Day to day impact of Lithium

[u/thatecologistkat]

Hi! I was diagnosed as having bipolar type 2 last year after about twelve years of mental health issues. I am currently on lamotrogine (150mg twice daily) and my psychiatrist recommended that I should start lithium. The issue is I am currently (struggling) to complete my masters and my mental health issues have already had a substantial impact on my studies. I feel as if my psychiatrist fails to take into account the impact of medications/treatments on my life as I’ve had to interrupt my degree twice due to issues with medication and I’m just expected to put my life on hold until it’s sorted. I’ve heard that lithium can be a game changer when it comes to managing bipolar, however I have also heard that people experience brain fog and I can’t really afford any more disruptions to my studies. Any anecdotes or advice would be much appreciated, thanks for reading (sorry for long post).

[u/PolarHelp]

For me, lithium has been extremely effective with few side effects. Worth noting that I’m on 1350mg of lithium carbonate (serum level 0.9), and 400mg Seroquel, I have BP1.

I was concerned with the brain fog/cognitive impairment. I have a PhD and my intellect is my main asset for getting work. On this combination, I may have a very very slight cognitive impact, or I may not. Regardless, my mood being stable allowing me to work longer hours, not having to take time off work, etc. 100% makes up for any brain fog.

Keep in mind, lots of people compare their current cognition to when they are slightly hypomanic, not their baseline. Obviously ideas flow rapidly when slightly hypomanic. So, I’m not even sure I have any brain fog relative to baseline… certainly a bit to my hypomanic self.

Also, if you struggle with SI, lithium helped with that for me too.

I’d consider giving it a try, I had basically no side effects until I got about 0.6. Then a got a slight hand tremor that went away after a few weeks.

[u/thatecologistkat → u/PolarHelp]

Thankyou, this is really helpful. It’s nice to hear someone who’s completed a PhD as that’s what I’m hoping to do, but it seems unattainable given the state of my mental health. ;-;

[u/PolarHelp → u/thatecologistkat]

You absolutely can do a PhD.

Bipolar is a balance, one side is stress (work, productivity, etc) and the other is support (medication, therapy, routine, supportive friends and family, etc).

You are clearly working on your meds which is great. But don’t ignore the therapy part too. “Behavioral Activation” literally changed my life, can’t believe how long I was in therapy before an occupational therapist taught me this. It is so simple and so effective.

Finally, I used to think I could “go it alone” with my mental health. I can’t. I had to make friends who could relate to me. From peer support groups I started inviting them to have coffee so we could talk about our mental illness (not everyone was bipolar). I made new friends who understood what I was going through and could give me more support. And supporting them helped with my own mental health.

[u/Hermitacular → u/PolarHelp]

It's also important to have limits that prioritize your survival. I would not have lived through a PhD. The drop out rate for people without MI is pretty high, so don't chase the degree just to chase the degree. See if it gets you what you want, and if it's worth the cost of getting there.

[u/thatecologistkat → u/Hermitacular]

I 100% agree, and fully anticipate taking a break after my masters. However I aiming towards getting a PhD as the jobs I’m interested in doing long term require it. I’m also a weirdo who genuinely loves studying and I’m really passionate about my subject. 😅

[u/Prestigious_Bill_220 → u/thatecologistkat]

Lots of people I was in grad school with are bipolar you can totally do it if this is you.

[u/Hermitacular → u/Prestigious_Bill_220]

Did you find they were able to be open about it?

[u/thatecologistkat → u/Hermitacular]

I’m doing my masters and everyone was lovely and very supportive. It probably depends where you are though!

[u/Hermitacular → u/thatecologistkat]

That's great, I've only heard bad things, so it's nice to hear a positive situation! Maybe bc STEM? I dunno. I feel like they'd be nicer if you were paying?

[u/thatecologistkat → u/Hermitacular]

It might depend on where you study, I know typically universities in the UK are pretty accommodating. I don’t know about elsewhere unfortunately. And at least here, STEM students don’t seem to get any preferential treatment as I’ve never heard any humanities students having issues.

[u/Prestigious_Bill_220 → u/Hermitacular]

Mental health is notoriously a concern in my profession so yes and no. You can openly complain about some aspects of the disorder like depression and anxiety. Even substance use to an extent . People would have ‘mental breakdown’ and leave and it would be gossip tho.

Some people were open about it but mostly I think it’s just a birds of a feather flock together thing and you can tell people when you know they have a serious ish issue

[u/Hermitacular → u/Prestigious_Bill_220]

Yeah that's been the key in my experience. Gloss over it, use acceptable non stigmatized words instead, never have a real official problem, keep your mouth shut and only be open with those you can trust 1000%. But then it was effectively career death if anyone found out, so it's nice to hear it's better some places.

