other conditions in part because it’s a natural substance: Elements on the periodic table can’t be patented. Pharmaceutical companies therefore have little incentive to promote lithium or develop other uses for it, despite its potential."
Sounds like a devastating indictment of how we develop drugs, doesn't it? Maybe the capitalist model doesn't work so well for drug development, where scientific cooperation, not competition should be the order of the day.
Cannabis can't be patented either, with devastating consequences for its legal status and the lives of those who could have benefitted from it, but instead suffered and continue to suffer needlessly.
Sounds like a devastating indictment of how we develop drugs, doesn't it? Maybe the capitalist model doesn't work so well for drug development, where scientific cooperation, not competition should be the order of the day.
Cannabis can't be patented either, with devastating consequences for its legal status and the lives of those who could have benefitted from it, but instead suffered and continue to suffer needlessly.
10
Go Jamie!!
Beautifully said. You are a fierce, brave woman!
Beautifully said. You are a fierce, brave woman!
4
Stay medicated ,folks.....do as your told......
3
I had a sister who was diagnosed with bi-polar. Unfortunately she passed away many years ago. Thank you for the article on what's it's like to suffer from bipolar.
3
Can you make the videos public? No one ever sees what untreated serious mental illness looks like. All public service announcements and PR efforts by mental health industry are designed to hide people speaking psychotic-fueled thoughts from public for fear of causing 'stigma.'. But it is important for public to understand what untreated serious mental illness really looks like. Please make tapes public. Thanks for great article. Good luck with transition to Depakote
6
Interesting topic. My mother is bipolar and has been untreated most of her life, except when she's had a few suicidal and sleepless manic episodes that take her many months to recover from. We did not realize that she was bipolar, and when diagnosed and treated she would not recognize it. I can understand much of what you write about. However, I also see how her strong Christian faith in God has influenced and protected her from many destructive behaviors. Substance abuse, sexual immorality and infidelity to my father were not an option for her, since to do so would have meant disobeying God (although her typical destructive interpersonal interactions were hardly a model of Christian behavior, I think the others were more definable behaviors to obey). She and my father have been married 54 years, somewhat a miracle in itself, and also very much a result of my father's faithfulness to her and to God. I also saw how her faith gave her hope even when she despaired that God had abandoned her. Her faith also gave her remarkable joy and and amazingly allowed her to teach us moral truth and the value of faith in God, even when her own life at times was a crazy and reckless wreck. I'm not a psychiatrist, but I have observed up close through many years, trials, and episodes how a belief in God has influenced and seemingly provided her with a source of strength, or purpose, or hope, and/or encouragement and/or a lifeline even in her darkest hours. Maybe that was God himself.
4
Wonderful piece, beautifully written. My wishes to you for a long life and your continued contributions. I was struck by the second to last paragraph: you may have connected the ancientness of lithium as primordial dust in the earth's atmosphere with the possible lack of it in your body as causing the bi-polar condition. Maybe some people need the lithium because they have more primordial body chemistries. I hope modern medicine will find a substitute for you.
2
What a remarkable and intense piece of writing, Jamie. May you arrive at a stable new medical regimen.
21
Jaime, this is a fantastic story. I hope you may find your way with your new medication.
3
Hi Jamie, I have two questions. The first question would be, what's a good thesis statement for Bipolar Disorder since you've mentioned that you had experienced it for 20 years? And the last would be, Why you don't believe In God? I know that these two questions might be irrelevant, but I would just like to know abut your opinion or point of view to it. Thanks in advance!
3
Fear not Jaime, there are lots of meds these days helpful for treatment of bi-polar disorder. Many of which are easier on the bod than Lithium. Keep looking till you find the right one(s). Many haven't gotten as far as you have, not even able to see they have this condition. Watch your mind and body, figure out some ways you can help the meds. Thanks for the great sharing!
3
NUPLAZID made by Acadia pharma in San Diego will be submitted for New drug application to the FDA this year and approved for treating Parkinson psychosis first, then Alzheimers, Bi Polar and Schizophrenia. The only drug to be approved in CNS space in the last 20 years and NO SIDEFFECTS which is unheard of...hope this help...wish you all the best....
ps..at the end everything always works out....
ps..at the end everything always works out....
5
This piece really moved me. My sister, Laura, who took her own life in August 2008, was sometimes diagnosed as being bipolar, when she was not diagnosed as having PSTD, schizophrenia or being a mystic and I experienced much of what Jaime describes with Laura, although I was on the "sane" side of the glass.
I recently had an argument with a medical student "Facebook friend" because she posted, unethically in my humble opinion, videos of two people suffering from mental illness on her page. I felt it was totally lacking in compassion because it seemed to me she was making fun of the mentally ill.
What I is so important about this piece is how humbly and objectively Jaime describes her Lithium self with her non-Lithium self. And that it opens a window on this scary mental illness for those who do not have it.
I am so sorry that the one thing that has kept Jaime stable all these years is also damaging her physical body and I hope that the new medicine is as helpful as Lithium has been.
I hope that the people who read this piece will come away with a sense of compassion and deeper understanding for those suffering from bipolar disorder and other similar mental illnesses.
Good luck to Jaime.
I recently had an argument with a medical student "Facebook friend" because she posted, unethically in my humble opinion, videos of two people suffering from mental illness on her page. I felt it was totally lacking in compassion because it seemed to me she was making fun of the mentally ill.
What I is so important about this piece is how humbly and objectively Jaime describes her Lithium self with her non-Lithium self. And that it opens a window on this scary mental illness for those who do not have it.
I am so sorry that the one thing that has kept Jaime stable all these years is also damaging her physical body and I hope that the new medicine is as helpful as Lithium has been.
I hope that the people who read this piece will come away with a sense of compassion and deeper understanding for those suffering from bipolar disorder and other similar mental illnesses.
Good luck to Jaime.
30
After a decade of abusing drugs and alcohol, especially cocaine to medicate my deep depression, I got sober and was diagnosed as bi-polar and was put on lithium. I felt that I had been licking the floor of hell, but now my mood stabilized, I thrived at work. But I felt lethargic and gained 30 pounds. Luckily, I switched to Prozac and would make my way to a cocktail of Effexor, abilify and lamogrine, which I've been taking daily for years. I'm now living my dream life.--married with children, own my own business and I have a large network of friends.
For some reason I was created without the elements that aided my sanity like most people.. Now, I just take psychotropic supplements and can live my life fully.
Thank you, Jamie, for your article. Anti-depressants are our psychological dialysis.
For some reason I was created without the elements that aided my sanity like most people.. Now, I just take psychotropic supplements and can live my life fully.
Thank you, Jamie, for your article. Anti-depressants are our psychological dialysis.
12
Diagnosis & treatment of Bipolar Disorder is a major challenge. Our understanding of Bipolar has evolved a lot over the years.
Many Bipolars several doctors over several years prior to receiving a correct diagnosis. Most spend a lot more time in a depressed state than they do being manic. When having a depressive episode, they usually can't be distinguished from a case of unipolar depression. But their response to treatment varies greatly. Bipolar I patients have both episodes of depression & full blown manic episodes like Jamie; mania often requires hospitalization & can include psychotic symptoms such as her grandiose delusions. Bioplar II patients also have depression, interspersed with (often brief) episodes of hypomania- similar to full blown mania, but much milder- no psychotic symptoms, usually not requiring hospitalization, & often difficult to recognize as hypomania without getting history from family members.
Before a Bipolar is properly diagnosed, they'll likely be prescribed an antidepressant. These can cause a "switch" into mania for about 25% of them. Lithium, Depakote, & Tegretol are better at preventing mania than depression; Lamictal (the only mood stabilizer which doesn't cause weight gain or need blood tests) is better at stopping depression. Most Bipolars need more than one medication. Many do well on "Atypical" neuroleptics (e.g., Risperidone, Olanzapine, Aripiprazole). Some still need an antidepressant. A medication regimen must be individualized.
Many Bipolars several doctors over several years prior to receiving a correct diagnosis. Most spend a lot more time in a depressed state than they do being manic. When having a depressive episode, they usually can't be distinguished from a case of unipolar depression. But their response to treatment varies greatly. Bipolar I patients have both episodes of depression & full blown manic episodes like Jamie; mania often requires hospitalization & can include psychotic symptoms such as her grandiose delusions. Bioplar II patients also have depression, interspersed with (often brief) episodes of hypomania- similar to full blown mania, but much milder- no psychotic symptoms, usually not requiring hospitalization, & often difficult to recognize as hypomania without getting history from family members.
Before a Bipolar is properly diagnosed, they'll likely be prescribed an antidepressant. These can cause a "switch" into mania for about 25% of them. Lithium, Depakote, & Tegretol are better at preventing mania than depression; Lamictal (the only mood stabilizer which doesn't cause weight gain or need blood tests) is better at stopping depression. Most Bipolars need more than one medication. Many do well on "Atypical" neuroleptics (e.g., Risperidone, Olanzapine, Aripiprazole). Some still need an antidepressant. A medication regimen must be individualized.
11
Please don't refer to those afflicted with the illness as "Bipolars". It is very insulting. Would you refer to people diagnoses with cancer as "cancers"? Our illness does not define us. Clearly you are well versed in the illness Dr, but I would recommend that you get some CMEs in sensitivity training as well.
2
Thank you for this brief explanation. I am Bipolar II and my experience was much like you describe. It is important for people to know that it takes experimentation to not only find the best medication/s for a particular patient, but also the proper dose of each medication. It is a cocktail of meds that finally worked for me. It took well over a year to get it dialed in correctly. People need to work with a good psychiatrist who understands this process, has significant knowledge of each drug and drug interaction, and can successfully combine drug therapy with talk therapy. It is worth the effort even though a patient may continue to suffer through this process of discovery. I have the highest respect for patients and psychiatrists who have the strength and patience to fight their way through this process together. One last thing....a reminder is in order here for those who forget and for those who don't realize this truth: Bipolars are people with a disease. It is not a failing of character on our part that we struggle with this disease. We are not nuts. We are human beings with an illness.
17
Dr. B - It is very insensitive and dehumanizing to refer to patients with Bipolar Disorder as "Bipolars". Would you refer to patients with a diagnosis of cancer as "Cancers"? Our illness does not define us.
4
terrific piece!
4
Lack of sleep can trigger mania in bipolar persons. ONe patient who had been symptom free without any treatment for 14 years became manic because of a pinched nerve in his neck so he couldn't sleep because of pain.
Two other patients who were taking lithium and were well controlled, became manic when they couldn't sleep. One because of prostatic enlargement which meant he had to urinate every hour and one because of central diabetes insipidus which meant he had to urinate every hour. So anyone who has ever had the diagnosis of Bipolar Disorder should try very hard to manage their sleep patterns and be sure to tell your doctor if sleep patterns change.
Two other patients who were taking lithium and were well controlled, became manic when they couldn't sleep. One because of prostatic enlargement which meant he had to urinate every hour and one because of central diabetes insipidus which meant he had to urinate every hour. So anyone who has ever had the diagnosis of Bipolar Disorder should try very hard to manage their sleep patterns and be sure to tell your doctor if sleep patterns change.
15
Jamie, this is a gorgeous piece of writing - graceful, emotive, impactful - and I'm so glad you're here sharing it with us. I do hope you and your physicians determine a course of action that continues to support you in the way you need, and I very much hope that you continue to share your journey with us.
A question: I have a friend, who lives very far from me, who is recently diagnosed as bipolar, but as far as I can determine, she is not following any medical protocol. There could be a lot of reasons for that, but I'm not in a position to do more than encourage her to get assistance, that there's no stigma attached to this (no one judges the diabetic who needs insulin to be healthy!), and assure her that I'm not "sick of her and her mood swings" (her words, not mine). She's an extremely talented artist, and among other fears, I think she's concerned she'll lose her connection with the art. She's currently in what I consider a serious downturn...and I guess I want to know if you have any advice about what more I might do for her, when we're limited to email exchanges.
Sorry for the length of this, but your beautiful article touched me deeply personally, and also had me thinking of my friend as well. Thank you again, and the best of everything to you.
A question: I have a friend, who lives very far from me, who is recently diagnosed as bipolar, but as far as I can determine, she is not following any medical protocol. There could be a lot of reasons for that, but I'm not in a position to do more than encourage her to get assistance, that there's no stigma attached to this (no one judges the diabetic who needs insulin to be healthy!), and assure her that I'm not "sick of her and her mood swings" (her words, not mine). She's an extremely talented artist, and among other fears, I think she's concerned she'll lose her connection with the art. She's currently in what I consider a serious downturn...and I guess I want to know if you have any advice about what more I might do for her, when we're limited to email exchanges.
Sorry for the length of this, but your beautiful article touched me deeply personally, and also had me thinking of my friend as well. Thank you again, and the best of everything to you.
16
You can start by contacting NAMI: National Alliance on Mental Illness to get a more complete understanding of Bipolar Disorder. They can help you locate a good psychiatrist/s in your friend's community. Assure her that other people who make a career in creative services (like me) function quite well on medication for Bipolar Disorder. If you have never experienced it a manic episode feels intensely creative. It's like no recreational drug because it is so intense and yet you feel completely sober. But the truth is that being in equilibrium does not diminish the creativity. It just doesn't feel as mind-blowing as it does when having a manic episode. That you are more creative when manic is a myth in my experience. It doesn't change, it just presents itself more quietly. It's hard to describe. Even at my most balanced times great ideas flow freely out of my brain. Please forgive my immodesty here. But it was very reassuring when I figured this out. The Effexor did not diminish my capacity for creativity, originality, or wit. But it did diminish the anxiety of others when I wasn't bouncing off the walls like a golf ball hit by Tiger Woods.
1
Thank you, Mr. M - the additional challenge is that she resides in a country that is not very open to issues of mental illness, but your comments are quite appreciated. Continued best wishes to you.
You have taken me on an unbelievable journey. If there weren't photos, I might think it amazingly written fantasy.
What stands out besides the obvious unknown of your next journey is The Brain, yours in particular. It is brilliant and imaginative and destructive and
uncontrollable. It is an organ so unknown to most of us who have ours pretty much under control.
I hope for a photo essay about the amazing lithium fields in Bolivia.
I hope that you keep writing as beautifully as this is written.
And of course I hope that you will transition to a drug that will not kill you.
You have so much to say.
What stands out besides the obvious unknown of your next journey is The Brain, yours in particular. It is brilliant and imaginative and destructive and
uncontrollable. It is an organ so unknown to most of us who have ours pretty much under control.
I hope for a photo essay about the amazing lithium fields in Bolivia.
