At this point I could ramble on about feeling like a guinea pig for a variety of medications, none of which have kept me stable for any length of time and made me feel like death; That my psychiatrist was trying to be creative, exploring alternative options of treatment, that he was paid by Glaxo? Anyway, I shall bullet point.
Prozac - Didn't work
Citalopram - Worked for a while at maximum dose, but then there was a health scare about heart attacks
Quetiapine - Massive sedation, massive weight gain, didn't stabilise me
Abilify - Weight gain, sedation, tremor (Requiring procyclidine)
Depakote - Reasonable mood stabilisation but only for 2 years and then it stopped working. Also caused weight gain and made my hair fall out
Lamotragine - Lasted about 4 days as I was allergic to it!
So I sit in his office discussing the pro's and con's of beginning the lithium treatment journey. Typically, he tries the hard sell of positivity first. It was discovered by ancient peoples by accident, it has been used as a treatment for mania very successfully for hundreds of years, it tends to work for treatment resistant people, it reduces suicidal tendencies and deaths dramatically. Ok, so what's the catch? (More bullet points)
It's toxic if not managed properly. Like death.
Effects your kidney function. Olympic urination.
Interferes with your thyroid. Energy levels all over the place, weight issues etc.
Effects your salt levels as it is combined with salt to make it enter your blood stream, therefore....
Sweating is an issue as the levels of lithium in your blood can fluctuate (Don't over exercise or sunbathe too long)
You can get the shakes quite badly
Oh and you need regular blood test every week for 2 months at first, then every month for a bit, then quarterly for the whole time you are on it. Also, Lithium interacts with pretty much every other medication on the planet making it, you guessed it, TOXIC, so I have to carry an alert card everywhere I go, and if I need to take antibiotics, ibuprofen, antihistamines etc, I have to take them at my own risk, get an additional blood test and look out for the signs of imminent death!
"Go away and think about it Emma, and tell me at your next appointment what you would like to do." How about Dr. Dyer, exchange my brain for one that works instead of trying to poison me creatively over an extended period of time.
It's a horrible place to be. My illness without medication is entirely unstable. My relapses have no pattern, and my mania tends to be rapid onset with little warning. Although I try and manage my triggers, don't drink or use drugs, rest, manage my stress and generally look after myself emotionally and spiritually, my illness is still pretty rampant. I also have more than myself to think about. I always have to consider my family situation in any decision I make. I can completely identify with those people who abandon medication and just live in the madness, as to be free of chemicals, side effects and the constant interrogation by practitioners must be magical. Sadly the consequences of that are rather dramatic and can cause devastation for patient and everyone else concerned.
I'm fed up of being fat, tired, slightly bald and miserable. Oh yes, and when like this, telling me that riding a bike might help me feel lifted, that I'm so demotivated my life is passing me by and I could try something new, is a REALLY BAD IDEA!!!!!! Sorry I digress! So I decide I will take the lithium. On balance, I need to start living again, feeling released from the heavy weights that follow me around all the time. The commitment and energy it takes to just "Turn up" every day is enormous and I want to feel some enthusiasm again and feel that I am genuinely engaged in my life, rather than watching painfully from the sidelines.
Bring in on Dr. Dyer.