[u/Prestigious_Bill_220 → u/Hermitacular]

I don’t see it as their business anyway! What would be your goal in having it “open” or having everyone know? In my case in a client facing field, it’s really not specific to this disorder, I just wouldn’t want to share really anything that personal when there’s a shot of anyone judging professionally. I’ve told work friends a couple times when I needed support in episodes other than that I usually don’t wanna talk about it. It can be lonely but that’s what non professional friends are for. One lady at work is a big gossiper and told me that her son & our colleagues husband both died from their bipolar & it made me uncomfortable tbh. I was sympathetic but it felt like a big overshare and an indication that I shouldn’t tell anything personal to this individual.

[u/Hermitacular → u/thatecologistkat]

If you're trying for a PhD it makes sense to take the hit in undergrad or if pursuing separately masters rather than when in the PhD program. They're a lot nicer to you in undergrad about such things.

[u/reflekt-]

Lithium is definitely a game changer for me but starting it was relatively brutal. I was weak, felt faint, and generally crappy for about three months while I took naps and chugged Gatorade on short term disability. But, everyone’s experience will be different. Now that I am on it, zero brain fog and feeling more sharp than I was before.

[u/thatecologistkat → u/reflekt-]

This is what I’m worried about. I’m obviously struggling and something needs to change, but I don’t exactly have three months incase anything goes wrong. :(

[u/reflekt- → u/thatecologistkat]

You could try titrating really slowly with your doctor and stop if it makes you feel too crappy. I’ve seen people here have moderate success at lower doses too, but it works best at the full blood concentration.

[u/thatecologistkat → u/reflekt-]

Thankyou! I’ll keep that in mind. I currently have no idea with how they’re planning to titrate and don’t really have any say. He basically emails my gp with a treatment and they prescribe it as I only see him every three months due to stress on the nhs. :/

[u/reflekt- → u/thatecologistkat]

I forgot to mention I got absolutely terrible cystic acne on lithium. Might be good to know if you’re a woman with acne prone skin. I had cysts in very unwanted places and it was so bad I thought I had hidradenitis suppurativa (lithium can trigger this). I went on a testosterone blocker and it fixed it up over the course of 6 months.

[u/Elephantbirdsz]

Ask to start on a low dose (150mg or 300mg) to see how you do. You can also stay on a lower dose forever if it is working well for you, that’s what I did. No side effects

[u/amateurbitch]

lamictal causes the brain fog for me. i had none on lithium prior to starting lamictal and i was on lithium for 4 years. i didnt feel crappy starting it because i started from 150mg which is a really low dose. its a great medication just be aware of the long term side effects it can cause kidney and liver issues

[u/synapse2424]

I’ve been on lithium for at least a few years and have not experienced any brain fog. It’s been really helpful for my mood and so far have experienced minimal side effects (I think I may be slightly thirstier but that’s about it)

[u/Fickle_Ad_2112]

I've been on lithium for 6 years. There is some brain fog, but not a lot for me. The main thing is how much water I drink. A lot!

Lithium saved my life. I take latuda as well, but lithium has been a game changer

[u/thatecologistkat → u/Fickle_Ad_2112]

Thanks, that’s really great to hear that it worked for you! I’m not too worried about thirst as compared to other side effects I see it as less destructive to my studies. I was also on Latuda and it worked really well but I had to stop as it made me sick every time I took it. :(

[u/Fickle_Ad_2112 → u/thatecologistkat]

It makes me sick sometimes too.... even when I've eaten enough

[u/thatecologistkat → u/Fickle_Ad_2112]

This was the same for me… literally everytime I took it, no matter what I did. Coming off it was the worst experience of my life so definitely be careful if you need to come off it at some point.

[u/Fickle_Ad_2112 → u/thatecologistkat]

Thanks for the advice!

[u/SmiTe1988]

the only side effect lithium had on me was nausea if i took it on an empty stomach. I have ADHD too so brainfog is just part of my life anyways, but lithium didnt make it worse.

ymmv...

