Healing Journey

Lithium

Advertisements

To write about the subject of Lithium I have consulted Dr David Healy’s book “Mania: A Short History of Bipolar Disorder” [1]. Some quotes and information at the start of this blog are from his book. I am in awe at the level of detail and research that must have gone into it.

As an alkaline substance, Lithium was initially used to treat gout and rheumatic conditions. “While using Lithium to treat gout, Garrod reported that patients often showed a general sense of well-being”, pg. 92. Considering the more recent knowledge about inflammation that functional medicine doctors discuss, I find this fact interesting.

“The key individual in the emergence of a prophylactic use of Lithium for mood disorders is Carl Georg Lange”, pg. 94. Another person to use Lithium with some success in treating Manic symptoms in patients was John Cade in Australia. However the toxic effect of Lithium carbonate caused the death of some of his patients. “The use of Lithium was linked to cardiac difficulties and it was banned by the FDA in 1949 … The question of toxicity highlighted the need to establish a safe dose and to be able to monitor treatment”.

“But consider what makes for a placebo response. The natural history of mood disorders means that many will improve within a few weeks whether treated or not. It is also widely thought that sensible clinical advice on matters of diet, life-style, alcohol intake, and work and relationship problem solving may make a difference. It is suspected that patients’ perceptions that they are being cared for by a medical expert may make a difference, and this effect may be enhancing by being given a substance they think will restore chemical imbalance to normal – even if that imbalance is mythical and the substance is placebo. The fact that the patients present themselves for treatment may also make a difference. All of these factors are reflected in the placebo response. But it is not possible to quantify the distinct contribution of these components” pg. 129.

I now want to talk about my own experience with Lithium and some of the things I learned when on it. It may under certain conditions lead to kidney damage and/or damage to the thyroid. If a woman becomes pregnant on Lithium it can damage the developing foetus.

In 2008, after my Adverse Drug Reaction to the anti-depressant Citalopram and when mainstream Psychiatry had hastily labelled me “Bipolar 1” (while ignoring advice in DSM-IV-TR) I was put on Lithium [3]. According to this book, “Bipolar 1” only affects about 1 in 100,000 people, so it is a rare condition. I’ve also learned that from Prof Ivor Browne. From my reading, I do believe that the overuse of anti-depressants is one of the factors in the current Bipolar “epidemic”.

When I was introduced to Lithium, it appeared to be informed consent at the time. Someone talked to me about this drug and I was given some material to read, but it wasn’t true informed consent. I wasn’t fully aware of the truly toxic nature of this drug. I was put on 1000 mg and ended up on that dosage for nearly 2 years. I had regular blood tests to see if the the Lithium levels were in the so called therapeutic range, as well as thyroid function tests.

After the anti-depressant Citalopram caused mania / psychosis or what I refer to as “SSRI induced Bipolar type symptoms” in August 2008, I have 9 foolscap pages showing the large cocktail of expensive drugs I was on from when I left hospital in October 2008 up until August 2011. While on Lithium (and Seroquel) I had a long Manic episode in 2010, for about 3 months. I don’t remember Seroquel having any benefit at all. I don’t feel that Lithium did anything for me therapeutically either, in a true sense. I was eventually switched from Seroquel to Olanzapine in June 2010 and things improved i.e. I eventually came out of that horrendous episode, which may have seemed fun at the time but I also remember feeling that I just wanted the “manic” feeling to end.

I also decided to come off Lithium towards the end of that “episode” and I let the Psychiatrist know. I withdrew from Lithium in jumps of 200 mg, which is far too fast a rate. As I write this I wonder why the Psychiatrist didn’t give me a strict warning and a better withdrawal plan. I was still going to see him on a regular basis (up until January 2012 when I left mainstream Psychiatry behind me and their drugs, other than a few 5mg Olanzapine that I kept on standby for a while but then they eventually went out of date, which in hindsight meant this whole disaster was coming to some kind of ending).

When jumping down off Lithium at what I now realise was a fast rate, I would have gone into withdrawal, with all the symptoms that goes with that. I became very depressed after coming off it and, due to the brainwashing about Manic Depression, felt that this was just part of “my illness”. I was lethargic and lay in bed with not much interest in life. Based on what I now know about the complexity of the withdrawal process, I see this differently [4].

I felt that Lithium blunted my emotions and also remember the day when this “fog” lifted and I started to feel again. I cried when I realised what the drug had done to me. I regret taking Lithium.

My father was on Lithium for years and his thyroid was affected by it. While he died from prostate cancer, I sometimes wonder if the kidney failure he experienced towards the very end of his life had something to do with being on this drug long term.

An Unquiet Mind by Kay Redfield Jamison

When I first read An Unquiet Mind [2] a number of years ago, while still ingrained in the biomedical model and on the drugs, I thought it was a good book. When I re-read it recently I see things differently now, not forgetting that it’s over 2 decades since it was published (1995). Jamison is a talented writer.

When she talks about the marvelous kind of cosmic relatedness, “the webbings of the universe”, and how everything seems interrelated even when sometimes others can’t see, I can relate to that. It tries to describe in words the experience of mania / psychosis (loss of touch with so called reality), which is not so easy to write about or even to describe verbally. A person’s thoughts can become out of control and tolerance can be lacking from others.

She says in her book that she briefly took antidepressants but they only made her more dangerously agitated. She also claims that it is not uncommon for depressed doctors to prescribe anti-depressants for themselves and that the results can be disastrous.

