Bipolar Disorder - When we use Lithium
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- čas přidán 24. 12. 2019
- Lithium is the first recommended treatment for bipolar disorder, but only when you have classic bipolar disorder. Classic bipolar disorder is when you have a clean separation between depressive episodes and manic episodes. I've defined depression and mania in several videos that are grouped into my bipolar disorder playlist.
A clean separation means that when one episode is over, you return to your baseline until the next episode comes. You don't have lingering depression with anxiety mixed in.
Lithium is not a good choice when you have a mixture of mania and depression symptoms happening at the same time. We call this bipolar disorder with mixed features. So you have the hyperarousal of mania where you are sped up, you may be impulsive, using poor judgment, irritable or angry while also having at least 3 depressive symptoms with your mania. I describe this in more detail in my mixed mania video.
In the case of mixed features, the recommended first choice is an antipsychotic medication like quetiapine. We use the second generation antipsychotic medications as mood stabilizers in bipolar disorder.
One thing that lithium does that the other medication don't do as well is it reduces suicidal thinking. The only other medication that addresses this at the same level is ketamine, which we use for treatment resistant unipolar depression.
Side effects of lithium
Lithium can cause weight gain, tiredness, and fuzzy thinking similar to some of the other mood stabilizers. But Lithium also has some side effects that can come with long-term use. Lithium can cause your thyroid to malfunction such that you start to produce inadequate amounts of thyroid hormone.
The second long-term side effects is to your kidneys. Everyone has some decline in kidney function as you get older. But long-term lithium use can accelerate this process. You can also get a condition called diabetes insipidus. This is different from diabetes mellitus where you get elevated blood sugar levels. With insipidus, your kidney loses its ability to concentrate your urine. You get frequent urination and excessive thirst.
Diabetes insipidus can happen even within the first weeks to months of taking lithium. In usually resolves on its own, but it can persist in about 25% of people. Sometimes this problem can be helped by taking your lithium all at once at bedtime. If the problem doesn't go away, then it's probably best to switch to a different mood stabilizer. If you catch it early, it's reversible usually within weeks.
Another way lithium can damage your kidneys is if it gets too concentrated in your blood. It can reach toxic levels and damage your kidneys. That's why it's important to have your lithium levels checked on a regular basis and you have to make sure you stay hydrated. If you loose a lot of fluid from excessive sweating, diarrhea or vomiting, watch carefully for signs of lithium toxicity.
Early signs of lithium toxicity are tremor, slurred speech, feeling tired and weak. You can also get diarrhea and vomiting from the toxicity. If you started feeling this way, you should get yourself to an emergency room or urgent care to be evaluated.
If you are on lithium, make sure all of your doctors know so they can check for any drug interactions from medications they prescribe. Also, if you have pain problems, watch your consumption of non-steroidal anti-inflammatory medications like Advil or Aleve. This class of medication can increase lithium levels.
What about lithium orotate?
This is a version of lithium that is available over the counter. It's a much lower dose of lithium than what you get with prescription lithium. The prescription versions are lithium carbonate and lithium citrate. Because you are still taking lithium, you are still susceptible to the risks that you have with prescription lithium.
Links to videos
Bipolar Playlist • Bipolar Disorder vs De...
Mixed mania • What is Mixed Mania an...
Want to know more about mental health and self-improvement? On this channel I discuss topics such as bipolar disorder, major depression, anxiety disorders, attention deficit disorder (ADHD), relationships and personal development/self-improvement. I upload weekly. If you don't want to miss a video, click here to subscribe. goo.gl/DFfT33
Disclaimer: All of the information on this channel is for educational purposes and not intended to be specific/personal medical advice from me to you. Watching the videos or getting answers to comments/question, does not establish a doctor-patient relationship. If you have your own doctor, perhaps these videos can help prepare you for your discussion with your doctor.
I was on lithium for a year. It saved my life, but the monthly blood tests, the shaky hands, the constant metallic taste, not to mention the weight gain, it made me feel physically crummy. It was worth it, though. I remember the first moments my mood began to lift. It was actually last Christmas. I was sitting in China town and told my family “I finally feel as if going to be okay.” After a year long battle, thanks to lithium. It still brings tears to my eyes. I went off it on labor day and I’ve lost 30 pounds (I’m on lamotrigine) and my Bipolar will never haunt me again. I turn 18 next month. Without lithium, I wouldn’t be having any more birthdays. Funny how you uploaded this today.