I hope that you keep writing as beautifully as this is written.
And of course I hope that you will transition to a drug that will not kill you.
You have so much to say.
18
Beautiful, beautiful writing. Thank you for sharing your story. Just a thought, but maybe it would help to believe in God too. He's looking out for you.
3
Yes. Even when a bipolar finds and follows the optimal pharmaceutical regimen, and therapist...they only arrive at the same starting line as the rest of "sane" society. The difficutlt and creative work of living a fruitful life lies ahead. The NYT recently ran an article arguing that scientists ought not be obliged to prove their worldviews, yet secularists mock people of faith because they "cannot prove" their worldviews. She she knows the truth, it will set her free.
I want to echo others in saying this piece deserved better placement. I have several family members with severe mental health issues and I saw the piece early, but shied away from reading it--the topic is so often just too painful. It was a beautiful piece, not without pain, but not hopeless.
29
Good for you for not avoiding this painful topic. My mother did this for years. She finally decided to educate herself about my illness and became the president of her local chapter of NAMI last year. Her understanding, compassion, and support has helped me almost as much as my meds!
10
If there was a god there wouldn't be Bipolar Disorder. Or look at it this way. If god created Bipolar Disorder one has to ask why. It would mean that he/she/it is cruel and not to be trusted.
2
I was diagnosed 9 years ago at age 39, was hospitalized 27 times over a 5 year period (in LA), had 52 ECT treatments (at UCLA because I was considered treatment resistant after a 4th suicide attempt), have been on every bipolar med (none of which helped) and have been relatively stable now for 3 years w no meds. For me, it's been a process of recognizing my mania even before other people do. I see it more clearly a few days later and then really see it for what it was a few weeks after that. I started believing in God at Cedars after my second hospitalization because I needed to. I was on lithium.
2
It is of no consequence to God whether one believes in Him or not because God is Omnipotent.
Jaime, Can you talk to parents of children who think, talk and behave very differently than typical kids? Unlike children who develop typically and for whom love and standard nurturing works well, these kids demand parents make choices about their care that have profound and long-lasting effects. And it is scary. And it feels like playing god.
Do we take a stand to love and accept our kids as they are and demand the world accommodates them? Force them to them conform? Do we curbing their obsessive interests? Medicate them? How much should we police who they befriend? Do we tell them that they are different? Do we tell them their diagnosis? Thanks for your insights on behalf of those of us parenting bipolar kids, spectrum kids, anxious kids, obsessive-compulsive kids, oppositional defiant kids, kids with attentional issues, gender questioning kids and similar.
Do we take a stand to love and accept our kids as they are and demand the world accommodates them? Force them to them conform? Do we curbing their obsessive interests? Medicate them? How much should we police who they befriend? Do we tell them that they are different? Do we tell them their diagnosis? Thanks for your insights on behalf of those of us parenting bipolar kids, spectrum kids, anxious kids, obsessive-compulsive kids, oppositional defiant kids, kids with attentional issues, gender questioning kids and similar.
2
I have had pretty good results with lamotrigine and Quetiapine for the past 14 years, but I still have manic episodes when my life becomes to stressful. I have learned to recognize the mania gearing up and I increase the quetiapine in small doses to return to normal. It can take as long as three weeks. I have to live a quiet life, which is sometimes hard to do. I have had quite a bit of weight gain. It took almost a year of trying different meds and dosages to find a good balance. I had too many side effects with the other drugs. Thank you Jaime for your brave and honest writing.
5
How come you are an atheist, Ms. Lowe?
Isn't the title of this article implying that, for you, lithium is your God, and now you are being forced to give up your religion?
Science, which you love, is the empirical study of the natural world. It should not, and does not have anything to say about transcendental beliefs because they are not provable, or disprovable by its methods. Any scientist who says otherwise, has left the safety of his field, and is no longer acting in the his capacity as a scientist. He is giving us his opinion. Religious beliefs are not in science's domain, and are an entirely different part of the human experience. Only materialists, rationalists and humanists believe that having no higher beliefs is a good thing. Everybody else knows better.
7
Jaime, Mr. Little, above, attempts to name off all categories of nonbelievers and mistakenly imagines a vast, like-minded "everybody" that "know better" in their belief in a god. In his comment about your relationship to the lithium that has kept your brain stable, he assumes that something deeply appreciated rises to the level of deity. He is dismissive of the millions of people, scientists and non-scientists alike, whose meaningful, loving, gracious, and giving lives contribute to the societies in which they live. Thank you, Jaime for the intensely reflective and honest piece you have written for us. Also, thank you to all the scientists – with or without religious beliefs -- who are searching for the causes, treatments, and cures for debilitating brain conditions.
Jaime, I transitioned to Depokote from Lithium several years ago, also due to kidney damage. I was terrified, but my health has been stable and I lead a full professional and personal life. I wish you the best. Your writing is brilliant.
22
Jaime, my daughter is 21. She has been on lithium for two years. She had several bouts of mania during the spring of her junior year in college. Her mania was much like yours, with psychosis, and she believed her brother and I were trying to kill her. She agreed to go into the hospital and I took her to an ER that I discovered after 7 hours only took voluntary admits, and at hour 8 they let her run out of the hospital, which she first tried to do in her gown.
I am happy to report that she is stable and was able to return to school. But she needed to add a second medication for depression (Latuda). I know she is at high risk of suicide and she still drinks socially--like a "normal" college student.
My fear, well, I can't even name them all, is that she, too, will suffer kidney damage and have to go off lithium.
Since you are willing to answer questions -- and THANK YOU -- one is was there anything you could have done to lessen the kidney damage and did you have any idea it was happening (my daughter is on 90 lithium, 40 latuda daily)? And secondly, why didn't they try you on Lamictal instead of Depakote?
Finally, I am so grateful for your story. It's reassuring yet frightening at the same time. Wishing you every possible good wish as you switch medications.
I am happy to report that she is stable and was able to return to school. But she needed to add a second medication for depression (Latuda). I know she is at high risk of suicide and she still drinks socially--like a "normal" college student.
My fear, well, I can't even name them all, is that she, too, will suffer kidney damage and have to go off lithium.
Since you are willing to answer questions -- and THANK YOU -- one is was there anything you could have done to lessen the kidney damage and did you have any idea it was happening (my daughter is on 90 lithium, 40 latuda daily)? And secondly, why didn't they try you on Lamictal instead of Depakote?
Finally, I am so grateful for your story. It's reassuring yet frightening at the same time. Wishing you every possible good wish as you switch medications.
9
I am on lithium but it is a low dose so hopefully I will avoid the kidney problems you have. I agree it helps immensely, but I went on and off several times and was fine for a while but after a year or so each time, I suffered and I had to be hospitalized and/or put back on pills. So far I have been on for last 8 years.
2
Good luck to you. Please write again to tell us you do on the new drug.
6
Great article. The history of lithium research, and the search for alternatives that don't cause the kidney problems after long use are fascinating and critical for current and future treatment.
Any suggestions for potential 'Mikes' out here? How to be in a relationship with a person who is bi-polar - or how to be a friend without being in a relationship? Some people say to back off completely. Fools step in where angels fear to tread. What to do when a person is so utterly fascinating and, well - cool?
Wonderful writing and powerful photography- Thanks.
Any suggestions for potential 'Mikes' out here? How to be in a relationship with a person who is bi-polar - or how to be a friend without being in a relationship? Some people say to back off completely. Fools step in where angels fear to tread. What to do when a person is so utterly fascinating and, well - cool?
Wonderful writing and powerful photography- Thanks.
4
Informed by stern doctor that I was "manic depressive" at 21. I was put on Lithium and remained on for almost 35 years without incident, recently switching to less side effect Depakote, due to potential, but non-detected organ damage. Intent here was to convey bipolar experience. The "breakdown" evolution began as what could best be described as a vague, but very real sensation that somebody was planning a big surprise party for me, but I had to pretend that I wasn't aware of it. Rapidly, over the course of two days I was secretly seeking clues to explain this sudden blast of attention. Somehow, through coincidence or reality, I found no problem finding my life experiences validated on TV, through song lyrics, colors and even strangers on the street. Their body language provided reassurance and approval telling me that yes, the focus was on me -- if anyone was up for the role I had been secretly cast for--it was me. I had to laugh and sometimes cry at how everyone "behind the scenes" was getting it all so right. It was overwhelming. It was actually very tragic and sad. I was experiencing a textbook, Bipolar One break. It was an unforgettable life experience beyond any drug trip. I can relate to all that this writer has detailed. They had to fight me down too, but life didn't. Thank you for this article Jaime Lowe.
13
Whoa! What is happening here? It's one thing to have duffers making prescriptions for the bi-polar but there is more than one supposed medical doctor here in the comments making diagnoses and offering up prescriptions for treatment. I have never seen a doctor make a diagnosis after reading a newspaper account (first hand or not) of any medical illness. Nor have I seen doctors give prescription advice in newspapers. That said I don't know if I've ever seen any article in any publication received with such rave reviews. "Captivating"! "Fascinating"! "Bravest thing I've ever seen"! "One of the best articles I've ever read"! "Can't wait to read more from you about yourself"! I found it rather hammy and self-glamorizing -- perhaps like a bi-polar person might translate their self-aggrandizing attention-seeking when on medication? The lithium information was interesting. Personally I would have preferred it having been written up by either an expert in the field of psychiatry or someone with expertise in medical science and/or it's history. It's nice to see those who dedicate themselves to important fields like medicine or science given the spotlight and being invited to share their expertise with readers. Not that I don't feel sorry for Jaime, because I do. I just find this emphasis on personal stories (there are more!) sort of low-brow for a Special Mental Health Issue in The New York Times.
6
Keep writing whatever you decide to do.
3
Thanks so much for this piece, not least because of it's title. Saying 'I don't believe in god' is still largely tabu in our society.
3
Fascinating. The need to stay on medication, whatever one or combination works to maintain stability for one who has bipolar disorder, is paramount, even when you are feeling fine and stable. That means it's working. But I question why you didn't know until so late how serious your kidney condition was. I thought it was established medical practice to do routine liver and kidney function testing on patients taking lithium and any meds susceptible to liver or kidney damage. It seems that a medication change earlier might have averted this health crisis. Lithium isn't the only known and satisfactory medication to control bipolar symptoms. I have never taken it and haven't had a major manic or depressive episode in years. My manic episodes were epic. I have periodic blood tests to check functioning at all levels. I don't drink alcohol or take any other drugs of any kind.
2
I was on Lithium for about 4 years, and began to feel paradoxical effects after 3 1/2 years — what physicians call augmentation, the symptoms it is supposed to alleviate worsened. Fortunately, it was later discovered my "disorder" was more aligned with alcohol-induced dementia, but the "bipolar happy" psychiatrists who treated me figured because I was homeless and psychotic (after drinking 4 gallons of scotch in 3 weeks, who wouldn't be? Duh. They never asked how much I drank!! Obviously, here was only one possibility open to them. (Not all of them though shared the same opinion — two Scottish psychiatrists said I seemed to be "literary, vain, and rather fatuous", but not bipolar.) So there!
After 2 1/2 years of continuous sobriety, stopping smoking, elimination of sugar and binge eating (more difficult than staying away from alcohol and tobacco together!) virtually all episodes of any kind ceased, manic, hypomanic, hypermanic - probably because that really wasn't the problem. I am now sober 9 years, take nothing but homeopathics for allergies and foot pain. Maybe my feet were bipolar. I just think some doctors are sometimes so anxious to get America medicated that bipolar can be stretched and squeezed to fit every creature large and small. It's like the spandex of psychiatry.
So there are no "one size fits all" diagnoses, certainly.
After 2 1/2 years of continuous sobriety, stopping smoking, elimination of sugar and binge eating (more difficult than staying away from alcohol and tobacco together!) virtually all episodes of any kind ceased, manic, hypomanic, hypermanic - probably because that really wasn't the problem. I am now sober 9 years, take nothing but homeopathics for allergies and foot pain. Maybe my feet were bipolar. I just think some doctors are sometimes so anxious to get America medicated that bipolar can be stretched and squeezed to fit every creature large and small. It's like the spandex of psychiatry.
So there are no "one size fits all" diagnoses, certainly.
5
From what I know, most lithium prescribed is not actually real lithium, it is synthetic, so chances are that the author isn't ingesting a natural product from Bolivia or anywhere else besides a factory.
3
Lithium is an element. As the author describes in the article, it's element #3 in the periodic table. You can't synthesize it, except with a nuclear reaction, like that inside stars. That said, the lithium that you ingest (lithium carbonate) is a salt of lithium. Yes, it is synthesized - from lithium salts harvested in the Nevada mine that Jaime believes her lithium came from, or high on a South American plain. The chemistry is pretty simple.
2
I am sorry my friend, you are mistaken. Lithium is a chemical element. It cannot be produced "synthetically" (well, outside of certain high-energy physical processes occurring at the Big Bang or perhaps in the heart of stars etc.). Mining and isolating whatever lithium is found naturally on earth is the only way to obtain it.
1
Awesome piece. Your vivid, layered explanation is at once an academic essay and a concise narrative with a twist.
Be certain that I'll seek out anything else you've written!
Thank you.
Be certain that I'll seek out anything else you've written!
Thank you.
4
The article ended too soon for me - I wanted to read more. Thank you!
The terrible stigma around mental health issues arises when people very mistakenly believe everyone's thoughts and emotions work basically like their own. NO THEY DON'T! This belief is not only mistaken but toxic. (Similar assumptions are too often made in matters of race.)
Our brains are so incredibly complex in so many ways - genetically, biochemically, endless possibilities for differing synapses, etc - that it's profoundly naïve to think any two humans have identical emotional wherewithal, any more than they have identical fingerprints.
People without any mental health issues - 'normal' people, or neurotypicals, as some say - naturally have little idea of how unrealistic feelings can simply overcome a vulnerable person. An article like this is a wonderful opportunity for others to gain insight into mentally disturbed experiences. I hope they will realize the people suffering with these have NO power to "just snap out of it." In fact, this is one of the cruelest things anyone can say to someone struggling with a mental health issue.
The terrible stigma around mental health issues arises when people very mistakenly believe everyone's thoughts and emotions work basically like their own. NO THEY DON'T! This belief is not only mistaken but toxic. (Similar assumptions are too often made in matters of race.)
Our brains are so incredibly complex in so many ways - genetically, biochemically, endless possibilities for differing synapses, etc - that it's profoundly naïve to think any two humans have identical emotional wherewithal, any more than they have identical fingerprints.