Even though she praises Lithium as a wonder drug in her life, the efficacy and safety of Lithium is not as compelling as she claims. She also admits that she had she continued to experience fluctuations in mood while on Lithium. When she eventually had her dosage of Lithium reduced “it was as though I had taken bandages off my eyes after many years of partial blindness … I wept for the poignancy of all the intensity I had lost without knowing it and I wept for the pleasure of experiencing it again … the subtle, dreadful muffling of the senses”. I can relate to this when I think back to the time I was coming off Lithium.

Dr Jamison talks about the mind healing if it is given a chance. She also mentions how important love is in the healing process and that it can act as a very strong medicine.  The love and support of others helped her through.

Several times she refers to the hereditary nature of Manic Depression and she mentions ongoing genetic research, but in reality no true bio-markers have been found. Even today over two decades later. While Dr Yolande Lucire has discovered that there can be a problem metabolizing the drugs and there may be a genetic aspect to that [5], in general nothing of real significance has materialised because of genetic research into Manic Depression / Bipolar, that I’m aware of.

She talks about the brain-damaging effects of stopping medication. While people have to be very careful changing or stopping prescribed drugs, if anything the opposite is true. The drugs cause brain damage. Olanzapine, for example, which came to the market in 1996 [6].

Changes in the brain can sometimes be explained by treatment history, as opposed to “mental illness”. Symptoms are not always beyond our control and we are not as “beholden to medication” as some would like us to believe. But that takes patience, self-discipline, persistence and daily work on physical / emotional well-being. As well as tolerance of setbacks and support from others. I do not believe it is a life long illness or disease, but if you tell your sub-conscious that it can become a self-fulfilling prophecy.

Hope is another cornerstone of the healing process. I do feel that my symptoms were mainly iatrogenic i.e. caused by taking the SSRI anti-depressant Citalopram for anxiety (between 2005 and 2008). I haven’t experienced Mania / Psychosis in nearly 5 years (December 2012). I was prone to relapse for at least 2 years after all the drugging. I am now free of of prescribed psychoactive substances, but if I had to write how I got there I would find it difficult. Support from doctors was lacking. They seem to have no problem getting you on a drug but stopping their cocktail of drugs is frowned upon.

I still struggle with other issues e.g. sleep. I do not believe that I have Manic Depression / Bipolar. If I did I would not be ashamed to say it. But I no longer feel conditioned into believing this. I do however suffer from Tardive Dysphoria (long term, sometimes severe Depression after being through drugging and the whole ordeal). In some ways I miss the highs. I occasionally experience a mild high, but I’m not complaining. Or a bit of a mixed episode which I feel is connected to being on the drugs. Female hormones are also a factor. I’m all for personal responsibility, but the bottom line is I feel mainstream Psychiatry got it very wrong at the start and caused major, ongoing, devastating trauma in my life on many levels. I’m still coming to terms with that and learning to let go.

{ Important Do not stop or change prescribed psychoactive drugs without consulting your prescriber, due to the dangers of withdrawal. Any changes need to take place under the supervision of an expert. Some people may feel they benefit from Lithium or other drugs I mention here. What I discuss in part of this blog is my own experience and is not medical advice. We all have our own unique journey }


References

[1] Mania: A Short History of Bipolar Disorder by Dr David Healy (2008)

https://www.amazon.com/Mania-History-Bipolar-Disorder-Biographies/dp/1421403978

[2] An Unquiet Mind by Kay Redfield Jamison (1995)

www.amazon.com/Unquiet-Mind-Memoir-Moods-Madness/dp/0679763309

[3] Article by Dr Peter Breggin ~
http://breggin.com/wp-content/uploads/2005/01/31-49.pdf

DSM-IV-TR “emphasizes that a diagnosis of Mania or Bipolar Disorder should not be made when the hypomania or mania first appears while the individual is taking a medication that can cause these symptoms”. DSM-IV-TR (2000) ~ Diagnostic and Statistics Manual. Fourth edition, text revision

[4] Coming off Psychiatric Medication ~ Advice for Prescribers ~
http://www.comingoff.com/lith.php

[5] http://www.drlucire.com/adverse-drug-reactions.html (Dr Yolande Lucire, Forensic Psychiatrist)

Dr Lucire explains that not all people are born with a full complement of metabolizing enzymes, increasing the risk of side effects which can range from mild to life-threatening. Changing dosage up or down and starting / stopping drugs are also crucial times, sometimes affecting the person months after stopping.

[6] “The Influence of Chronic Exposure to Antipsychotic Medications on Brain Size before and after Tissue Fixation…” ~ http://www.nature.com/npp/journal/v30/n9/full/1300710a.html

In 2005, a study funded by the maker of Zyprexa / Olanzapine, found that chronic / long term exposure to this major tranquilizer causes shrinkage of the brain. “significant reduction in brain volume that affects both gray and white matter”! I learned about this from honest Psychiatrists Dr Peter Breggin and Dr Joanna Moncrieff. I was put on Zyprexa, at what I now consider too high a dosage (10mg) long term in 2008! I did not have informed consent about this powerful but potentially damaging drug. Very short term use would have been enough and proper advice about withdrawal and stopping. Something I never got from a private hospital. I was let out the door with nothing but a prescription. I ran to the train and thought all was great.

2 weeks later I went into what I now know to be withdrawal and akathisia (a severe inner restlessness). I ended up back in hospital for a month, a broken woman. The year that followed is a complete blur and the last 9 years have been difficult because of what I was put through. Mainstream Psychiatrists I saw at the time withheld valuable but vital information.

 

Advertisements