Yes that is very interesting timing of this video. I’m glad the limo to Jean picked up where the less him left off for you. Yes the shaky hands can be a real problem especially for someone who uses their hands. It also can be embarrassing because it’s so noticeable. I’m glad you’re feeling so much better. Here’s to many more birthdays. 👍🏽
lol
Thank for sharing. You could have helped someone by sharing that
Hold up, that's why I always tasted metal?!?! How did I not know this?
What was the dosage u had been taking ?
Wish you well!
Hi, there. I'm on lithium for about a month now, after being diagnosed with bipolar disorder. I almost shed in tears when you said it adresses suicidal thinking. It's true. One week after starting the medication, I couldn't be happier. All I could think is how my life could have been easier if I had searched proper treatment before.
What kind? Lithium carbonate? How's ur mood while ur on it?
(I'm taking Lithium Carbonate and my mood is usually neutral while taking it)
You’re doing it now brother 🙏
Lithium makes me think of the song
Evanescence, and Nirvana lol
The real one or the Evanescence one?
“I’m so happy”
Liiiiiithiummmm liiiiiiithiiium
Yess! Its One of my favorite songs by nirvana
I really take advantage of what you share everyday,
Keep it up mrs,Psychiatrist
Oh I'm glad to know that. Keep taking advantage!🙂
Appreciate video content! Excuse me for butting in, I would love your initial thoughts. Have you thought about - Peyadison Initial Principality (erm, check it on google should be there)? It is a good one off guide for discovering how to get rid of depression without the hard work. Ive heard some extraordinary things about it and my close friend Aubrey after a lifetime of fighting got cool results with it.
@@DrTraceyMarks I was a patient at a mental health clinic and it all started when I first was diagnosed with anxiety from like over a year earlier after I drank some marijuana tea then I kept on drinking alcohol from their on and seems I was staying up online and wasn't getting enough sleep so it all comes crashing down on me and I started feeling terrible headaches and i was very dizzy like the entire room was spinning.
When I went to the doctor he got tired of seeing me and finally sent me to the psychiatrist who diagnosed me with insomnia.
@@DrTraceyMarks so the psychiatrist started prescribing different meds such as sleeping pills first midazolam which would completely stop my panic attacks because I remember telling the doc I felt like I'm dying.
Midazolam would work but the headaches afterwords was terrible so they started prescribing melatonin and different pills .
I stop going to the psychiatrist since they put me on cpz
Which was the most terrible thing I ever expected. Now I gets very sleepy as soon as it reaches like 7 o clock and I found that I spelt on my own without meds even last night and it's being like over 8 months I've use meds.
Thing is that if I listen music then it starts playing back in my head which is so annoying and causing me to can't sleep idk what it is and even though I sleep I'm still kinda not so energetic in the days .
I only felt normal and very strong and wakeful when if I use Xanax
@@DrTraceyMarks hi dr, does it help for MANIC depression or only bi polar? because im basically depressed all the time, i still have a full time job, and i never feel HAPPY to be honest, when i have a coffee i start talking more, but thats not MANIA, would lithium tablets like LITHICARB help me also? thanks
I’m 20 and have been on lithium for 2 years. I must have got lucky, because apart from excessive thirst, I’ve had zero side effects! I spent 4 years on anti psychotics that ruined my life with the side effects, so I am so happy to have finally found a medication that has saved my life. I haven’t had an episode in nearly 2 years. There is hope!
There is hope what dosage do you use
What's ur diagnosis? I have bipolar II
Sound amazing 🥺🥺🥹🥹
@@vph6823 bipolar 1
@@bricotico6498 800mg, which is upped to 1g in the winter
As someone with bipolar disorder currently prescribed lithium, really glad to see accessible information out there. I greatly appreciate this.
Really hope it's working for you comrade
One thing I gain from reading all the comments is how much of a challenge dr’s must have treating us. The variety of meds, symptoms, and how every person seems to react differently to treatment is fascinating.