People without any mental health issues - 'normal' people, or neurotypicals, as some say - naturally have little idea of how unrealistic feelings can simply overcome a vulnerable person. An article like this is a wonderful opportunity for others to gain insight into mentally disturbed experiences. I hope they will realize the people suffering with these have NO power to "just snap out of it." In fact, this is one of the cruelest things anyone can say to someone struggling with a mental health issue.
4
Please check out depakote. The drug company originally sent out a notice indicating that it had not been used for chronic administration. My brother had been treated with lithium for many years and developed kidney problems. He was switched to depakote and suffered brain damage. Whether cause or effect of other factors I do not know. Depakote enhances inhibitory processes in the brain (a GABA agonist) and thereby decreases neural activity, which is good for seizures, its original use. Please check it out further.
2
The descriptions here of bipolar disorder and psychiatric interventions with lithium and other medications are vivid, accurate and compelling as is the writing that is a true mirror of the symptoms and treatment of those afflicted by this disorder. However, often in this discussion and like forums, it’s not about just those diagnosed. It’s also as much - or even more - about those who care for the family members, friends and colleagues diagnosed with bipolar disorder. As many have said, and is very true, those who live close to others with the disorder also need to take good care, seek wise counsel, and make informed decisions about their own lives.
2
Dear Jaime, I was so very moved by your wonderful article and would like to know if you could please read my own comment and tell me if you can relate to it some way -- if it makes any sense to you. Thanks again for your article.
1
Your writing is brilliantly poetic.
I'd love to see some images of you dressed as you describe....wow!
I'd love to see some images of you dressed as you describe....wow!
22
This is an incredible piece. I share the sentiment that it should have been more prominently featured in the Times. It transcends the usual; it is art.
Whatever happens, keep writing. I hope you're published here again.
Thank you.
Whatever happens, keep writing. I hope you're published here again.
Thank you.
25
So you're telling me that me knowing when I'm going to die, knowing when the universe is going to end and obsessing over thermodynamics are all symptoms of my bipolar?
I wasn't in quite as restrictive a mental hospital as you were but it also didn't help me very much.I was prescribed abilify and Zoloft, in my opinion the two worst drugs I've ever taken. They're just bad and they made me worse.
Thanks for sharing, this is a very good article and though I don't think my bipolar is quite as bad as yours I feel like I can understand. Have a great day
I wasn't in quite as restrictive a mental hospital as you were but it also didn't help me very much.I was prescribed abilify and Zoloft, in my opinion the two worst drugs I've ever taken. They're just bad and they made me worse.
Thanks for sharing, this is a very good article and though I don't think my bipolar is quite as bad as yours I feel like I can understand. Have a great day
6
I am not your psychiatrist, of course, but Abilify and Zoloft strike me as a very odd regimen for treating bipolar disorder. Zoloft is an antidepressant, usually avoided in bipolar because of the risk of triggering mania. There is no mood stabilizer, the usual first line treatment.
All in all, odd. Are you sure your diagnosis is bipolar disorder?
All in all, odd. Are you sure your diagnosis is bipolar disorder?
Seems like one could believe in both God and Lithium.
11
Maybe, but for some people on of those beliefs would constitute a delusion.
3
One could. I don't believe the author suggested otherwise. She was speaking of her own experience and beliefs. You are free to believe in both.
1
Unless not believing in God is the delusion. Isn't that the crux of the matter? It may be the very reason we are here, and what our lives are about, day by day, moment by moment. What I have just said may not make any sense to you though.
Based on things she told me about her early marriage, my mother was at least psychotic as long ago as as 23. She was not diagnosed as bi-polar until she was my age, about 70. But likely she was psychotic on and off for nearly 50 years before being put on Lithium. Which was like a miracle!
I now look back on strange occurrences in my childhood, and things she related in later years, including at least at least one suicide attempt and an attempt to smother me - when I was probably 3 years of age.
She likely began self-medicating with alcohol when I was in early elementary school. And psychosis during those years as well, which likely explains so many memories of being severely punished - without understanding what in the world I, a fearful child by then, had done.
She is gone now. I bear her no ill will. She had been sexually abused by her father, as it turned out. And may have married to get away from home.
The tragedy of bi-polar illness is thar it seems to strike highly intelligent individuals, smart enough to try and hide their problems, until their craziness gets worse and worse.
For her Lithim was a godsend. And thankfully she stayed on it for nearly 17 years prior to her death. What a shame, however, that her craziness and alcohol abuse was hidden for so long, partly by my father. He humor end he strange ideas - until she began actlng so strangely as to come to the attention of law enforcement - who fortunately took her to a hospital.
I now look back on strange occurrences in my childhood, and things she related in later years, including at least at least one suicide attempt and an attempt to smother me - when I was probably 3 years of age.
She likely began self-medicating with alcohol when I was in early elementary school. And psychosis during those years as well, which likely explains so many memories of being severely punished - without understanding what in the world I, a fearful child by then, had done.
She is gone now. I bear her no ill will. She had been sexually abused by her father, as it turned out. And may have married to get away from home.
The tragedy of bi-polar illness is thar it seems to strike highly intelligent individuals, smart enough to try and hide their problems, until their craziness gets worse and worse.
For her Lithim was a godsend. And thankfully she stayed on it for nearly 17 years prior to her death. What a shame, however, that her craziness and alcohol abuse was hidden for so long, partly by my father. He humor end he strange ideas - until she began actlng so strangely as to come to the attention of law enforcement - who fortunately took her to a hospital.
15
Correction in last sentence. Re my father, " he humored her until her behavior got so bad, it came to the attention of authorities."
She was literally so manic that she believed she and my father were "leaving on the Mayflower" and believed people on tv were communicating to her. My father humored her. But the policeman who wandered by asked my father if he "needed help." Yes, he did!
She was literally so manic that she believed she and my father were "leaving on the Mayflower" and believed people on tv were communicating to her. My father humored her. But the policeman who wandered by asked my father if he "needed help." Yes, he did!
2
My father was diagnosed with depression 20 years ago but last summer, even while medicated, he dove into an anxiety/depression tailspin and landed in the psych ward for three weeks. He's 82 years old. The doctor prescribed lithium, which he is still taking. He seems pretty normal today, but a year ago, he thought he was on a watch list at the post office in Florida. I spent one afternoon on the phone, in front of him, calling various post offices in Florida to verify that there was no watch list. He had other paranoid thoughts, and they were all very powerful. The minute I would make one disappear, a new paranoid thought would pop up. It was as if the anxiety took on a life of its own and had to manufacture a crazy thought to attach to. He recently told the doc he wanted to taper off the lithium, that it made him a little dizzy. My father told me the doc just laughed and said, "You will be on this the rest of your life." He's lucky there is such a thing as lithium.
8
Phenomenal article -- thank you so much Jaime for your honesty, humor and clear perspective. I'm especially grateful for folks who've written comments regarding bipolar II disorder. I'm struggling to find good resources re bipolar II. I believe my dearest friend who lives in Italy has just been diagnosed: i.e. she has been put on lithium since last month after suffering a terrible "nervous break-down" this past winter; she's been on Lamictal for several years. She has never had the manic episodes characteristic of bipolar I, but she has been going through deep depressive episodes; and several anti-depressants caused very bad reactions. Anyway, her recent mental care has been confusing (as followed from across the Atlantic!), swathed in a combination of secrecy ("privacy"), denial and perhaps outright incompetence. I'll be spending a couple of weeks with her next month and I am very anxious especially because she does not seem to know -- or at least admit -- that she has this disorder -- and she refuses any form of psychotherapy; she is slipping back into apathy. I imagine that some kind of cognitive-behavioral therapy would be most recommended so that she might begin to learn new habits of thinking? I apologize for the ramble but I am so very fearful for her and not sure how to help; her brother failed suicide last year and her sister is incapacitated by what has been considered depression.
Anyway, Jaime thank you again and good good luck to you!
Anyway, Jaime thank you again and good good luck to you!
10
Step 1: A primary care physician should make a psychiatric referral.
Step 2: A psychiatrist should do a thorough interview, physical, neurological and mental status examination, relevant blood work and come up with a diagnosis.
Step 3: If the diagnosis is bipolar II (or bipolar III (cyclothymia)) disorder, review with the psychiatrist (in conjunction with the primary care physician) lifestyle modifications, psychotherapy options and pharmacotherapy options.
If one has never had a manic episode but shows periods of hypomania with periods depression (bipolar II) or periods of dysthymia (bipolar III) in their history, medications such as Lamotrigine (Lamictal) or Oxcarbazepine (Trileptal) can help achieve stability (often as monotherapy). The case you describe, however, seems a bit more complicated. Before jumping to a conclusion that your friend actually had bipolar I disorder (which is possible), a thorough medical workup is necessary to rule out organic causes. Endocrine, metabolic, neurological, infectious and neoplastic disease should all be ruled out as potential contributors to your friend's worsening symptoms. Good luck in your endeavors.
Step 2: A psychiatrist should do a thorough interview, physical, neurological and mental status examination, relevant blood work and come up with a diagnosis.
Step 3: If the diagnosis is bipolar II (or bipolar III (cyclothymia)) disorder, review with the psychiatrist (in conjunction with the primary care physician) lifestyle modifications, psychotherapy options and pharmacotherapy options.
If one has never had a manic episode but shows periods of hypomania with periods depression (bipolar II) or periods of dysthymia (bipolar III) in their history, medications such as Lamotrigine (Lamictal) or Oxcarbazepine (Trileptal) can help achieve stability (often as monotherapy). The case you describe, however, seems a bit more complicated. Before jumping to a conclusion that your friend actually had bipolar I disorder (which is possible), a thorough medical workup is necessary to rule out organic causes. Endocrine, metabolic, neurological, infectious and neoplastic disease should all be ruled out as potential contributors to your friend's worsening symptoms. Good luck in your endeavors.
3
It raises a thought that how ordinary and uninteresting our life is, so pretentious being part of the society. A few days of freedom from Lithium gave you your true and real moments to cherish. I wish you find an alternative to the med soon and live a life surrounded with lovely partner, job and many beautiful events.
Would love to read more on how life unfolds at your end.
Would love to read more on how life unfolds at your end.
4
A couple of questions for Jaimie:
a) In the times when Mania began to take hold of you - could you tell what
was happening as the Mania increased or did you just wake up one day
in full blown mania ?
b) In your Manic states did you have any idea that your clothing/thoughts
were a bit extreme ?
c) Could anyone, again when in full blown mania, have sat down with you
and said: Jaime, lets just take a look at how you are dressed/your actions
your words/sentences - don't you think there might be a bit of a problem
here and it might be time to go back on your meds ?
d) I noticed in your writing a rather odd use of words here and there.
Is that because of creativity or the desire to say something in a novel way.
I have a nephew who makes up words and like to state things in very odd
ways. His mother thinks he may well be bi-polar but when she brings up
the possibility that he might need help he explodes in anger at her and
rants and raves that it is the world that needs help, not him.
If you happen to reply to these questions I would be thankful.
Hope the new medicine works for you.
a) In the times when Mania began to take hold of you - could you tell what
was happening as the Mania increased or did you just wake up one day
in full blown mania ?
b) In your Manic states did you have any idea that your clothing/thoughts
were a bit extreme ?
c) Could anyone, again when in full blown mania, have sat down with you
and said: Jaime, lets just take a look at how you are dressed/your actions
your words/sentences - don't you think there might be a bit of a problem
here and it might be time to go back on your meds ?
d) I noticed in your writing a rather odd use of words here and there.
Is that because of creativity or the desire to say something in a novel way.
I have a nephew who makes up words and like to state things in very odd
ways. His mother thinks he may well be bi-polar but when she brings up
the possibility that he might need help he explodes in anger at her and
rants and raves that it is the world that needs help, not him.
If you happen to reply to these questions I would be thankful.
Hope the new medicine works for you.
3
After reading this article, my husband and I became curious again about his only manic episode which required involuntary hospitalization, followed by repeated electroconvulsive sessions.
This was in early May, 1970 and the shock therapy erased his short term memory of what exactly happened.
While surviving official records of what occurred during this 1970 manic attack are unlikely, every May for the next 45 years he'd get hypo-manic - Lithium and kidney transplant notwithstanding.
This was in early May, 1970 and the shock therapy erased his short term memory of what exactly happened.
While surviving official records of what occurred during this 1970 manic attack are unlikely, every May for the next 45 years he'd get hypo-manic - Lithium and kidney transplant notwithstanding.
4
Wonderful article. Thank you so much. I was on lithium carbonate a short time in my 20s and did not have the need to continue treatment. But mental illness and society's lack of knowledge in that area blew me away 25 years ago. I seriously could not fathom that as a society, we could land on the moon, transplant a heart, and build a 100 story building, yet we didn't know the essence of mental illness. Bringing up mental confusion in my world silenced people faster than bringing up the "funny uncle" of the family. So today, I am relieved every time I see a normal, typical, day to day mental health issue being discussed in mainstream media. Again, thank you.
11
Ms. Lowe, you've written a fascinating piece, I couldn't put it down.
Being a psychiatrist who long used lithium as a first line medication for those with truly type I bipolar disorder, I was fascinated by the description of your mania, yes it was the real thing. The comprehensive history of lithium, including the Bolivia connection, is worth a read by anyone who has bipolar disorder or treats bipolar patients. For those whose bipolar disorder may need lithium, my advice is find a psychiatrist with experience and confidence with lithium; some physicians, including psychiatrists, have not enough of either and steer their patients to less effective treatments. Diminished kidney function is the most serious concern from long-term lithium use and regular kidney function testing (blood and urine) is strongly recommended. The sudden alarm by your physician about your kidney function got me to wonder if it had been followed regularly over the years. If you care to respond that question, it may shed some light. Thanks, your piece will be widely appreciated and circulated.
Being a psychiatrist who long used lithium as a first line medication for those with truly type I bipolar disorder, I was fascinated by the description of your mania, yes it was the real thing. The comprehensive history of lithium, including the Bolivia connection, is worth a read by anyone who has bipolar disorder or treats bipolar patients. For those whose bipolar disorder may need lithium, my advice is find a psychiatrist with experience and confidence with lithium; some physicians, including psychiatrists, have not enough of either and steer their patients to less effective treatments. Diminished kidney function is the most serious concern from long-term lithium use and regular kidney function testing (blood and urine) is strongly recommended. The sudden alarm by your physician about your kidney function got me to wonder if it had been followed regularly over the years. If you care to respond that question, it may shed some light. Thanks, your piece will be widely appreciated and circulated.
