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PLease excuse the anonymous post, but as you may all appreciate
mental health issues are a bit delicate.
I have been taking an anti-depressant for some 4 years (Remeron -
-mirtazapine generic), but I am increasingly irritable, angry
and anxious. The psychiatrist I saw at Kaiser (my analyst cannot
prescribe meds) says I have dysthymia and is recommending that
after my blood tests come back to show whether I can take
lithium, I should add lithium, rather than any sedative or Xanax-
type anti anxiety drugs. He thinks lithium will
have ''synergistic effects'' with the Remeron, unlike the other
drugs. I am aware of some of the toxicity side effects from the
literature, but I would like to know if others have used
lithium, for what type of situations and to what effect, so I
can make a more informed decision before I start pumping this
stuff into my system.
Thanks so much,
It does sound like you would do well to add a mood stabilizer. I take both an anti-depressant and a mood stabilizer- with just an anti-depressant I also eventually swing into an anxious, edgy, confused, irritable, and angry state, but with both I do well. I've used xanax along the way, I think it's a great med, and it can offer some valuable short term relief. But if you've got a real mood disorder, it's a bandaid, not a long term solution.
Lithium was the first mood stabilizer, it works great for many people, and it's safe when properly prescribed and monitored. In the years since lithium, other good ones have been found, all of them anti-convulsants that were originally developed for epilepsy. The one that's worked best for me is Lamictal, and it's being widely used because it does help many people, and often helps where other drugs have failed.
Lamictal is a patent drug, it's grossly expensive, and some health plans may resist paying for it right off. But I'm at Kaiser too, and my docs have been able to prescribe whatever they've thought best, patent or not, formulary or not.
When I say ''safe'', I'm not being cavalier, it's always risk v. benefit in taking a med or in driving a car or in getting up on a ladder to change a light bulb. No med is without potential side effects, no med is right for everybody, any med has to be monitored and carefully dosed. If you read the manufacturer's insert on ANY med without having more info you'll scare yourself half to death.
Organize all your questions and concerns and talk openly with your doc about them. Remember to be proactive (I know this is easier said than done when your mental state is bad, but do your best). Maybe there's a particular reason he's recommending lithium for you, maybe not. Maybe a change of anti-dep in combination with a mood stabilizer would be worth trying.
If your doctor doesn't like questions, consider meeting another one (but ask for an appointment quickly, don't let them make you wait for weeks, you need some help now) anon
Early on, I struggled a bit with excessive thirst and hand tremors, but those eased up within about 4-6 weeks. Now I only experience tremors when I overexert myself. I make a point to keep myself hydrated (dehydration increases blood levels of lithium, which can lead to the tremors and taxes the kidneys).
I have my lithium level, kidney function, and thyroid function checked every 6 months. All levels have been good so far. Lithium has been around a long time, so the side effects (mainly kidney & thyroid problems) are well known, unlike some of the other, newer mood stabilizers.
I am so grateful to the doctor who suggested that maybe my depression needed more
than antidepressants. There is a good deal of literature about how lithium
augmentation can be very helpful for some people. I hope it works well for you!
***liking Lithium so far***
Re: Therapist for 11 year old boy
If you don't want to medicate (after you find a therapist) - consider giving him 1 1/2 teaspoons of fish oil a day (mix with juice). It is a natural form of Lithium - a highly effective anti- depressant.
I recently started seeing a psychiatrist for my bipolar disorder and was prescribed Lithium. He explained the medication and side affects to me, but I was a little surprised at the time and had many questions after I left his office and took in the severity of my condition. I have not filled the prescription yet.
I do not know anyone who is/has taken Lithium before and would like to get some comments on the medicine from someone who has taken it. Did this medication really help you? Why do you have to take the blood tests? Is this something I will have to take for the rest of my life? What will I feel like when I do take it? What will happen if I miss a dose, or a few days? My doctor told me not to drink any alcohol when I am on this medication. What will happen if I do? Do you get a stomach ache or headache? Or make a public idiot out of yourself? I do not want ANYONE (except my husband) to know I am taking this medication....is it normal to feel embarrassed about taking psychiatric meds???
Any advise on any or all of my questions is appreciated! Anon
The bottom line is if you are truly bipolar and your symptoms are affecting your life, you need a mood stabilizer. Try the lithium--give it a month or two--and see if you feel better. If you don't like it, ask for a different mood stablizer--or if you are new to this diagnosis and not sure about it, question the diagnosis.
There are more modern mood stabilizers which have different side effects but lithium is still the ''gold standard'' for certain symptoms, as I understand it. Mom of bipolar kid
Whether you'd take it your entire life I can't say. As I understand bipolar disease, it can be a lifetime illness and I hear that medications for its treatment are so good that you can start to think you don't have it anymore once you've been on your meds a while. However, it might be the case you would have to take it for your lifetime to keep those benefits of seeming illness free. The blood tests how they monitor your dose and they are important.