Thank you so much for this video ❤️
Thank you for all your hard work, Dr. Marks!
Other tips for lithium survival: Salty foods and beverages, ice water, taking it all at bed time, lab tests every 6 months, taking on a full stomach, taking electrolytes
not taking it is the safest way
@@JoaoPedro-lb6mr given that it's proven to prevent suicide, taking it if it works to treat your bipolar or unipolar depression is significantly safer
Why salty foods?
@@WhitneyAbrina The body will use lithium in place of salt if there is not enough salt. That leads to trouble talking in me, and I guess it's lithium toxicity. I drink a large amount of V8 which has high sodium, and I feel better.
@@JoaoPedro-lb6mr why
Other doctors, especially the ones in my country must watch your videos and educate themselves. Not only for the knowledge you present and share but for the honesty and sincerety you possess. You're an awesome human being. Have a nice day and take care :)
Thank you so much for making this video. I actually went to counseling today, and she is going to suggest to my APA that I switch to lithium. I subscribed to your channel and plan to keep watching them.
I really appreciate your videos, your approach to sharing this information and the fact that you’re making this content. A big thank you. Happy holidays.
Lithium never made me feel any different, physically, but in terms of treatment it was so effective.
Your channel is the best I found so far.
The best channel I subscribed to in 2020 of the nearly hundreds that I did !
You're such an amazing doctor.
All cheers from India 🇮🇳
Awesome!! Thank you so much. 😊❤️
I just want to give my experience. I don’t think I have classic bipolar but was probably closest to that when I was younger. I started developing mixed features about 8 years ago when my mom died. At that time I sought treatment for a second time at the request of my primary care. I was put on lamictal, which turned out to be horrible for me. I dropped off medicine for about 18 months. I finally agreed to give Lithium a try. OMG I can’t believe the difference it has made. My suicidal thinking is gone, my anxiety is not gone but reduced, unfortunately my euphoria is also greatly reduced but it has given me hope for the future. I am sleeping better. I just wanted to give my experience for someone else who may be going through a similar experience.
Thank you! ❤️🙏
Yes lithium is great
Any acne ?
This video has been so helpful, so as always thank you. My experience with Lithium was horrible at first, I was taking the immediate release capsules and I would start vomiting about a half hour after taking it, in addition, I was constantly urinating-to the point of bed wetting, also I was shaking so bad I couldn't hold a glass of water without it falling to the ground. I asked if there was an extended release that I could try and was switched immediately. My life has changed so drastically for the better. I had to be taken off of my Lisinopril by my cardiologist for drug interaction and once he saw that I was taking Lithium he asked how it was going with the drug and without even thinking I replied "amazing". It has changed my life for the better and I no longer slack on taking my medication because I know that I have finally found a treatment that works. Thank you for your insight on the topic, and please continue making these awesome videos.
Hello, I am about to start lithium and I am a bit sceptic. Do you have some side effects from the slow release medicine? Did it change your life for the better?
Thanks again for your time and thoughtful videos. GOD bless you and your loved ones and may you have a very Merry Christmas
Thank you so much Tom 😊
Dr. Marks you are such a blessing to me. Thank you for your videos, and please have a safe and happy new year. =)
I needed a review for a psych nursing exam where we’ll need to assess the pros and cons of some treatments, this video helped clear up things, thank you!
Thank you so much for breaking this down for us. I was diagnosed with Bipolar I a year ago and have been trying to pick up the pieces of my life since then. I wish my psychiatrist had the time to explain all of this information before I was put on lithium. He really wanted to take me off of depakote when I got out of the hospital because he just had something against any woman of child bearing age take it. I really wish I had stayed on it now though because I have been realizing that about half of all my mood episodes are mixed. Thank you for such an enlightening video, I plan on bringing up the mixed mood episodes in my next appointment.
Did you bring it up with your psychiatrist?
This dr is first class. Wish she was my doc.
i'd love to see a video about bipolar disorder in teens! teens can have different experiences with bipolar disorder, so i think it'd be good to make a video so teens and their parents can learn.
This is a great channel.
Thanks so much J Jones 😊
@@DrTraceyMarks You're welcome!
thanks for the free educational videos as a person with bipolar this is super helpful god bless.