16
One of the best articles I've read, as a clinician, from the "inside" of the bipolar experience. Thank you Jaime. Some observations regarding treatment: for someone with a well-established diagnosis, one of the better and safer ways to switch medications is what is termed a "cross-over bridge." In this, the first drug is continued while the second drug, in this case Depakote, is started. This is a way to insure the second drug is tolerated before the first is tapered. As in the case of Lithium, Depakote must be adjusted to the therapeutic range (in psychiatry, above 60 - I usually aim, for a stable patient, for 70-80, no more than 100). There is scant evidence to suggest Trileptal (oxcarbazepine), a less biologically active metabolite of Tegretol (weight neutral), also known as carbamazepine. Persons with Bipolar Disorder, while often prescribed antidepressants, may experience mood-destabilizing effects of these drugs: the research base suggests that a mood stabilizer or antipsychotic should be prescribed before the introduction of an antidepressant to mitigate these mood destabilizing effects. In my clinical practice spanning three decades, I have had success in combining Lithium, Depakote, or an antipsychotic, with Lamictal for Bipolar Depression. A great source of information about mood disorders may be obtained by contacting the Depression and Bipolar Support Alliance at DBSA.org. PS. For any patients reading this - make no changes in your regime. Talk to your Doc 1st.
15
I am a psychiatrist and agree with the good points raised by Dr. Who, below. To reiterate, there is good evidence that even a low dose of lithium can augment the effectiveness of other mood stabilizers, while reducing the risks to your kidneys. Fred Goodwin, MD, a mood disorders expert, is a proponent of this approach. You might consider that if Depakote alone is not sufficient.
I have treated two bipolar patients over the years who have opted for dialysis over stopping their lithium. Yes, they 'believed in lithium' that much. Other drugs helped them; but only lithium made them 'normal.' It took more than 30 years for each of them to require dialysis; they each thought of those 30 years as the gift lithium had given them.
I have had other patients opt to stop their lithium, and fortunately many of them found a good alternative. There are so many choices now, compared to even ten years ago.
Jaime, thank you for your wonderful essay. It echoes Kay Jamison's best-known book, "An Unquiet Mind," perhaps not surprisingly since she also was treated at UCLA NPI. With all the negative publicity about psychiatric treatments and the negative stigma of psychiatric illness in general (albeit, fading slowly), the world is a better place when patients share their stories. I wish you the best.
I have treated two bipolar patients over the years who have opted for dialysis over stopping their lithium. Yes, they 'believed in lithium' that much. Other drugs helped them; but only lithium made them 'normal.' It took more than 30 years for each of them to require dialysis; they each thought of those 30 years as the gift lithium had given them.
I have had other patients opt to stop their lithium, and fortunately many of them found a good alternative. There are so many choices now, compared to even ten years ago.
Jaime, thank you for your wonderful essay. It echoes Kay Jamison's best-known book, "An Unquiet Mind," perhaps not surprisingly since she also was treated at UCLA NPI. With all the negative publicity about psychiatric treatments and the negative stigma of psychiatric illness in general (albeit, fading slowly), the world is a better place when patients share their stories. I wish you the best.
27
I find that my husband's depakote treatment for bipolar 1 is supplemented well by a low dose of lithium - which he receives transdermally as his hobby (longboarding) uses white lithium grease.
I can tell which days the hardware has all been taken apart, cleaned and relubed, because he is a much more pleasant and reasonable fellow than typical for a couple days following.
I can tell which days the hardware has all been taken apart, cleaned and relubed, because he is a much more pleasant and reasonable fellow than typical for a couple days following.
2
This is one of the most courageous articles I have ever read. You are an amazing writer. For the first time, I can sort of understand what it must feel like to be manic.
My best wishes to you on your new journey. This might sound naive, but I have read repeatedly that getting off all grains is recommended for those with bipolar and regular depression. I doubt it is a cure, but it might be a help.
My best wishes to you on your new journey. This might sound naive, but I have read repeatedly that getting off all grains is recommended for those with bipolar and regular depression. I doubt it is a cure, but it might be a help.
11
Jaime's description of her frightening manic hghs replete with street rapping, delusions of grandeur and power-seeking behavior, along with lack of sleep and a hunger for attention may differ a bit from my mother's highs. But my mother made claims about her service rank and planned others' lives premised upon insubstantial facts which led to illusory conclusions in totally illogical arguments. Unlike Jaime however, my mother enjoyed her highs. But as Jaime recommends, the lithium was wonderfully powerful to restore mother's sweet, modest, ingratiating nature to us. It had th capacity to change the course of Mother's life. The fact that she was over 35 when it was accepted by the FDA to distribute may mean even greater promise to a younger bipolar patient. I hope so, as having mother back, even ever briefly, brought a cherished ray of sunshine into our lives. My father called her "sweetheart": that mother was.
10
I have a good friend who is bipolar. He almost took his life in the mid 90's, and has been on medication and counseling since. In my view, his more outward looking and socially connected actions and thinking have lessened and moderated his bipolar swings. Except for an eye catching title for the reader, don't see the connection of existence and belief in God or not and lithium use.
3
I have to wonder why research is left to pharmaceutical companies, who have an overriding interest in making money rather than patients well being. It would be better if more of it were government or foundation sponsored, where patents wouldn't apply.
9
Because it is very, very expensive to run drug trials. The NIH, with its funding flat for years, certainly doesn't have the cash. There's no way our current legislature is going to authorize it. So we leave it to the free market.
On the bright side, it mostly works. Yes, we get ruinous prices on drugs, and we get lots of me-too copycats and transparent tweaks to keep patents, but the drug pipeline steadily churns out new drugs, from the mundane to the real breakthroughs like Sovaldi for hepatitis C. Where it runs into trouble is mostly things that can't be patented or have been used before patents. Lithium is one example. Colchicine is another: it was a known treatment for gout for decades, but a single company decided to officially prove its effectiveness in exchange for an exclusive license. Once they had exclusivity they ratcheted the price up to about 50 times what it was before.
On the bright side, it mostly works. Yes, we get ruinous prices on drugs, and we get lots of me-too copycats and transparent tweaks to keep patents, but the drug pipeline steadily churns out new drugs, from the mundane to the real breakthroughs like Sovaldi for hepatitis C. Where it runs into trouble is mostly things that can't be patented or have been used before patents. Lithium is one example. Colchicine is another: it was a known treatment for gout for decades, but a single company decided to officially prove its effectiveness in exchange for an exclusive license. Once they had exclusivity they ratcheted the price up to about 50 times what it was before.
Life is not fair. I wish you all the luck and support while getting through your med transition.
6
Thank you for a captivating article. The photos are eerily fascinating. I wish you every success with your health and your writing, and hope to see more of it.
4
After reading the editorial mentioned in this wonderful essay, i started taking one pill of lithium orotate a day, along with my zoloft. its an over the counter health food store supplement. the lithium has been helpful, giving a small evening out to my moods and making it easier to respond to my day job's demands. I am grateful for your article and that editorial.
Talk to your doctor about this and be careful with self-prescription of even over-the-counter supplements. As the article points out, lithium can be toxic, and especially in unregulated supplements it's very hard to know what dose you're getting.
I agree that lithium can effectively treat Bipolar Psychosis (psychoses are the most serious forms of mental illness since these patients exist – at least sometimes – in a world outside of Reality).
Of course, it is the – at least sometimes – that is the real killer, since before diagnosis the patients have no way of knowing when, or even if, they have left reality.
Only after lithium treatment, bipolar patients start to become aware that they have a serious problem and can begin to deal with it.
After many years of dealing with Bipolar, I do believe I have learned a thing or two. But first, please note that I am NOT a medical professional of any kind and these comments only apply to me.
I have come to believe that Bipolar somehow hijacks the Attention Circuitry of the Brain. Attention (focusing on anything) in a normal person is both self-controlled and open to continuous real-world-to-mind verification and correction.
But in the Manic Bipolar Patient, once Attention has focused on a specific subject area in the brain, the patient not only loses the ability to control what they are attending to, but real-world-reality is locked-out from the patients attention-stream so that real-world social norms and mores no longer have the power to verify or correct what the Bipolar is attending to, or more importantly, doing.
It is exactly the consequences of what the Bipolar was DOING during the Manic Phase that causes the huge number of Bipolar Suicides in the Depressive Stage.
Of course, it is the – at least sometimes – that is the real killer, since before diagnosis the patients have no way of knowing when, or even if, they have left reality.
Only after lithium treatment, bipolar patients start to become aware that they have a serious problem and can begin to deal with it.
After many years of dealing with Bipolar, I do believe I have learned a thing or two. But first, please note that I am NOT a medical professional of any kind and these comments only apply to me.
I have come to believe that Bipolar somehow hijacks the Attention Circuitry of the Brain. Attention (focusing on anything) in a normal person is both self-controlled and open to continuous real-world-to-mind verification and correction.
But in the Manic Bipolar Patient, once Attention has focused on a specific subject area in the brain, the patient not only loses the ability to control what they are attending to, but real-world-reality is locked-out from the patients attention-stream so that real-world social norms and mores no longer have the power to verify or correct what the Bipolar is attending to, or more importantly, doing.
It is exactly the consequences of what the Bipolar was DOING during the Manic Phase that causes the huge number of Bipolar Suicides in the Depressive Stage.
2
I have a family member who is in his mid 30s and has had two major episodes of mania separated by about 15 years. His fear is that he will have another episode and not be able to listen to his friends and family members who would [and have in the past] tried to let him know that his mania had obviously kicked in. Do you have any suggestions about how to convince someone who is manic that he/she is if that happens? [hopefully, medicine will prevent a recurrence]. Thank you for your candid, honest account.
1
When a person is actually manic, it is very difficult to convince them of anything. If a person has had previous manic episodes, often there are some sentinel signs (e.g. - worsening sleep, increased irritability, decreased concentration) that the patient can use to proactively go to the local emergency room for evaluation. In the midst of a manic episode, however, sometimes the only option is to call the police (as opposed to an ambulance) to transport the patient to hospital. If your state offers crisis services, a psychiatric treatment team could be contacted to do the same. If the patient is already being seen by a psychiatrist (or certain other types of physicians), a pick-up order (physician instructing police to bring patient to hospital) can be made.
Whatever method is used, all roads lead to the emergency room where an assessment can be done and a recommendation to admit for further treatment as an inpatient or discharge back to the community with an outpatient level of care will be made.
Whatever method is used, all roads lead to the emergency room where an assessment can be done and a recommendation to admit for further treatment as an inpatient or discharge back to the community with an outpatient level of care will be made.
1
Thank you for sharing your story in such a beautifully-written way. It gives me insight into what my patients go through. Best of luck switching to Depakote. Don't despair if that isn't your answer; as other commenters have noted, there are multiple combinations of medications that may be helpful. Unfortunately, it will take some time and experimentation, so I am keeping my fingers crossed that Depakote works for you. I have a number of bipolar patients on Depakote for years, and they are all stable on it.
3
Jaime, thank you so much for openly sharing the details of your bipolar ride. I am sorry to hear about your kidney issues, isn't dealing with bipolar enough?
As a BP 2, I rely on lithium to give me the sanity and stability to be a highly functioning mother of a highly functioning family, despite my memory loss and zoning out. Managing my disorder is my top priority, and all the work on top of lithium seems to help. After finally embracing my diagnosis 10 years ago, though I was a crazy teenager no surprise, I avoid anti-depressants, and avoid whatever triggers me to go up or down. I miss the intensity, the creativity, and was considered smart and a ton of fun. But for now, the lithium zone is ok. We live in chapters don't we.
As a BP 2, I rely on lithium to give me the sanity and stability to be a highly functioning mother of a highly functioning family, despite my memory loss and zoning out. Managing my disorder is my top priority, and all the work on top of lithium seems to help. After finally embracing my diagnosis 10 years ago, though I was a crazy teenager no surprise, I avoid anti-depressants, and avoid whatever triggers me to go up or down. I miss the intensity, the creativity, and was considered smart and a ton of fun. But for now, the lithium zone is ok. We live in chapters don't we.
5
Thanks Jaime
I was diagnosed bipolar 8 years ago. On a cocktail of antidepressants, anti-psychotics and lithium. I stopped taking my meds for over a year and was high for all that time. Like you 2 to 3 hours sleep and being incredibly "productive"; I set up and ran 80 internet domains and I loved every minute of it. Then came a breakdown and hospitalisation. Stable and back on all my meds now but not high anymore and I miss it terribly. I don't feel so alive as I did then. I am 66 now and have been bipolar presumably since my teens, I can remember highs and lows. But I traveled around the world overland for ten years and went on to earn two degrees all without medication. I became a probation officer and drug counsellor all without medication. There were suicide attempts during my lows and relationships got screwed but in retrospect the highs were worth the lows. So is lithium worth it? Or are there better ways to mediate the highs and lows?
I was diagnosed bipolar 8 years ago. On a cocktail of antidepressants, anti-psychotics and lithium. I stopped taking my meds for over a year and was high for all that time. Like you 2 to 3 hours sleep and being incredibly "productive"; I set up and ran 80 internet domains and I loved every minute of it. Then came a breakdown and hospitalisation. Stable and back on all my meds now but not high anymore and I miss it terribly. I don't feel so alive as I did then. I am 66 now and have been bipolar presumably since my teens, I can remember highs and lows. But I traveled around the world overland for ten years and went on to earn two degrees all without medication. I became a probation officer and drug counsellor all without medication. There were suicide attempts during my lows and relationships got screwed but in retrospect the highs were worth the lows. So is lithium worth it? Or are there better ways to mediate the highs and lows?
2
I was a 1970's patient of Dr. Fieve. People would ask me if I believed in God. I would say: I don't know. But if their is a God, he has a very weird sense of humor.
2
The root of depression is not feeling to be loved, for a long, long, too looong period of time. I have much experience with depression, both personally and from my family. The only way out is to find someone who really loves you. Not "likes" you, that's not enough. Not "is good" to you. That's not enough. Not "appreciates" you. That's not enough. It MUST be Real Love (and this is a Trademark of... God, the Almighty Himself. Believe it or not, you have free will to decide. BTW, lithium is an element of Nature, which has been created by... (humans??).
3
Beautiful article. You exemplify the correlation between bipolar disorder and creative genius. Thanks both to your friend Mike's documentary skills and your way with words, we have a vivid and accurate portrait of a manic episode - from the oscillation between coasts, to the makeup and jewelry, to the fire starting, the sleeplessness, the grandiosity, the singing.