The combination of my antridepressants and lithium had side effects I could not trace to one med or the other. I gained weight and was thirsty all the time. You ask your doctor what side effects you should watch for so you can inform her because some indicate a dosage problem.
There is no reason any side effects would ever indicate to others your medical condition. However, you might be feeling sort of stimatized, already, perhaps even by your own feelings of your diagnosis. If this is the case, it is a sad statement that our society still produces that in us. Try not to worry that you are not really ''mainstream'' anymore because you seek to treat illness. You are seeking to live a happy and productive and fulfilling life and might be able to do that much better with medication. If you had high blood pressure or diabetes, you'd take a daily medicine to do just this. ''Mental illnesses'' (lets call them illness of the nervous system instead ok?) are chemical imbalances and you deserve treatment and a quality life if medical science can help you with it.
Good luck! Former Lithium Queen
I also highly recommend that you seek therapy, too. You do not have to have any deep-seeded issue to need therapy. It is often beneficial to be able to talk about having this illness. In fact, a mixture of therapy and medication is almost always the best treatment for bipolar. All too often, patients that only seek one or the other, have much more difficulty and confusion dealing with it.
And it is not uncommon to feel shame or embarrassment about taking medication. In fact, there is a scientist at Cal Berkeley that is dedicating his talents towards the social effect of bipolar. He is the first to really do this. (Sorry, I don't remember his name.) But, he has been finding that mental illness, most commonly, bipolar is the leading ''handicap'' in the workplace (he used a better word for it). It is also one of the leading illnesses in the US. However, due to the shame surrounding it, most companies, families, etc are unaware of the social impact it is making.
I have gone back and forth in my life, of acceptance and embarrassment. It is an ongoing challenge. But you are so much better off seeking treatment.
Best to you! Cathy
Although this is easier for me to say since I am not on meds, I wish more people would be straightforward about it, so there wouldn't be so much stigma. The only thing average people hear about bipolar disorder is from the few people with very serious illnesses who manage to commit violence when off their meds. My sister is not like that at all, though she has a challenging personality. Others that I know with the disorder would probably rather not let people know about it, but I do think our society generally could be better educated
Of course I don't know what the dosage was or if you are taking the same amount, etc. Since you are so unsure about taking this drug, maybe you should get another opinion? After I stopped taking it I never started it again, and have been pretty much fine ever since. Or at least I think I am!? Anon
This site claims that there is no proof of a chemical imbalance. And it is correct. But any ethical doctor will tell you this. The reality is that if you truly suffer from a mental illness, there is no real clear-cut answer. This is why it is so important to seek a therapist, as well as a psychiatrist. I have been dealing with my depression for almost 20 years. (I am doing very well these days.) The key has been in finding a therapist and/or a doctor I can truly trust. Doctors and therapists should always be seeking out various forms of treatment for you, not just drugs. They should also always be very open and honest about treatments and willing to answer all your questions. What responsible doctors know is that they cannot locate the area of the brain that causes the theoretical ''chemical imbalances''. But they have found other activity in the brain that responds positively to drugs.
The body and mind are interlinked. So it makes sense that one affects the other. And as others have already stated, everyone's experience is different. Not everyone suffering from a mental illness needs drugs. They are surely over prescribed. But it doesn't mean that all prescriptions are wrong either.
As if the illnesses themselves are difficult enough to deal with! I hope that this helps. Cathy
My own ''case'' was ''treatment resistant'', which meant that I had to go through years of trying different meds before getting well stabilized.
At first, I was terrified of meds & ashamed that I needed them, but I had been living in hell & so hung in through those years. I had good doctors who gave me time & information, & I also did my own research. Eventually I got used to the trial & error nature of the process, calmed down, began to learn to distinguish a side effect from other body sensations, & learned to trust my intuition about whether or not a particular med was a good choice for me.
Lithium didn't happen to be a good choice for me- it threw my sense of balance off- & my niece got mental confusion from it. My friend has done great on Lithium for 20 years (except for a few months when she decided she didn't need it any more, stopped taking it, & cycled into mania).
I take a combo of meds, but my primary mood stabilizer (and my niece's also) is Lamictal, a newer one that's now widely used. It's a very expensive drug, & some health plans may not offer it unless cheaper meds have failed, but I recommend inquiring about it. It has changed life for me, & for my niece.
Bi-polar disorder is permanent, it's a genetic disorder, it doesn't go away. If your diagnosis of BP is correct, you will need to take meds for the rest of your life. It's a pain in the butt, but I'm just grateful that these drugs exist.
I am very selective who I tell about my disorder- even in this psychologically sophisticated part of the world, there is still a lot of subconscious fear & judgement about mental illness. Trust your instincts and keep your own counsel as you need. You are who you are, you are not your illness, & even though it is a defining part of the life experience for those of us who have it you don't have to explain yourself to anyone!
Best of luck to you, hang in there- with good professional help you can find the stability you need anon
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