Thank you for this. I’ve been taking lithium for 13 years. It was the second mood stabilizer my doctor tried and was the best option for me.
You're welcome Jennifer. I'm so glad it's working out for you. 🙂
do you have kids lithium 400 mg .. does it cause anything bad realted to marriage
Yes I have a son. The disorder had a negative effect on my marriage. When I was first diagnosed, the therapist suggested that I not make any life changing decisions but I didn’t listen.
What was first one
I take 900mg of lithium a day been taking it for almost 20 years.ijs
me doing my research to save britney from her conservatorship
Literally why I'm here lol
🤣
Cool story. Those of us who have severe mental illness are really pleased to hear that this is entertainment for you.
@@jonsmith1162 issa joke, calm down. Besides, who said we weren't mentally ill?
me watching this to make sure Britney’s health is still alright.
Thanks for your best description dr❤️❤️🙏🙏
my doc started me on lithium right away and it definitely has been helping me with my mania for a little over a year now.
how it going?
Thank you for your videos, Dr. Marks. I've been taking my meds religiously and always wondered why the doc wouldn't give me lithium, and now I know.
I am a veterinarian with type 2 bipolar, with clear ups and downs. I'm slowly transitioning from sodium valproate to lithium and I'm really appreciating it. Sodium valproate made me feel hazy. Transition is clearing my head.
Diabetes incipidus would be a minor inconvenience.
And I appreciate your response on OTC medications with potentially lethal overdose consequences. We see animals juiced up by their owners on OTC medications to toxic levels commonly. Please always seek PROFESSIONAL advice people. That's why we study and train for so many years.
Hey what animals do you treat?
Beautiful it's so nice to see someone who looks like me talking about psychiatric education thank you so much
♡♡♡
You care too much about looks hmm?
(Just teasing)
And what about the information she is conveying?
Thank you ! This is so clear and comprehensive!
I super appreciate this video! I just started taking lithium like a month ago and it never hurts to get more info on it.
How's it going?
Lithium orotate is like a mineral supplement. 5mg a day + magnesium really helps calm the nerves and feel grounded. No negative side affects so far for me. Increased apetite, thirst and a bit of nausea maybe, but it helps negate bad thoughts.
I’m surprised 5mg does anything. Maintenance dose is usually 600-900 mg a day. I might try supplementing with magnesium tho
@@RCPMK --- You're comparing apples and oranges. Orotate is FAR more bioavailable and absorbable than carbonate. It's the biggest mistake people make in trying to compare the two.
I love lithium Orotate! As someone who hates SSRIs, it works very well for mood. I take 10 mg of lithium Orotate.
It is not toxic.
It doesn’t have the side effects like lithium carbonate. I’m not sure why she mentioned that. Completely wrong.
@@avril.227--- She's trying to be a good little establishment doctor, poo pooing over such "unconventional heresy," Doctors Suck, generally.
Awesome video and merry Christmas
Thank you and Merry Christmas to you as well.
Great video Tracey!! I am on lithium for my bipolar disorder 2 - I never knew the side effects but I never thought to look it up either. However, I do make sure every doctor I see knows all my meds since interactions can be scary.
Keep up the great work and information!! I turn to you when I’m down to help me understand what is going on with myself. I hope you had a wonderful holiday and happy new year!!!!
Always great information
I know this video is from 4 years ago but this popped up on my feed as I was explaining why I stay on lithium. My tardive dyskinesia was showing last night so my friend was asking what the benefits were since the side effects can be so severe.
Lithium saved my life.
I love your channel! Not only does it help me understand things but it helps my friends understand me better too.
Great series on bipolar! Would be great to see a video discussing hyperreligiosity and spiritual/religious experience in mania. Not just the phenomenology (which often overlaps with normal spiritual/religious experience, e..g., sense of oneness, synchronicity, divine mission), but also the difficulties of making sense of these experiences after the fact. It can be a lifelong struggle to reconcile having a diagnosis of psychiatric disorder with what are often extremely meaningful and compelling insights gained in these experiences. Integrating them in healthy, adaptive ways (e.g., balancing spiritual and medical appraisals) is a challenge for both clients and practitioners, especially in secular cultures where shared religious beliefs and communities aren't often available or appropriate.