If you are going to taper off lithium and titrate up on Depakote, wait until you're therapeutic on the Depakote before starting the lithium taper. It may mean tolerating both for a while, but worth it to avoid an affective episode. No matter how tempting to just jettison the old drug, go off the lithium gradually and slowly. One source recommends 300 mg per day per month. http://pro.psychcentral.com/using-lithium-in-bipolar-disorder-a-primer/0... and http://www.ncbi.nlm.nih.gov/pubmed/8498879
If you are going to taper off lithium and titrate up on Depakote, wait until you're therapeutic on the Depakote before starting the lithium taper. It may mean tolerating both for a while, but worth it to avoid an affective episode. No matter how tempting to just jettison the old drug, go off the lithium gradually and slowly. One source recommends 300 mg per day per month. http://pro.psychcentral.com/using-lithium-in-bipolar-disorder-a-primer/0... and http://www.ncbi.nlm.nih.gov/pubmed/8498879
2
Simply put, self-control is the best "drug" there is.
If you want a further reference, look up "self-awareness".
Shalom.
If you want a further reference, look up "self-awareness".
Shalom.
With respect, oh my goodness!
Do you seriously think "self-control" is sufficient to manage a serious, indeed devastating illness?
Do you think "self-control" is sufficient to manage leukemia?
If not, why not?
Please think about this.
Do you seriously think "self-control" is sufficient to manage a serious, indeed devastating illness?
Do you think "self-control" is sufficient to manage leukemia?
If not, why not?
Please think about this.
2
Does self-control work for high blood pressure? Diabetes? Okay, maybe to a point; both are diseases strongly influenced by diet and exercise. But not completely, and refusing to include medication when necessary is foolish.
What about infection? Is self-control the best treatment for sepsis? Does it work for heart attacks? Is the best management of epilepsy to just will yourself to stop having seizures?
This is the attitude that stigmatizes mental illness and makes it hard for people to seek treatment and, all too often, leads people to decide to try to stop treatment because there's something wrong with medication, leading to relapses just like the one that Ms. Lowe describes.
Sometimes we have illnesses of mind or of body or of both. Lifestyle modification is a part of treatment, but only a part. The right meds are critical too!
What about infection? Is self-control the best treatment for sepsis? Does it work for heart attacks? Is the best management of epilepsy to just will yourself to stop having seizures?
This is the attitude that stigmatizes mental illness and makes it hard for people to seek treatment and, all too often, leads people to decide to try to stop treatment because there's something wrong with medication, leading to relapses just like the one that Ms. Lowe describes.
Sometimes we have illnesses of mind or of body or of both. Lifestyle modification is a part of treatment, but only a part. The right meds are critical too!
2
Unfortunately what I picked up in this article is the failure of the psychiatric establishment to communicate alternative or blended med solutions. As a fellow sufferer of this disease with more than one instance of "leaving the fog" of lithium to go back to a more dangerous but real existance, I can't help asking why wasn't this person better educated about other possible medicines? There are alternatives, many that do include both lithium in reduced doses with other drugs such as Lamictrol for example. It's not an easy task to find the right combination, and especially since all but one pill dispenser I've dealt with (did I say pill dispenser? I think meant shrink), just quickly said, "how you feeling?, here's another script, see you in a few months, please pay my $200 bill for 10 minutes of work". It's difficult dealing with a mental illness, in the end I believe most who succeed is due to support from loved ones, with little if any help from the psychiatric industry.
5
This is a very powerful story. Working with people out of (and going back into) prison, many are bi-polar. Puzzlingly, the vast majority have no interest in taking medication that would improve their lives, and help keep them from doing the stuff that causes them to get locked up again, and again, and again. The same seems true for the drug addicts, that shun methadone and suboxone like the plague (except when forced into detox). My hypothesis, the mediations work, usually too good. Once medicated, the mental highs are gone, they become 100% flat-line, neutral. (The same is true for the opiate addicts, on the full dose of medication). When medicated, there is no opportunity to get the stimulation from feeling hyped up (and high). Of course there is the long term (and some short term) health issues, as described in this beautiful, biographical,history, but most people don't care too much about their health, as evidenced by the self destructive stuff many of them do. Its the addiction to being up there, naturally (or artificially) doped up, high. The medications put an abrupt end to their elevations, it makes them normal, so normal, its boring. Its too boring to be normal.
4
This is my husband very such so, and although he feels outside the rules, he still craves the self-respect that "normal" achievements give: supporting a family, maintaining a career, owning a home/ car...
then, realizing this, becomes bitter and acts out - sometimes blaming the meds for not being able to be "productive."
Best of luck to Jayme's partner; may they never have to get on the roller coaster - but it's not a matter of 'if' now, but 'when.' Best thing you can do: have them find a local NAMI and take the Family2Family, or they may not have much understanding and could react badly out of fear.
then, realizing this, becomes bitter and acts out - sometimes blaming the meds for not being able to be "productive."
Best of luck to Jayme's partner; may they never have to get on the roller coaster - but it's not a matter of 'if' now, but 'when.' Best thing you can do: have them find a local NAMI and take the Family2Family, or they may not have much understanding and could react badly out of fear.
1
I've actually discussed this with a patient. He has bipolar disorder, and typically for the disorder he had more time spent depressed than manic. But the mania felt amazing. It was, as he describes it, better than cocaine or heroin, both of which he has used. Yes, he was terribly self-destructive. The mania ruined his life. But it was the depression in between that brought him into treatment.
Over the ten odd years of treatment, he's stopped taking his lithium a few times, and the reason is always the same: he misses the high. There's nothing like it.
Over the ten odd years of treatment, he's stopped taking his lithium a few times, and the reason is always the same: he misses the high. There's nothing like it.
You, like all people who have a life experienced one-off from the norm are exceptionally strong of mind and heart. (I am one too). Having said that, I love your description: "...feels like a hallucination; there’s an island populated by century-old cactuses, a blood-red lagoon, flocks of hot pink wild flamingos and piles of a blindingly white crystalline substance." Pure LSD 25 couldn't pain a better picture! WOW!
4
A great article.
I have lived experience of deep depression, going back twenty years to when I was 17. I needed drugs, and talk. I understand bipolar is even more reliant on drugs. I can understand the fear of medication change. Without the drugs that work for me my name is more likely to appear as my cause of death than any accident or disease, and it only takes weeks after stopping meds that things get scary. I now know to look for the warning signs, to recognize what is happening to me, and to go back on drugs quickly.
I spent a couple of years in talk therapy recently, it helped me immensely. I am no longer sociophobic. hate myself, and nightmares about my suicided significant other have quieted. I thought I was cured, but found out that without medication I am still my mortal enemy.
Changing meds isscary. I wish you the best possible outcome. If I had words of wisdom that could reach through the delusions you fear I would be sure to bring them to you. I do not. I am sure you know to talk to, and rely on those around you ahead of time, be sure to do that.
Yes, this is scary and may be difficult, but remember, you are a proven survivor.
I have lived experience of deep depression, going back twenty years to when I was 17. I needed drugs, and talk. I understand bipolar is even more reliant on drugs. I can understand the fear of medication change. Without the drugs that work for me my name is more likely to appear as my cause of death than any accident or disease, and it only takes weeks after stopping meds that things get scary. I now know to look for the warning signs, to recognize what is happening to me, and to go back on drugs quickly.
I spent a couple of years in talk therapy recently, it helped me immensely. I am no longer sociophobic. hate myself, and nightmares about my suicided significant other have quieted. I thought I was cured, but found out that without medication I am still my mortal enemy.
Changing meds isscary. I wish you the best possible outcome. If I had words of wisdom that could reach through the delusions you fear I would be sure to bring them to you. I do not. I am sure you know to talk to, and rely on those around you ahead of time, be sure to do that.
Yes, this is scary and may be difficult, but remember, you are a proven survivor.
48
I have a young friend, a woman I mentored, who I believe is bi-polar. She is currently in the process of blowing up a very good marriage. She has never been diagnosed or medicated but these episodes seem to come and go. I believe her mother also had undiagnosed mental health issues. Do some people function very normally and then have periods of manic/depressive episodes or once the condition takes hold is it one or the other all the time?
14
I have just been recently diagnosed with Bipolar 2 disorder. My episodes would come under stress. It is almost like a survival mechanism where I feel like I could do anything. Unfortunately,this would wreak havoc with my persona life where I would be unfiltered in how I deal with people, rampant spending, and grandiosity. And then the depressive mode would come in and I would feel worthless and how life was painful and not worth living. My psychiatrist explained to me that in my manic episode I would use up serotonin which would result in the depressive mode where I would be deleted of serotonin. So to answer your question, in my case I was not bipolar all the time, just when I was stressed. Kind of like the Incredible Hulk.
Yes, people can have periods of mania, periods of depression, and periods of "euthymia," a normal in-between mood. In fact, while bipolar disorder is literally defined by the presence of at least one manic episode, very few people sustain mania permanently, and depression tends to be more frequent and more prolonged.
I actually don't know the answer to this. My impression is that bipolar disorder is a little different for everyone. I do think that's possible to be functional most of the time and then cycle, BUT I would consult a psychiatrists and get into the specifics of her situation. Is she willing to go to a doctor or be treated?
1
My Bipolar 1 disorder was cured completely with sertraline (Zoloft) without any detrimental side effects. Perhaps this would be a better choice for you. Great article!
1
As antidepressants such as sertraline can actually throw people with bipolar disorder into a manic episode, it is generally considered a good idea to stay away from them in this disorder.
15
I have Bipolar 1 Disorder. At first I was misdiagnosed with unipolar depression and treated with every antidepressant available during those years without results. Bipolar disorder does not have a "cure". I wish there was one. I question your diagnosis as an antidepressant would not have cured it.
1
A landmark 2014 study calls that conventional wisdom deeply into question. December 2014 Journal of the American Psychiatric Association.
2
A fascinating essay indeed. As a historian interested in the history of human use of therapeutic mineral springs, I would be interested to know more about how bathing in a lithium spring could have benefited bipolar individuals, before the advent of modern mental health diagnosis and treatment. Was it actually drinking the waters that provided the therapeutic effect, or was there an effect just from soaking? Thanks very much!
13
just like "the Patch" works for nicotine, any substance can be "ingested" though the skin, unfortunately, back then, they didn't realize too much of it can be bad for you
1
I would love to know more on this too! My impression was that soaking and sipping the waters were part of the treatment and that the treatment was for a range of mental illnesses, like depression or mania or both.
1
BPII here. I have been on Lithium going on 20 years (as well as stints with Prozac, Zoloft, and now Wellbutrin to combat very depressive periods). I owe my well being to this drug. I have gone away for weekends and left my lithium behind....changes start very soon (short half-life). The "Fog" starts to lift, thoughts become crisper, and unfortunately much faster, and worse is the agitation. I have never had manic episodes to the extent you have, but I miss the energy, exhilaration, and self esteem of them. When i was manic and agitation low I was king of the freakin' world. Kidney numbers are starting to slide up, hopefully just a blip. That's one thing I wouldn't miss, the twice+ yearly blood work. This was one of the most relate-able pieces I've read and there have been a few. Thank you.
55
I've never been on lithium, so I can't say for certain, but I always get the impression that the "fog" is at least in part the subjective unpleasantness of not being manic. Because, while it's dangerous and often destructive, mania feels amazingly good. Your thoughts feel crisp, clear, focused. You're full of energy and drive.
It's not fun to give that up. Better, maybe, but not pleasant.
It's not fun to give that up. Better, maybe, but not pleasant.
Note the title: "I dont believe in God but I believe in Lithium"
The odds of a prime mover or higher power existing is a septillion to one. You have much better odds winning the mega millions a dozen times and getting struck by lightening every day for the rest of your life than you do being an atheist. I can understand that you may be against organized religion, but a prime mover or higher power would work in ways that you can't understand.
But your on medication designed for insanity. This would explain your willingness to ignore insanely high probabilities in exchange for putting your faith in nearly impossible ones. It's like selling all your worldly possessions to become a professional slots player at the casino instead of getting a job.
It is Interesting though. Pharmaceutical companies are making more and more money, as less and less people believe in God.
The odds of a prime mover or higher power existing is a septillion to one. You have much better odds winning the mega millions a dozen times and getting struck by lightening every day for the rest of your life than you do being an atheist. I can understand that you may be against organized religion, but a prime mover or higher power would work in ways that you can't understand.
But your on medication designed for insanity. This would explain your willingness to ignore insanely high probabilities in exchange for putting your faith in nearly impossible ones. It's like selling all your worldly possessions to become a professional slots player at the casino instead of getting a job.
It is Interesting though. Pharmaceutical companies are making more and more money, as less and less people believe in God.
6
Nohalfsteps,
Belief in some higher power or ultimate source or even G-D does not preclude uSing meds. In fact, if a G-D teaches thAt the body is the vessel of the spirit, that is essentially saying one must take care of the body. That may include meds.
Some people even believe that they have found treatment for illness-through meds, surgery, therapy, whatever--through divine intervention. Whatever belief system helps them and doesn't harm others, I have no issue with.
The author might not believe in G-D but others might. I doubt G-D, if G-D exists, is going to tell those who believe to skip the lithium if it works. In fact, uncontrolled mania or depression can be its own bell for patient and loved ones. G-D does not invite that on anyone.
Belief in some higher power or ultimate source or even G-D does not preclude uSing meds. In fact, if a G-D teaches thAt the body is the vessel of the spirit, that is essentially saying one must take care of the body. That may include meds.
Some people even believe that they have found treatment for illness-through meds, surgery, therapy, whatever--through divine intervention. Whatever belief system helps them and doesn't harm others, I have no issue with.
The author might not believe in G-D but others might. I doubt G-D, if G-D exists, is going to tell those who believe to skip the lithium if it works. In fact, uncontrolled mania or depression can be its own bell for patient and loved ones. G-D does not invite that on anyone.
2
I think her point is Lithium is more effective to her in treating her mental disorder than believing and praying to God, or whatever religion. Sorry if that offends you.
No correlation between the profits of Big Pharma and atheism. More people are turning to medication to deal with mental health concern (from situational depression to serious mental illness) for a variety of reasons. Insurance companies will reimburse for pharmaco therapy whereas they have put time limits on talk therapies or before the ACA simply not covered mental health services). Additionally, the pharmaceutical companies can now directly market to consumer who now come into doctors offices requesting specific medications. Many patients would prefer to take a pill or administer a pill to their child rather than engage in the time, effort and change that psychotherapy (in whatever model) requires. When I was a therapist, my client for the most part were inclined to be church goers, and their faith communities sometimes contributed to the problems that brought them into therapy in the first place. Blind faith or devotion to a religious belief can be a barrier to critical thinking and the decision to make necessary life changes. If lack of faith has been problematic for clients, it has not been a lack of faith in god that is the issue. It has been a lack of faith in oneself and other people that has been the area of concern. I have never believed in god but I have learned to believe in myself, and to trust other people with my heart, and that has been the source of my healing.
