Li

“Bipolar disorder is an illness that is biological in its origins, yet one that feels psychological in the experiences of it; an illness that is unique in conferring advantage and pleasure, yet one that brings in its wake almost unendurable suffering, and not infrequently, suicide.”-- Dr. Kay Redfield Jamison, Ph.D., An Unquiet Mind

Lithium is my least favorite of all of the medications I take. It slows me down, makes my mouth dry, upsets my stomach terribly, gives me a hand tremor, and causes terrible weight gain.

There are many alternative medications available, but most are in classes of drugs that I can't take. Not that it matters. My doctor insists on lithium because in my case, it works. There is one other thing. Lithium provides protection against suicide, and no other mood stabilizer works so specifically in this area.

The exact mechanism that provides this protection still is not known, but research shows a strong and consistent relationship between lithium and the patient's reluctance to suicide. In my case, my doctor feels strongly about not making a change, no matter how unpleasant the side effects. Because I believe suicide is a valid and appropriate option of pain cessation for people with bipolar disorder, it means I lack the psychological barrier that protects me from harming myself this way.

Taking lithium doesn't stop me from being suicidal; it just stops me from following through on the idea. I am like the Terminator model T-101 in Terminator 3: I cannot self-terminate. There are days when that frustrates me, and days when it just makes me very, very sad. Doomed to keep going.

I am sure that some day lithium will quit working for me. I'll consider my options then. For now, I endure and cope.

Four years ago, at the height of mixed-states and rapid cycling, my tolerance for stress and frustration were minimal. Even the most minor setbacks caused my brain and behavior to spin off erratically, resulting in near-total meltdowns. And when I say minor, I mean like going out to eat only to find there are no vegetarian items on the menu.

Such is the power of lithium. I cope with a difficult and disappointing medical condition that causes me relentless excruciating pain. Life keeps throwing me curve balls that hit me square on the head. I'm overwhelmed. And nobody knows except for Frank. Yes, four years ago, this would have killed me. I would have killed me.

I have been told more than once that this is a big success for me and my treatment. My feelings about this so-called success are decidedly...ambivalent. This is what I'm supposed to happy about? This is the measure of my health?

This is not what I had in mind. I do not find any comfort or triumph in this so-called success.

I'm saving my money for a trip to Switzerland. Just in case.