Very true, just because your bipolar doesn't mean that the experiences you may have are not real.
True@@jdl2180
Merry Christmas. Meeting you was the most wonderful thing that has happened to me. You give me Euphoria, Gratitude, Admiration, Enthusiasm, Happiness, Satisfaction, Amusement. You are an amazing person & An amazing human bean. May all your dreams and wishes are fulfilled. I wish you heartfelt wishes & blessings towards your way. I pray that you receive more than you have hoped for and asked for. I am thankful for giving me the unique opportunity to be able to wish you a heartfelt wishes & blessing towards your way and I pray that You will continue to bestow blessings of health and joy, successes in your life. have an amazing Christmas with your family, friends, And everyone that you love dearly. I am wishing you many more blessings towards your ways.
Wow Trevor thanks for all the blessings and beautiful words. I did have a wonderful Christmas with my family and I hope you had a blessed Christmas as well. Thank you.
Hahah, hypomanic episode warning
I hope you see this comment, and I will keep it brief. I have primarily the atypical features described in your other video. My two big episodes were both psychotic with mixed features. I do not return to a nice functional baseline between episodes, and I have several comorbid conditions. But lithium works wonders for me; my episodes start to resolve within days, and it's been a very effective maintenance treatment. Anticonvulsants didn't do much at all, and antipsychotics made my symptoms worse. If I'd been trialed on lithium sooner it would have spared me a lot of suffering. You should emphasize that this is a heuristic, not a rule, and it's something to bear in mind in your practice. I tend to think lithium is underutilized and I'm sure there are others like myself who don't fit the classic picture but are nonetheless strong lithium responders, who are effectively being harmed by their medication regimens while they cycle through ineffective drugs when the first-line treatment hasn't been tried.
Thank you ❤ I am dx both schizophrenic, and bipolar. Also a personality disorder. I nearly died from PE after receiving an injection of a powerful drug made by Pfizer (I'm not going to say which, for legal and ethical reasons) and I collapsed the next day, in cardiac arrest. I was 48 years old and I exercise daily. While inside of a psychiatric ward, at the beginning of covid, I was admitted and the staff removed the lunch tables and chairs to adhere to suggested "social distancing" and put in collapsible tables, and heavy chairs. The staff got to wear a mask of their choice, while me and my fellow patients were never given any masks. I would have worn it. It's nearly impossible to be 6 feet away from everyone, including the staff.. I had been researching high dose Lithium in conjunction with NAC to fully treat "mental illness".
I have some bad genetic mutations, and no one in my immediate family was ever dx with a "mental illness". My older brother shows signs of narcissism, AND I believe he's a psychopath to boot. My younger brother has OCD that's untreated. I'm the middle child (the scapegoat for my mother, father and my older brother) but we live in OH and NC respectively. Both of my brothers ended up living 5 miles apart in Raleigh. I have 3 nieces from my older brother (17 months older than I) and 2 nephews born thru IVF. My folks passed, and they lived here in Ohio and rented a condo in NC for the winter, to spend time with their grandkids. My ex and I couldn't have children naturally, and I was going to counseling to deal with infertility issues. I was placed on various antidepressants, benzodiazepines, pain meds and muscle relaxers, to treat the issues with my CNS. and I take Coumadin for life to prevent another deadly blood clot. I take 275mg of Seroquel total, and I have been on Seroquel b4. It made me ravenously hungry and I put on 90 lbs. In less than a year. Right now I am taking a divided dose. It does help w anxiety, and I like to treat illnesses with targeted supplements. For example, high BP and high cholesterol. I'm able to check my warfarin at home, and I got a new primary care physician. My old one served me with papers, saying I was 'noncompliant' (I missed 2 scheduled office visits while in the hospital being treated for covid) and it took 3 MONTHS for me to find a new PCP in-network. So my conditions went untreated for about 4 or 5 months, and I take quite a few supplements. I depend on an integrative medicine doctor for my Armour thyroid and bio-identical progesterone cream, but I already have dry mouth and recurrent corneal erosions which can be very painful. Tylenol is all I can take.. And I sometimes have migraine headache s but now due to "the opioid epidemic" I will not be treated for my spinal column, which is giving me trouble. I refused gabapentin for the nerve damage in my feet
. My father took it, but it was still painful for him to walk. I believe I MIGHT be bipolar2, and when daylight savings time kicks in I tend to be dysthymic. I have only been manic & OCD while tapering off the rest of my benzo. Cog fog and insomnia, plus SAD may be my issue. A circadian rhythm issue is not easy to dx and treat. I believe I have one, but my physicians disagree. A sleep study and hearing tests were ordered, and my agoraphobia gets to the highest point in winter. What I need is a warmer climate. I am 5"7 and 132 lbs. Long covid made food unappealing, and until I get my colonoscopy/upper endoscopy done, there's no valid reason why I lost 90 lbs in the last 2 years. I just kept shoveling the food in, but anhedonia made me eat sweets again. Having to keep moving due to the akathisia.