Great article - very brave of you to share all this. My father was on prednisone for non-hodgkins lymphoma and it made him manic. He was given lithium which helped curb his mania, but it made his hands shake tremendously. He stopped taking the lithium because of this and his behaviour became super scary. We didn't have a good psychiatrist nor internist who cared and went through some very ugly times. He ultimately died because of the cancer I think (his kidneys did shut down). I would love a follow up on how you are doing and what meds you end up taking. Best of luck.
18
Great article and writing skills. The detailed description of your illness is eye opening and thought provoking. I am employed in a psychiatric facility, but never looked at it in quite this way. Thank you
30
Thank you for writing this article. I added lithium to my pantheon of drugs three months ago. I have bipolar II disorder. I was initially diagnosed as depressed and have been taking Effexor for about 12 years. A few years later, we added lamictal. Then about 5 years ago, after changes to the DSM, I was diagnosed bipolar II and started taking rispredal. Though it helps with anxiety spikes it as made me feel listless and apathetic. Hence the addition of lithium. I am taking a sub-therapeutic dose and I have cut my rispredal dose in half with the hope of taking it away altogether. So far the lithium seems to be working as I had hoped; I am more stable and more able to function while still feeling a connection to my emotions and the world around me. I do not believe in God either, bit I am beginning to believe in lithium.
15
Thank you for sharing such a moving and open account. As a psychiatrist, with 2 siblings who have been diagnosed with bipolar disorder, I have found that I have both a genetic and personal affinity for those suffering from the illness. Many of my patients have benefited from lithium, despite its many risks. Lithium can be so effective if used safely. Many psychiatrists believe that lower levels can be effective, especially when combined with other mood stabilizers, also uses at lower doses. To protect the kidneys, while on lithium, blood pressure should be well controlled and other kidney damaging drugs avoided. Nicotine, through its elevation of blood pressure, and restriction of blood flow is one commonly overlooked drug. Drugs such as aspirin, ibuprofen, naproxen and any other non-steroidal anti-inflammatory drugs (NSAIDs) cause a small amount of kidney damage with each dose. By the way, there are still researchers exploring the benefits of lithium. Nassir Ghaemi, MD, from the Mood Disorders Program, Department of Psychiatry, Tufts Medical Center is a leader in psychiatric research into Bipolar Disorder. He has also been exploring lithium as a treatment for Alzheimer's disease. There is so much more to be understood. I wish you all the best on your journeys.
100
Thank you for this fantastic and heartbreaking article. My sister has lived with bipolar disorder for 26 years, diagnosed at 18. I saw her story in your article and it brought me to tears. My sister is smart, creative and fun, but the disease has kept her from realizing her full potential. She's struggled with compliance for most of her diagnosis because medication well keeps her medicated. Lithium has been most effective for her, but now I worry - I had no idea of the long term side effects.
Bipolar disorder is a family disease, not just in the biological sense, but that it impacts the entire family dynamic and can destroy relationships. It has in my family. More needs to be done to remove stigma associated with mental illness, and to provide education and support for the family caregivers. And most of all, more investment in drug research is needed.
I wish you well in your journey.
Bipolar disorder is a family disease, not just in the biological sense, but that it impacts the entire family dynamic and can destroy relationships. It has in my family. More needs to be done to remove stigma associated with mental illness, and to provide education and support for the family caregivers. And most of all, more investment in drug research is needed.
I wish you well in your journey.
107
You article really resonated with me. I have never had bipolar disorder, but have exhibited similar behavior in response to a deep, intense meditation retreat: thinking I am destined to save the world, seeing and hearing beings that aren't there, etc. I wrote about it in an ebook memoir I published last year, "Silicon Valley Monk". I had never had an issue with mental health prior to that, and had in fact been practicing meditation for many years. I was prescribed Resperidol and took it for a couple weeks, but then was switched by a psychiatrist to Seroquil, which is normally used for psychosis, even though I was not exhibiting any specific symptoms at that point. I stayed on about a half to a quarter of a normal dose for 3 months and the symptoms disappeared. The major downsides are 1) a flattened affect and mood, loss of creativity and 2) it is really, really expensive. I don't know if that would work for you and of course you would probably need to take it all the time, but it might be an option you might want to explore as most of the others seem to be fraught with problems from the comments.
3
There is now generic sequel, much cheaper. I have heard of this happening on deep meditation retreats. Also those with pre-existing disorders, having worse symptoms while on or after the retreats. Good luck..
Seroquel is an antipsychotic. Bipolar disorder can be treated with antipsychotics, particularly if it has psychosis as a component, but it's rare for antipsychotics to be the primary or sole drug used. Mood stabilizers are more effective and important.
Abilify, something of an oddball among antipsychotics, may work better, but it's still a less common choice and also very expensive.
Abilify, something of an oddball among antipsychotics, may work better, but it's still a less common choice and also very expensive.
Thank you thank you for writing this article. I started taking lithium 3 months ago. I have bipolar 2 disorder and am on a sub-therapeutic dose and so far it has been a positive addition to my cocktail of drugs. I have been taking Effexor for years as my first diagnosis was depression. Then we added lamictal a few years later as it became apparent something was going on with my moods. Five years ago I started respridal after loosing my 15th job and finally being diagnosed as bipolar due to the changes in the DSM. But I hate the flatness of rispridal so we decided to try lithium and see if it makes it possible to come off it. So far I have halved my dose of respridal but still take it as a PRN. I have a fantastic psychologist and psychiatrist and have been seeing both of them for over ten years. I highly recommend psychotherapy to the mother who wrote a comment about her daughter. It is helpful in adjusting to a new state of mind and a new sense of self. I am now in what feels like a "recovery" period and am taking a few years to adapt before trying to work again. I really appreciate the additional information and am grateful to read the additional comments. I wish you the absolute best of luck with your new regiment.
21
Thanks for writing this. I don't know why it helps to read other people's experiences with mania, but it does. I guess just knowing I'm not alone goes a long way.
58
I'm always happy to read an account of a fellow sufferer of bipolar, especially such a hopegiving one. I'm 22 right now and I often wonder what my future life will look like with bipolar. Like you, I've been taking lithium ever since I was 16. My thyroid is dysfunctional, but my stable periods are truly stable so I can't complain too much.
My question to you is: do you have any advice for my loved ones?
My question to you is: do you have any advice for my loved ones?
18
I would ask them to please find a NAMI and attend a Family2Family class for loved ones of people with serious mental illness such as bp, schizophrenia, or borderline personality disorder. As a result of this class, I have been better positioned as a spouse of someone with bp1, to:
advocate for my spouse more effectively within the medical establishment
understand complications of medications (including interactions such as with citrus)
recognize signs that an episode is coming and have tactics for alerting our loved one
have more empathy for the experiences of their suffering loved one
have better tools for co-existing with our loved ones' "quirks"
advocate for my spouse more effectively within the medical establishment
understand complications of medications (including interactions such as with citrus)
recognize signs that an episode is coming and have tactics for alerting our loved one
have more empathy for the experiences of their suffering loved one
have better tools for co-existing with our loved ones' "quirks"
That's a really good question, I think my advice for your loved ones is perseverance and patience and more patience. My family could probably answer this question better because I'm not entirely sure how they did it. I think they may have bribed me with glitter stickers and rainbow cigarettes to keep me in line. (I don't smoke, but when I was manic, I smoked like a fiend.)
1
Jaime,
Please ask your psychiatrist about lamotrigine (Lamictal). It's a great substitute for lithium and it can take the edge off the mania very quickly and permanently.
Here's wishing you lots of luck!
Please ask your psychiatrist about lamotrigine (Lamictal). It's a great substitute for lithium and it can take the edge off the mania very quickly and permanently.
Here's wishing you lots of luck!
6
I would advocate for lamotrigine over depakote any day. I too took lithium for manic-depression (used to play in punk bands -- when I was manic we were the best band ever! -- I know you can appreciate that!), after many years, switched to depakote and after about ten years, tried lamictal on the advice of a friend after I mentioned feeling lethargic and "cloudy". That was a great description as when I began taking lamotrigine it was as if the sun had come out. With depakote I felt "subdued." Taking lamotrigine truly did feel "brighter." I felt more alive. It was equally effective (if not more so) but it removed the somber cloud the depakote had brought with it.
1
Jaime,
Very incredible story. As Mac said this should be in he Opinionator section.This is one of the most interesting article I have ever read. The title itself fits my religious belief- secular humanist and I am also diagnosed as a bipolar disorder.
The story itself was a complete sinusoidal wave of Bi-Polar. This is one level abstraction of my story but again, mine is still in infancy - in terms of time but in social complexity, the cumulative weight of my story should be reasonable. However, I still believe I am in positive swing. I spent my first five years in developing country and is living in United States for about five years now.
I am still a big proponent of Lithium. I have two questions for you . what was the dose you take - i am taking 300 mg per day. Recently, my psychiatrist recommended seroquel. During my maniac, they also used Olanazaphine. The point is there are lot of complex variables in each patient. How did you know that your kidney has a problem so suddenly - how often did you test your kidney and thyroids?
Maybe we should write a story - I just felt I am other side of the coin. Honestly, I was sad at the end of the article , the first part of the article took me in maniac phase but apparently swing to depressive phase. I felt my days are coming..
Very incredible story. As Mac said this should be in he Opinionator section.This is one of the most interesting article I have ever read. The title itself fits my religious belief- secular humanist and I am also diagnosed as a bipolar disorder.
The story itself was a complete sinusoidal wave of Bi-Polar. This is one level abstraction of my story but again, mine is still in infancy - in terms of time but in social complexity, the cumulative weight of my story should be reasonable. However, I still believe I am in positive swing. I spent my first five years in developing country and is living in United States for about five years now.
I am still a big proponent of Lithium. I have two questions for you . what was the dose you take - i am taking 300 mg per day. Recently, my psychiatrist recommended seroquel. During my maniac, they also used Olanazaphine. The point is there are lot of complex variables in each patient. How did you know that your kidney has a problem so suddenly - how often did you test your kidney and thyroids?
Maybe we should write a story - I just felt I am other side of the coin. Honestly, I was sad at the end of the article , the first part of the article took me in maniac phase but apparently swing to depressive phase. I felt my days are coming..
6
"Blue Wind," Dose depends on blood level which should be between ~.8 and ~1.5. And hopefully the blood test will work best for you. There is a short therapeutic range. Too low: no positive effect; too high: toxic effects; very high: can be deadly. Therefore blood work must be done appropriately.
1
Hi there, I take 750 mg now, down from an original dose of 900 mg. I have ALWAYS had my blood monitored, my thyroid monitored and my creatinine levels monitored — about every 6 months by my psychiatrist. My creatinine levels were getting higher and I knew that that meant an eventually decision about my kidneys and taking lithium. But the combination of going to a new primary care doctor and my blood pressure being so high made the issue more immediate.
1
In place of Depakote, which requires monthly blood draws to check liver enzymes, my Bipolar family member has had great success using another anti-seizure medication, oxcarbazipine. The psychiatrist prescribes it in combination with Viibryd, a brilliant new SSRI. Ability is another choice that worked well for our 20 something loved one for over two years. There are good options available. Our hopes go with you for a successful transition between medications.
6
My mother was bipolar, and went untreated much of her life. It's good to see discussions about mental health, like every other health issue. If people can hear about it from all sides--personal stories, medical opinions, statistics, politics/economics etc--then maybe we'll have a better chance of dealing with it, both individually and as a society.
Good luck to you. Thanks to you for your writing, and to the NYT.
Good luck to you. Thanks to you for your writing, and to the NYT.
6
Hi, Have you tried quetiapine? Any comment on effectiveness & side effect between quetiapine vs litium?
Hello Ms. Lowe, thank you for sharing this article. I have many questions for you: How long did you suffer 2-3 hours of sleep per night before you received your first medical confirmation you were having a manic episode? When you did sleep during mania, did you dream? Did you experience the depressive side, and if so, did you have dark vivid nightmares when you slept or involuntary thoughts of suicide? Do you have memories of your manic episode and do they cause you pain, embarrassment, or regret when you are stable and/or depressed? Do you know if any of your family members have BP1 or BP2? Will you write another article after you try Depakote? I wish you and your boyfriend the best, he could be your anchor, tell you when he sees changes and help you transition to a new med if Depakote doesn't work well for you. Best, Ku'ulei
8
Thank you! I probably slept significantly less for months before I was diagnosed and about a month or two before my second episode as well. I don't remember having especially vivid dreams and I did have a long difficult bout of depression after each manic episode, mostly because it felt like I was waking up rational in pile of emotional and physical rubble caused by irrational behavior. I, thankfully, have never been suicidal. There were times that felt incredibly bleak, but I pushed through with help of medication, therapy, family and friends. I do remember most of my episodes and decisions I made during them and they cause me pain and joy equally. I don't really believe in regret, I think life happens and you deal with the consequences — good and bad. I feel like a lot of my manic episodes have made who I am but at the same time I don't want to be defined by them. No one in my family has bipolar disorder which makes my case a little bit of an outlier.
3
Harmful effects that have been listed forgot one tiny FACT: Lithium will FRY your thyroid.
1
Yes, thyroid failure can occur but this is easy to remedy with thyroid supplement medications. Lithium does not cause thyroid cancer.
And, by the way, every medication can cause problems. I guess Maria would also say that Tylenol can "fry" your liver and aspirin, Motrin, and the other non-steroidal anti-inflammatory drugs can "fry" you gastrointestinal tract. In fact, these can actually kill you whereas the thyroid problems related to Lithium are easy to correct.
And, by the way, every medication can cause problems. I guess Maria would also say that Tylenol can "fry" your liver and aspirin, Motrin, and the other non-steroidal anti-inflammatory drugs can "fry" you gastrointestinal tract. In fact, these can actually kill you whereas the thyroid problems related to Lithium are easy to correct.
8
I've been on lithium carbonate for 35 years, after having undergone some wild manic episodes in my late teens. Stopped seeing a psychiatrist 25 years ago. Had one manic episode when I stopped the lithium; have taken it ever since. My family doctor prescribes the lithium carbonate and also an antidepressant. So far no adverse medical problems. I take the lithium because I fear the results of another manic episode.