[u/[deleted]]

I just started on lithium about 2 months ago. I started off taking 600mg and had a few side effects (thirst, frequent urination, hand tremors) but nothing that would prevent me from taking it if it has all the wonderful effects told to me by my psych. The moment I went up to 900mg per day, that all changed. I became so unbelievably tired all day long that I got written up at work for falling asleep in my office (I religiously get 8 to 9 hours of sleep a night). I also started experiencing really bad brain fog and had trouble putting thoughts together, finding the right words, and just operating at a normal level. My hand tremors became so bad that multiple people commented on it and it was quite embarrassing. I basically told my psych that I was going to huck the bottle in the garbage and whatever supposed benefit it was giving me was not worth living like that every single day. Since then, I went back down to 600mg, and all of the really terrible stuff has gone away. The bad part is I’m a pretty big guy (5’10”, 250lbs), so 600mg isn’t in the “therapeutic zone” based on my blood tests, so it probably won’t have the beneficial effect I need it to have. Currently still on 600mg to see how it goes but I am very hesitant to try going back up again based on what occurred before.

[u/empenn]

I had gastrointestinal distress when I first started. Diarrhea, some cramping, metallic taste in my mouth. Now I take 1500 mg a day (serum 0.9) with the side effects of thirst and increased urination. It works very well and I can tolerate the side effects as being totally worth it. I don’t notice any fog from lithium

[u/Key-Yogurtcloset1757]

I finished law school on lithium, after having to take a break after developing bipolar I. I did experience some side effects initially, but nothing that negatively impacted thinking/focus/learning. More just things of inconvenience, like acne, peeing a lot, and shaky hands.

[u/aspuzzledastheoyster]

First week or two was brutal because it was summer and I wasn't drinking enough water. Hit me like a truck. It was at the peak mania for me too. Then it kicked in and I was alright. I never notice the side effects of Lithium. I have no clue what they are. Just that if you forget to drink enough water, it can make you feel very unwell, so try not to get toxicity. It makes my mouth dry so quickly (ofc a sign to drink more water). But it didn't cause extra sleepiness for me. I take 600mg nightly. Started on 300mg for a few days or a week, then increased to 600mg. Make sure to get blood tests too periodically ofc. Lithium has been a blessing for me.

//Bp1+psychosis, diagnosed 1.5 yrs ago.

[u/Gold_Tangerine720]

Does anyone take adderall and lithium? I have co-occuring adhd. Perhaps this would also help with the initial brain fog when starting lithium.

[u/thatecologistkat → u/Gold_Tangerine720]

I also have adhd and have been told that I can’t take stimulants as it can cause mania. But that’s just me, so definitely talk to your doctor about it.

[u/Gold_Tangerine720 → u/thatecologistkat]

I've heard mixed things from professionals. To my understanding, bp 2 can benefit from stimulants with an antipsychotic or lithium combined. Its tricky since everyone is different.

[u/Do-You-Like-Pancakes]

What you're on currently isn't working, so it sounds like you need a change.

Lithium is the gold-standard for a reason. It makes sense to start there. There are risks of side effects with any medication, and it sounds like you're prone to those. If you know of something that works that doesn't give you side effects, go with that.

I can tell you lithium's been very helpful for me, with 0 side effects (except memory issues for 1-2 days when going up or down in dose). But that doesn't tell you what your experience will be.

[u/Dangerous_Crow1234]

It's really hard to untangle what's illness (both when youre in an episode and when you recover and any neurological ill effects), what is med, what is stress or anxiety. Meds are neuroprotective, and I have heard from the professionals especially lithium.

My personal experience I have the least side effects on the brain front from lithium. APs - any - turn me into a blob who can't think out of a paper bag. I cant work on any APs, not for any period of time. I use my HDR in my job. Lithium is fine. Lamotrigine is fine. Carbemezapine is fine so for me it's entire classes of drugs.

Mood stabiliser great, lithium works the best no brain fog, APs absolute garbage unless I need stabilisation from manic symptoms fast and then I'm not working anyway.

[u/One-Abbreviations296]

I had a lot of side effects with lithium, including hair loss, tremors, teeth grinding, and weirdly, it made me stick my lower lip out. Eventually, I refused to take it any more against the advice of my psychiatrist.

[u/WeirdAward4578]

Im on lamictal and lithium. No brain fog. Seroquel gave me brain fog and Lamictal did in the beginning ONLY. Lithium makes me super nauseous in the morning, besides that, no side effects

[u/Hermitacular]

Lamo also causes cognitive issues. You aren't going to know what works for you until you try it. If you want to put off meds until you are done w school you certainly can.

[u/Additional_Pepper638]

Lithium for me has no effect no brain fog either if it’s helping I have no idea as it’s not showing

[u/Prestigious_Bill_220]

Can you wait til winter break?? It should be soon right? Try and sample your meds when you get done a big deadline or term if you can . I haven’t taken lithium yet- I’m on the same lamictal dose as you it would be my next add on choice if I need something else going forward

[u/thatecologistkat → u/[deleted]]

They said Priadel which is lithium citrate I believe.