I'm probably going to try Lithium, along with some nutritional interventions suggested by my current psychiatrist and my integrative medicine doctor.
Mic drop
Thanks, very useful information in a simple but scientific way, I subscribe
Thank you for what you do. 💚💚💚💚💚💚
Love your videos, merry Christmas. When I was on lithum I know personally I felt more suicidal depression, and was depressed more often. So I stopped taking it, but I was also a teen when I was on it. My advice to anyone is make sure whatever drug you're on that it's right for you, don't do what I did and lie to the psychologist cause you're tired of changing drugs. I haven't taken any meds since, but I have learned how to deal with my bipolar. For instance I know I can't be anywhere near social media while manic or I'll get myself in trouble, and usually best to avoid it more so when I'm depressed. Again love your videos they're always great.
Hi Cheshire cat. Thanks a lot for your comment and for watching my videos. I wonder if you had a similar reaction to lithium that teens can have to antidepressants as far as feeling more suicidal. I’m glad though that you’ve been able to manage without medication and you know what your episodes look like. I talk about that a little in a video I did on three signs your mania is coming. I talk about recognizing early signs so that you can make an intervention before it gets out of hand. Sounds like that’s what you’re already doing that. Good for you.
@@DrTraceyMarks ya it probably was, and overall I tend to have my bipolar under control because I learned how to tell when I'm manic or depressed, which really helps. Although thankfully I basically never get the horrible not able to sleep part of manic. I can imagine that gets really rough at times, since I know I have issues if I don't sleep enough the whole day.
I gave up social media for that and many other reasons...way too triggering and yes always the possibility of posting way too much or saying horrible things
@@RCPMK Ya like the news, no one really cares to talk about the good things, they always focus on the bad things. That or someone tries to talk about their drama and force you into it.
I’ve been on Lithium since I was diagnosed with BPD in 2015. I’m so thankful for it. When I was manic, I did some really dangerous and damaging things. When I was depressed, I was suicidal at times. I’ve been hospitalized in a mental institution twice. Since, I have had some “moments”, but nothing even close to the way I was. I do love Advil, so I will have to look into taking something else. Thanks for the info.
So how is for u now that u Take lithium ? I have Bpd and anxiety and i want to Take it
M P Well, I explained it in the second part of my comment. It has leveled off my mania significantly. I take the max dose of Xanax for my anxiety.
I take Lithium for my Bipolar with mixed features. It has served me well the last 10 years, paired with Lamotrogine. I tried several antipsychotics in the past but developed life threatening side effects so they clearly are a no go for me. The tremor is what bothers me the most, followed by intense sensitivity to the sun. Thank you for the informational video.
Thanks Doc.
This was really helpful.
Thank you for this incredibly intelligent and insightful video. I wish you were my psychiatrist, but mine is also good thankfully. Thanks for sharing this.
Dr. Marks, thanks for this video. I got off Lithium for that same reason you mentioned about the thyroid. For me, it wasn't worth it.
Dr Mark's, can you do an episode on particular mood stabilizers and side effects. Which are DOC and reasons. Thanks. Love your channel!
Thanks for this. I've been on lithium for a while I do good on it. I need to get my levels checked.
Can you please talk about the relationship of bipolar disorder and memory loss and what can be done to try to minimize memory loss? I’m very interested in their correlation.
I agree, my memory is terrible.
I feel you. I have huge ass holes in my “story”. Makes it a little uncomfortable to talk to people at times.