6
How does it affect your relationships? I was diagnosed right around my 18th Birthday (I just turned 24), and for the first 4 years of that I was really sick and not functional. I've been in some very poor, abusive relationships throughout this, and as a mental health professional I know that's way more common for those with mental illness. I feel like I"m in a good place, but I still struggle to stay in a relationship or interact consistently with others when I'm not following protocols of my work. Are there things you've learned over the years about interacting with people (particularly in reading body language) that you found helpful? I have lots of wonderful people that accept me and I do well, but I have such a hard time finding a healthy relationshp and am wondering what I can try working on to improve that. :-) Since you've got more experience dealing with Bipolar, thought you may be a good one to ask!
8
Hi Megan! I think relationships — good ones — are hard for everyone, mentally ill or not. It took me a very very long time to figure out how to be in a good and healthy and loving relationship, in fact it's something I feel like I'm still working on. I would say that the bad experiences should be things that you learn from and you have to decide what feels best for you.
1
I am a psychiatry resident (a psychiatrist-in-training.) It was very important and meaningful to my training to experience your article. I have previously learned about the discovery and research of Lithium, and yet you gave this metal, well, life. Your own mental health story is an eloquent and reflective one I might not get to hear when I am stabilizing a manic patient. Might I be presumptuous to say that your voice is theirs, as well. Thank you for the education.
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I am in a relationship with a girl from the last four years. She have Bipolar disorder she had first maniac attack in 2012, it was a long distance relationship initially but from the last 10 months i am with her and she have been admitted to mental hospital twice in the last 10 months. she is on medication currenty using olanzipine and depakin, i have to force her to take her medicine, she even dont believe that she is sick, she create lots of issues, sometime sshe is uncontrollable , i am not working , i am a student doing masters and it very hard to me to cope up with her sickness, she insist to marry me but i am scared about her behaviour after marriage. need help
15
Aamir, I hope you follow up on finding help for yourself. Your girlfriend may be wonderful, but until she is willing to get help to stabilize herself, her problems are probably too big for you to handle and you can't control her illness. It's good to be a supportive friend, but make sure you get support for yourself, too, so you don't get dragged down into someone else's illness.
29
Indeed, it is very important he gets help and support. But I would strongly caution against the too common phrase "if the ill person is not willing to get help, there is nothing you can do" This is fundamentally wrong. When people go through manic and/or psychotic episodes, they are not in a position to want or not want help. Their understanding of reality is severely distorted. Often the emotional connection with their loved ones is the only thing that can get them to accept medical treatment. Family and friends should try to contribute as much as possible to their loved ones' recovery. We, as a society, are very afraid of mental illness, and I believe this is a major hurdle for people who suffer from it. I'm saying all this from first hand experience of a family member.
5
I believe in God (not sure if she/he/it is Christian, Jewish or Muslim, though) and I sure as heck believe in my fluoxetine (Prozac) and olanzapine (Zyprexa). Been taking the Prozac for almost 2 years and the olanzapine for almost a year now. It sure feels nice to know I'm human!
Do you ever feel regret for your actions when you were off medication? I am haunted by my actions from years ago - even as a teenager/young adult - and I have comparatively mild bipolar. Thinking back on things I have said, done, and the way I have acted, really hits me hard at just how horrendously my actions must have appeared to "normal" people. I meditate (taught to me from cognitive behavioural therapy sessions) to try and help me achieve catharsis, but it doesn't really help with the guilt.
Do you ever feel regret for your actions when you were off medication? I am haunted by my actions from years ago - even as a teenager/young adult - and I have comparatively mild bipolar. Thinking back on things I have said, done, and the way I have acted, really hits me hard at just how horrendously my actions must have appeared to "normal" people. I meditate (taught to me from cognitive behavioural therapy sessions) to try and help me achieve catharsis, but it doesn't really help with the guilt.
14
My 12 step program helped me. Though for another issue, I took the twelve steps and applied to my illness. They helped with the guilt a lot. Perhaps this might work for you. Good luck!
2
This a good and really complicated question. I sometimes feel longing for the freedom that mania affords but extreme sadness and pain about the wreckage that comes with it. Regret is a tough thing to assign to it all though because I don't regret the good things — some of the people I've met, the parts of mania that are funny, the stories that come with it, the random experiences. I wouldn't change who I am. It helps to have distance though, to process the whole experience.
2
Great article Jamie. I can so relate to the burden of feeling the world is going to end and only you can save it. I had the same feeling when first diagnosed 3 months post partum. Don't worry about switching to Depakote from Lithium - did the same 6 years ago when approaching 50 with an inherited kidney disease. The fog was lifted, no mania and I have never felt better! Good luck and keep on writing.
4
You are an excellent writer, Jaime Lowe.
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Wonderful article! I've been taking lithium since 1979 (after six up-and-down years emerging from adolescence). In 2006 I was told that my kidney function was less than half of normal, and was given the same advice about going off of lithium or eventually needing a kidney transplant. But, with my psychiatrist's help, I very gradually combined lamictal with a lower dose of lithium. My kidney function has been stable for the last nine years. I am so thankful I have not had to give up lithium. One last thing--we bipolars are unique individuals: creative, hard working, loving parents, and responsible role models. It's always been sad to me that the stigma surrounding the illness makes many of us closet bipolars.
14
Thank you for sharing your story, Jaime. As the daughter of a mother with bipolar disorder, I learned a great deal about lithium and its effects. When I was a child, my mother had manic episodes which resulted in hospitalization for a time. She took lithium for at least ten years following that hospitalization and was mostly stable. Unfortunately, although her blood levels had been monitored regularly, she eventually developed toxic levels of lithium such that she could no longer take it - the lithium had damaged her kidneys. At various times, my mother was alternatively prescribed Depakote, Wellbutrin and other medicines, but none of them really worked as well as lithium. Fifteen years after she stopped taking lithium, her kidneys were so non-functional that she had no choice but to start dialysis, which she endured three times a week for almost three years until her body gave up fighting.
I appreciate this chance to comment because I rarely get to talk about my mother's lithium experience - indeed, her doctors did not readily admit to me that her lithium toxicity eventually led to her need for dialysis. I hope that you have excellent doctors and a good support network and that you continue to stay well as you taper off lithium.
I appreciate this chance to comment because I rarely get to talk about my mother's lithium experience - indeed, her doctors did not readily admit to me that her lithium toxicity eventually led to her need for dialysis. I hope that you have excellent doctors and a good support network and that you continue to stay well as you taper off lithium.
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Thank you for this beautiful essay that closely resembles my own experience and that of my sister who is also bi-polar. I was on lithium for almost 18 years, and it definitely saved my life and relationships. However, my thyroid stopped functioning about 4 years in, and ultimately I had to go off lithium because my kidneys were permanently damaged and now function at about 50%. The transition was horrible, but I don't regret the lithium use. I now use a combination of Lamictal and Clonopin, which has kept me more stable and with more energy and creativity. I wish you well on this new phase of your journey, and hope to read more work from you.
11
Fascinating stuff. Thank you for this crystal-clear window into a world that few of us experience--and, good luck.
7
One of my closest friends has struggled with her bipolar disorder quite severely in the past few years once she got off lithium (her digestive system began to react badly.) She's been trying various medications that give her some relief, but isn't able to be consistent enough to hold down a steady job or keep her boyfriends, despite being - like yourself - a well educated and charming woman in all aspects.
When she's 'stable' - so to speak - I feel I can communicate with her about anything except her manic states. Ill try to bring up her behaviour (ranging from stealing to bathing in lemon juice) Its almost as if, in her mind, those moments we spent together simply didn't happen.
Ive always wondered what its like for her mind when its in that impulsive, sometimes self-destructive zone, but she cant put words to it anymore than 'i cant remember' or 'it felt fast and blurry'
Are you able to recall your emotional spectrum in those incidents you list (waitress at a wedding vs. kumquat salad) although you feel they were acted out by 'another you'? That is to say, do you feel happy, scared, sad or thrilled in those moments? Do you feel anyone can help you, or understands you?
Second, do you ever wonder if thats maybe a truer, unfiltered you that comes out in those moments, and if so, is it one that you crave to or are curious to tap into at will?
Ive enjoyed your work via Gawker for a while - always thought you should be more noticed. Thrilled to see you in NYT!
When she's 'stable' - so to speak - I feel I can communicate with her about anything except her manic states. Ill try to bring up her behaviour (ranging from stealing to bathing in lemon juice) Its almost as if, in her mind, those moments we spent together simply didn't happen.
Ive always wondered what its like for her mind when its in that impulsive, sometimes self-destructive zone, but she cant put words to it anymore than 'i cant remember' or 'it felt fast and blurry'
Are you able to recall your emotional spectrum in those incidents you list (waitress at a wedding vs. kumquat salad) although you feel they were acted out by 'another you'? That is to say, do you feel happy, scared, sad or thrilled in those moments? Do you feel anyone can help you, or understands you?
Second, do you ever wonder if thats maybe a truer, unfiltered you that comes out in those moments, and if so, is it one that you crave to or are curious to tap into at will?
Ive enjoyed your work via Gawker for a while - always thought you should be more noticed. Thrilled to see you in NYT!
37
Thank you for, among other things, saying I am well-educated and charming! This is an excellent question and one of the things I've wrestled with a lot. I have always felt that it is me, the only me I can identify with, throughout each experience, manic, depressed or otherwise "normal." Everyone deals with this differently, though. There are elements of my mania that embarrass me, embolden me, terrify me and that are just plain annoying. But I am there throughout, I don't forget or blackout, sometimes things get hazy but only because so much weird is happening at once. I don't think it's possible to explain what it feels like, except to say that everything is big, emotional and very real. But then when an episode is over, it isn't as big, emotional or as real. And yes, there is a feeling sometimes that the person making a brilliant kumquat salad is the real me....but then I become so unhinged that it's most definitely not. I crave the freedom and boldness but I am terrified of the destructive chaos that follows.
39
I've always likened it to being madly in love with someone who's actually a terrible person. While everyone's waving their arms saying "what's wrong with you?" you're blowing them all off because they're just jealous and you are SO GLAD TO BE ALIVE (in all caps, for sure). Then when they drug you back to reality you look back and go, "hmm, that wasn't so great after all". When I think back to my manic episodes, years later, I get the same sort of mild revulsion as when I go back and read something I wrote when I was a mopey teenager.
I'm sorry to hear you're losing your lifeline. I never tolerated lithium well, but I have had the "let's try no mood stabilizer" experience and I know how terrifying the prospect of switching can be. Many people don't realize how quickly you can turn your life to custard when you think you're invincible.
I'm sorry to hear you're losing your lifeline. I never tolerated lithium well, but I have had the "let's try no mood stabilizer" experience and I know how terrifying the prospect of switching can be. Many people don't realize how quickly you can turn your life to custard when you think you're invincible.
7
My husband was diagnosed "manic depressive manic" and started taking Lithium in 1970. He continued on it until Lithium toxicity caused his renal failure, almost three decades later. Nine years ago, after his peritoneal dialysis failed, he received a kidney transplant and has had no manic episodes since taking Aripiprazole (Abilify).
1
Ms Lowe: Can you tell me how important you think it is to see a psychiatrist? If you do, how often do you think it necessary to see them? I have a daughter diagnosed as Bi Polar and she has not been going to see anyone, but still gets her meds issued to her. I feel the medication she is on (she won't tell me or her daughter what it is) is ineffective as she frequently has manic episodes. Any recommendations? She is in Antioch, CA. Thank you for sharing your story; it is incredibly well written.
18
Well, I should start by saying I'm not a medical professional by any stretch of the imagination but it seems like you and your daughter should know what kind of medication is being prescribed, whether it works or not. I would suggest finding a psychiatrist that is more open with the process, it seems both unethical and illegal to prescribe medication without disclosing what is being prescribed. In terms of the importance of going to a psychiatrist regularly, it has been crucial and important to me. Part of my therapy is monitoring my meds but it also involves talk therapy which is also helpful tool for navigating life, in general.
23
He said his daughter wouldn't tell him or her own daughter what meds she is on.
1
As a psychiatrist in training, I would encourage her to see a psychiatrist. You're noting that she has frequent manic episodes. Would you say that a diabetic whose blood sugar is frequently sky-high is adequately treated or push them to see the doctor again? What about someone with an infection who gets antibiotics and continues to feel terrible and have fevers for the next week?
Mental illness isn't so different. If treatment is not working it's important to go see a doctor so things can be changed for the better. I'm curious, though. If she's not seeing a provider who's providing the refills?
Mental illness isn't so different. If treatment is not working it's important to go see a doctor so things can be changed for the better. I'm curious, though. If she's not seeing a provider who's providing the refills?
4
I grew up with a single bi-polar mother....we lived in a different world - her world. Not being manic or bi-polar, but just a gullible child, I felt every moment of her incessant episodes. I saw every twist and turn coming right just before it came it was exasperating, heartbreaking and all consuming even for a child. Years we lived like that, my sisters and I and then following her eventual sectioning - puff! It as all gone in weeks. I didn't know where I was. Reading this pains me more than I have for years. I am glad you wrote it and glad I read it - eternally grateful for my mental health. Life can never get harder than that!
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I was on lithium for a while, but honestly it scared me due to its potential side effects. I tapered off it several years ago, and have been fortunate enough to find a combination of drugs that works for me since. I never had mania the way you do, though--I'm bipolar type 2, so I get hypomanic, not full-blown mania--and a lot of the time it manifests as panic and anxiety. Lamictal has been really good for me, as has Risperdal--the Risperdal knocked my anxiety flat when I added it to the mix.
I wish you luck with the Depakote. It made me gain 100lbs (no, that's not an exaggeration) when I took it for migraines, but it did help somewhat.
I wish you luck with the Depakote. It made me gain 100lbs (no, that's not an exaggeration) when I took it for migraines, but it did help somewhat.
16
After 12 years on lithium, my neurologist recommended to my psychiatrist that I go off lithium. Next, depacote didn't stop mania from pushing through. Next, lamictal caused a skin rash. For the past year I'm on respertal which can knock me flat if I lean toward mania. I watch my mood, and under the guidance of my shrink, regulate my mania with respertal and depression with anti-depressants. The manic moments of being at one with the universe makes this bumpy ride worth it. Like those returning to the Cave in The Republic, it's hard to adjust to "the real world."
26
Lithium is one of the few substances in Psychiatry that work (I dare call it a drug since it is a natural element). It is quite sad seeing that most antipsychotics and antidepressants create more problems than they solve (e.g., weight gain to the point where it acts as a catalyst for diabetes, restlessness, brain atrophy, etc.).