I know during depression your brain can stop encoding memories. 🙁
@Emma Goldman Try brain wellness exercise like crossword puzzles, exercise, coloring, try to write some poetry just a few lines, etc. Exercise is probably the best.
Dudeee same my memory is terrible!!
Hi Dr.Marks great video thank you for addressing the question. I would also like a video on anti-psychotics and their benefits but also information of long term use side effects . If you could talk about one in particular like Seroquel! Thank you
This was really informative! As I’m on lithium bicarbonate right now, it’s worked better than Seroquel, personally. Thank you for this information!
You’re welcome Stephanie. I’m glad it was informative for you.
I feel traumatized by seroquel. I'm scared to try Lithium now because of my bad experience with seroquel.
Helpful video been taking Lithium and Zyprexa for my Bipolar for about a year was always more curious about side effects.
very insightful. wish they provided this videos to patients
I didn't have a very good experience with lithium unfortunately, but have been on valproate + an SGA for several years with good success. I'm going to be titrating off of the valproate soon as my partner and I are thinking of having kids in the new year which is super exciting! I'd love a video on treating BPAD in pregnancy. Thanks for the video! Great hearing other people's experiences with lithium too :)
Thank u. Talkked my dr into gettin me on lithium a few years ago and never understood why it was soo bad. Thanks again.
This was so insightful. Britney Spears recently claimed she was forced to take Lithium while under her abusive conservatorship. 💔
Thank you for this info, my doctor is about to move me to lithium after being unsuccessful with most meds we've tried so far. Only thing that I have found useful is lamotragine, but that has produced very limited results. I'm worried about lithiums side effects, but if it can make me a normal functioning member of society, I can live with it.
Hi Dr. Marks, First off I wanted to thank you so much for providing these educational videos! I've watched everyone since my newest diagnosis. I was recently put on lamictal and undergoing the process of slowly titratting up. I was wondering if you were planning on making a video discussing the pros and cons of lamictal, similar to this video.
I was on lithium for 15 yrs. It gave permanent muscle disorder. I have chronic kidney disease. My memory sucks. Lithium, and God saved me. The outcome, out weights what could happened.
Lithium helped me out so much and I've never felt more in control of my emotions and impulse control. Things were great for about two years until I got badly over heated and dehydrated only one time. After that if I tried to take it my body would react and wouldn't let anything stay down in ten minutes or less.
Happy Holidays Dr. Marks.
Your too Ale!
Thank you for this video. I didn’t know that the way you cycled or experience symptoms would be why you went on lithium. I thought it was just dependant on the psychiatrist. I currently feel lost because I was diagnosed with bipolar 2 in may 2018. I took lithium for a year which actually worked with my swings, they felt less extreme but I did experience some side effects as you mention. Also often became non compliant- not surprisingly this coincided with erratic mood and behaviour changes. I also took quetiapine for this time also for the year. When a new psychiatrist diagnosed me with bpd in may 2019, I did a very silly thing and stopped taking meds all together. This landed me in hospital for a month but because of diagnosis change, they said I won’t be on meds now. Ever since my moods have been erratic from maybe a week or 2 hypomanic, to maybe depressed for a month or more, to normal. If I supposedly don’t have bipolar, and have just bpd, could lithium be something we consider again? Because I still cycle and experience moods episodically, I just have the emotional instability as well. Psychiatrist now says he’ll keep his mind open to me having bipolar as well but not having the diagnosis obviously is affecting treatment and thus me being able to deal with the mood changes. Thanks in advance! X
Thanks 🙏🏾 a lot. I have heard that Lithium orotate is a safer form of Lithium which doesn’t cause weight gain or thyroid issues. I was on Lithium it made me gain 25# & screwed up my thyroid. Best decision I made was to stopping Lithium never go there again. Now I’m on Latuda atypical antipsychotic & works 👍🏾.
My best friend began taking Lithium, it took a few weeks to work, but long term it has helped his bi polar disorder.
I have borderline personality disorder traits and actually I just got prescribed the lithium on top of my quetiapine. Actually, this feels amazing... one so far 300mg. I’ll take one at night. My haziness is actually less and my desire to do drugs has gone down. It has helped so far, after the effects seemingly have set in, to reduce my aggression, blah attitude.