The pharmaceutical industry has a noose on Psychiatry. It's about time we created drugs to help the most vulnerable—the mentally ill—instead of pursuing profits.
The pharmaceutical industry has a noose on Psychiatry. It's about time we created drugs to help the most vulnerable—the mentally ill—instead of pursuing profits.
64
In fact, the antipsychotics and antidepressants are very efficacious for the disorders for which they are indicated. There is continuing research to find better ones but this is true in all areas of medicine not just psychiatry. No one thinks that the current diabetes drugs or hypertensive medications or cancer treatments, all of which by the way carry their own very severe side-effects, are the final words. Or does Sal believe that none of these drugs should be used either?
Also, with regard to side-effects, it is doubtful that there is a single medication that doesn't have serious side-effects. Even Tylenol can cause irreversible liver damage that can be fatal unless a liver transplant is performed.
Any doctor will tell you that the first thing taught in pharmacology is that all medications have at least two effects, at least one of which is bad.
Also, with regard to side-effects, it is doubtful that there is a single medication that doesn't have serious side-effects. Even Tylenol can cause irreversible liver damage that can be fatal unless a liver transplant is performed.
Any doctor will tell you that the first thing taught in pharmacology is that all medications have at least two effects, at least one of which is bad.
9
Excellent point Sal..
1
Sal, the article notes lithium has side affects including kidney damage which the author experienced. It can blunt emotions and leave one in a fog; the weight gain can be severe. It can be toxic, some people have used it to commit suicide.
It is a great drug for some long term and others short term. I wish I had known about the "lithium fog" and memory issues. I switched psychiatrists after taking lithium and lamictal for a few years. I stayed on lithium for one more year but the weight gain was too much. After tapering off, I am on lamictal only and did find that the "cottage cheese brain" cleared and my good memory came back after I stopped lithium. Lamictal alone has been effective for years.
I agree big pharma brutally pursues profits, but I am grateful big pharma has developed effective drugs other than lithium. But, had I not had a good prescription plan, I would not have been able to afford Lamictal on patent. In its generic form, it is more affordable. I take another med that came off patent a few years ago but even the generic is hundreds a month. I get it through my mail order drug plan but even then the cost is almost a hundred dollars. How many people can afford that?
It is a great drug for some long term and others short term. I wish I had known about the "lithium fog" and memory issues. I switched psychiatrists after taking lithium and lamictal for a few years. I stayed on lithium for one more year but the weight gain was too much. After tapering off, I am on lamictal only and did find that the "cottage cheese brain" cleared and my good memory came back after I stopped lithium. Lamictal alone has been effective for years.
I agree big pharma brutally pursues profits, but I am grateful big pharma has developed effective drugs other than lithium. But, had I not had a good prescription plan, I would not have been able to afford Lamictal on patent. In its generic form, it is more affordable. I take another med that came off patent a few years ago but even the generic is hundreds a month. I get it through my mail order drug plan but even then the cost is almost a hundred dollars. How many people can afford that?
4
I certainly hope Depakote works; we need anyone who writes this well to remain in a functional state, hopefully fulfilled by the exercise of her talent.
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Thank you so much for writing about lithium. While yes, it's certainly not for everyone, and it can be life-threatening, it has allowed me not only to function, but to thrive with postpartum bipolar one disorder. Lithium also helped my father, a violinist for the Los Angeles Philharmonic who had bipolar disorder was also a U.C.L.A. Neuropsychiatric patient. He was able to play brilliantly in the first violin section for many years without lithium's notorious shaking hands side effect ruining his career. I have taken it for almost a decade and thank God for it saving my life and allowing me to pursue my writing career. My memoir "Birth of a New Brain - Healing from Postpartum Bipolar DIsorder" with a foreword by Dr. Walker Karraa will be published in Fall, 2016 by Post Hill Press, and as the founder of the Depression and Bipolar Support Alliance (DBSA) of Santa Cruz County I faciliate free support groups for women with mood disorders. In our current group a third of our members take lithium, including a writer whose work has been published in the New York Times, and lithium helps these women write, teach, and much more, such as be involved mothers, wives, advocates, and members of our community. Thanks again for examining a old-school medication that deserves much bmore disucssion, and research. You immediately had me at your title!
41
Questions: when you had the second manic episode, after you stopped the lithium, how long did it take to become manic after you stopped? And how long to return to "normal"? Were there any barriers to your being recognized as manic that time, like not seeing your psychiatrist or the like?
Now, do you think you may have had toxic lithium levels for any period that might have caused the kidney damage? Or did it happen despite "normal" therapeutic levels? Do you consider such drugs as Lamictal as substitutes? (Depakote is a poor substitute in my opinion although it might work just fine; restrict your diet to avoid weight gain...) There are several possible substitutes other than Depakote, and I'm sure you'll try them if Depakote doesn't work, but what are your thoughts on that?
Medically oriented questions, sorry, but that's all I think about, not being particularly creative.
Now, do you think you may have had toxic lithium levels for any period that might have caused the kidney damage? Or did it happen despite "normal" therapeutic levels? Do you consider such drugs as Lamictal as substitutes? (Depakote is a poor substitute in my opinion although it might work just fine; restrict your diet to avoid weight gain...) There are several possible substitutes other than Depakote, and I'm sure you'll try them if Depakote doesn't work, but what are your thoughts on that?
Medically oriented questions, sorry, but that's all I think about, not being particularly creative.
12
Thank you for your questions! I was hoping you would ask me about the seasonal-gourds-impulse-buy! I became manic roughly 3-4 months after I tapered off the lithium. I was manic for a couple months and then once I finally agreed to take meds, I started to feel closer to normal but having been through what felt like extreme emotional trauma it took a while to really feel normal. I would say six months to a year later. I was depressed and in some kind of weird mourning — like I missed the manic me. Eventually, I began to take interest in other things and let go of that experience a little. But it was all in varying degrees — there were moments before I was officially manic when I would do things that in retrospect seemed manic. I did see my psychiatrist through it and I have a big supportive family that I'm close to, but it was still difficult to actually spot the mania. I don't think I had lithium toxicity and I am considering whatever medication works best, all options are on the table!
60
Why do you think that you did not have lithium toxicity?
This is the article that should have been featured on The Opinionator section, rather than the ridiculous "Breaking Up With My Meds". It is a real, heartfelt account that seeks only to inform and illuminate. Thank you for sharing this beautiful story. Good luck and be well.
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Jaime, the bipolar landscape has changed since your diagnosis. Even if the Depakote doesn't work for you, there are now quite a few other options out there.
14
A factor of two between the minimal therapeutic dose and the maximal safe dose is cutting it pretty fine. I have known a few people who got permanent kidney damage from using it. It might be sometimes necessary but it is poison.
8
Lithium works for some people only up to a certain point. I've known people who took it for decades - only to have it stop working, literally overnight. That's the problem with these drugs - they only a certain shelf life in a person's body and then they either quit working or cause severe bodily injury - even death.
Depakote, I'm afraid to say, probably will not be a forever drug, either, for the author. It causes lethargy, extreme weight gain - and kidney problems - in many people. I am surprised, in fact, that this was offered as a substitute.
The problem seems to be that there is very little interest in coming up with drugs which can truly help people with brain issues, while not killing them at the same time.
Depakote, I'm afraid to say, probably will not be a forever drug, either, for the author. It causes lethargy, extreme weight gain - and kidney problems - in many people. I am surprised, in fact, that this was offered as a substitute.
The problem seems to be that there is very little interest in coming up with drugs which can truly help people with brain issues, while not killing them at the same time.
13
To Norton,
Many medications can stop being effective after patients take them for awhile: diabetes medications, antihypertensive meds, opioid analgesics for example.
And I'm not sure who you believe has little interest in developing new drugs. It sounds like you believe someone is out to kill the people who are taking these medications.
Many medications can stop being effective after patients take them for awhile: diabetes medications, antihypertensive meds, opioid analgesics for example.
And I'm not sure who you believe has little interest in developing new drugs. It sounds like you believe someone is out to kill the people who are taking these medications.
1
There's no evidence that drugs 'stop working' in most people, especially lithium.
Depakote does not cause kidney problems. It can cause liver problems, though.
Depakote does not cause kidney problems. It can cause liver problems, though.
LITHIUM IS TRULY A WONDER BUT UNHERALDED DRUG . . .
Until the FDA approved lithium in 1970 there were almost no ameliorative drugs or other treatments to deal with (what was then called Manic-Depressive Psychosis -- which is now labeled as bipolar disorder. The name was changed not for PC reasons -- but do to that the alternation of forms of depression and mania did not necessary include psychotic behavior.
It not only controls bipolar to some degree (from some degree to complete remission in 75% of the original studies done. When being treated with lithium there is a rather short blood range of effectiveness in the blood. If <.8 it has no effectiveness; >1.5 it is potentially dangerous; if it gets much jigher it can be toxic and cause death. So, blood tests must be done appropriately to determine the level.
It not only has the capacity to control (to some degree in some patients), it also can act as a prophylactic in helping control suicide ideation and the act itself. There are also many possible side effects.
It is the drug of choice for people experiencing mania but, is hardly advertised. Why? As a natural substance no one can get a patent on it so other usually less effective drugs (on patent) are often recommended by drug companies.
Since Kay Jamison, Ph.D., professor of psychiatry and others have demonstrated that people with mood disorders are twice as likely to be creative ... many on lithium have complained that the drug does cause a loss of creative behavior.
Until the FDA approved lithium in 1970 there were almost no ameliorative drugs or other treatments to deal with (what was then called Manic-Depressive Psychosis -- which is now labeled as bipolar disorder. The name was changed not for PC reasons -- but do to that the alternation of forms of depression and mania did not necessary include psychotic behavior.
It not only controls bipolar to some degree (from some degree to complete remission in 75% of the original studies done. When being treated with lithium there is a rather short blood range of effectiveness in the blood. If <.8 it has no effectiveness; >1.5 it is potentially dangerous; if it gets much jigher it can be toxic and cause death. So, blood tests must be done appropriately to determine the level.
It not only has the capacity to control (to some degree in some patients), it also can act as a prophylactic in helping control suicide ideation and the act itself. There are also many possible side effects.
It is the drug of choice for people experiencing mania but, is hardly advertised. Why? As a natural substance no one can get a patent on it so other usually less effective drugs (on patent) are often recommended by drug companies.
Since Kay Jamison, Ph.D., professor of psychiatry and others have demonstrated that people with mood disorders are twice as likely to be creative ... many on lithium have complained that the drug does cause a loss of creative behavior.
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I am allowed to have a much lower blood level than the .8 that David said was ineffective. It is now below .4.
I also do thank goodness for Lithium, which I have been on for 33 years now. It can be an excellent prophylactic medication.
I presented with a severe agitated depression and was hospitalized. I had had some hypomania before that but it was not a problem. I
don't know whether I believe in God or not but I also do believe in Lithium. There is alot of mood disorder in my family. My grandmother for one -- Lithium was used in Denmark when my grandmother was getting ECT. Too bad that it had not yet come to the U.S. Thank you to the doctors that fought for its acceptance.
I also do thank goodness for Lithium, which I have been on for 33 years now. It can be an excellent prophylactic medication.
I presented with a severe agitated depression and was hospitalized. I had had some hypomania before that but it was not a problem. I
don't know whether I believe in God or not but I also do believe in Lithium. There is alot of mood disorder in my family. My grandmother for one -- Lithium was used in Denmark when my grandmother was getting ECT. Too bad that it had not yet come to the U.S. Thank you to the doctors that fought for its acceptance.
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It's a widespread myth that the mentally ill are more creative. I have never seen any clear proof of this.
And it's funny that I have repeatedly heard how psychotropic medications and psychotherapy kill creativity contrary to the fact that there are many very creative people who have been helped by these.
And it's funny that I have repeatedly heard how psychotropic medications and psychotherapy kill creativity contrary to the fact that there are many very creative people who have been helped by these.
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"Steve," I can assure you that what you refer to as the "creativity myth" is absolutely true. See the works of Psychiatrist Nancy Andreasen, M.D. of Iowa State University and psychologist Kay Redfield Jamison, Ph.D. at Johns Hopkins University Department of Psychiatry.
Both accomplished peer reviewed studies which indicated that of people labeled "creative" they evidenced double the rate of artistic and other similar accomplishments when compared to "normal" members of the population.
As I mentioned before one possible side effect of lithium is a lessening of their creativity. I, however, do not know of any studies which validate this hypothesis.
Both accomplished peer reviewed studies which indicated that of people labeled "creative" they evidenced double the rate of artistic and other similar accomplishments when compared to "normal" members of the population.
As I mentioned before one possible side effect of lithium is a lessening of their creativity. I, however, do not know of any studies which validate this hypothesis.
A sobering piece. What more do we need to understand about the utter corruption of our values than that Big Pharma won't pursue further studies about the potential medicinal uses of lithium because lithium is a naturally occurring element and can't be patented.
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Do you work for free? That is essentially what you are asking drug companies to do in this case. I don't know anything about how they operate except I know that they donate developed drugs to people in need. Perhaps there's another pro bono unit in some pharm companies that devotes itself to making medicines the companies will never see a profit from. But if they have shareholders, I doubt that happening. That's not Big Pharma; that's 21st century American capitalism.
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Why should a drug company pay for this research rather than ... You? How’s about you donate to a non-profit which subsidizes this kind of research (maybe by paying that drug company). Or, get your congressmen to have the government pay for it.
Oh, by the way, the feds already are paying to investigate some intriguing and unpatentable alternative medicine treatments.
Oh, by the way, the feds already are paying to investigate some intriguing and unpatentable alternative medicine treatments.
What an absolutely terrific article -- thank you so much! So much information I never had, such a hilarious account of what becomes desperately untenable and can ruin our lives. Oh, I had the gold skirt too! And the stereo set to blast out the front door and the next messiah being born next door and number theory and naked rolling under the tree, re-enacting Eve.
I hope that you will try Lamictal; it has been a terrific substitute for lithium for me. I hope you soon find what will enable you to keep your sanity (but leaving just a bit of it behind). You writing beautifully. Thank you.
I hope that you will try Lamictal; it has been a terrific substitute for lithium for me. I hope you soon find what will enable you to keep your sanity (but leaving just a bit of it behind). You writing beautifully. Thank you.
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what a beautifully written & incredibly raw journey. Lithium is one of the most confusing drugs Ive ever seen taken: a dear friend in college started taking it and gained 30 pounds overnight -- but your account of its effect on your life is perfect.
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