Thank you SO MUCH for this video, Dr. Marks, I've been getting stuck trying to understand the many side effects of lithium. You've helped me understand quite a bit more, but I'm still confused about the specifics.
*Disclaimer, I'm a first-year PA student and am just starting the psych module*
I understand that acute/subacute side effects are due to neurotoxicity, but is this due to excessive inhibition of BDNF? I thought lithium (somehow) sensed the patient's BDNF level and potentiated (via the GSK3 pathway) or inhibited BDNF (via the PIP2/ISK3 pathway), so why does a high serum lithium level cause these neurotoxic effects? I understand the long-term nephrotoxic side effects and diabetes insipidus are due to a high serum concentration of lithium, especially if there is a reduced concentration of sodium (vomiting, diarrhea, ACEIs, ARBs, diuretics), but I am still confused about why lithium damages the thyroid? It seems like lithium's cardiac and dermatologic side effects can be linked to its effect on the thyroid as well, is this correct?
Merry Christmas Dr. Tracey Marks. 🎄🎁😆
Thank you and Merry Christmas to you!
Great video as always! I tell everyone - even other psychiatrists about your videos.
1. I heard an attending say that if people have a manic or hypomanic episode AFTER starting mediation then this cannot be considered true bipolar...thoughts?
2. You mention the depression that is part of bipolar is different then that of unipolar depression - can you speak to the treatment methods you find most useful for the depressive aspects of bipolar? Do you ever use SSRIs once they are on mood stabilizers?
Just found out my cousin has bipolar II, alcoholism AND borderline personality disorder. He has always been wracked with psychiatric illness, now it's all been labelled. He's always been super non compliant with treatments of any kind. He's had a sad life.
Lithium breaks me out like crazy. Worse than when I was a teenager. I’ve also gained a ton of weight. I love the lithium it’s helped me control my moods but it also sucks at the same time lol
I legit had to start taking accutane because my skin stopped responding to topicals especially after (now ~2 years) of lithium use. Accutane is so fricking exhausting and destabilizing, for me at least, but my skin is starting to improve. ALSO bonkers thing is you're not supposed to take much tylenol on accutane, so if you're also on lithium you have like no regular pain killers available. Gotta love trying to stabilize mood but then getting depressed from acne lol. Sorry to rant, but I'm here in solidarity and hope you find something that works for you. Best of luck!
@@TheMakeupnerd77 everyone needs a good rant once in a while. It's exhausting having a mood disorder medicated or not. I think it's the frustration of having to be medicated and then to top it all off - adult acne. So yea rant away :-)
Yeah being fatter and pimple will make anyone depressed right?
Appreciate the vid doc. Just diagnosed after dealing with it untreated for 20+ years and wondering what I was in for.
Thank you for all your videos. My son hasn’t been diagnosed with bipolar but it’s something the team that helps me with him and I have suspected for a long time. I feel like the mental health system has failed us. When he has that down it’s sounds like a mixture of mania with depression. He does super crazy things like trying to brake into to homes, stealing from me, fighting with anyone, is on probation with GPS and still try’s to get out of the house.... among many other things. I’ve taken him to Childrens hospital before for being suicidal and even though he’s text me things like this will be over soon and you won’t ever have to worry about me. They let him out saying he’s not sympathetic, then he tried to jump off my running car... I want him to get the proper help but at this point I don’t know where to turn. I know there’s more then just depression and anxiety going on with him. He’s behavior goes up and down.
Oh dear parent! I feel your struggle. Looks like your comment was posted three years ago and I hope things have gotten better or at least leveled out for your son and your family. My family is going through at this time with my 15 year old granddaughter. It is hard to know what to do and not do or the young person. The mental health/behavioral support Industry is so drug driven. We were so cautious about the meds. We let them put granddaughter on as she went in and out of facilities. It seemed that the psychiatrist just suggested meds by any Meany Miny Moe. In fact, one doctor said we should put her on Prozac because she wants to try it. When I asked granddaughter what she knew about this medication, she said that she liked the name, that it was cool. This was not reason enough for grandma, who is constantly reading and researching these medication‘s/diagnoses/treatment plans. Insurance companies rarely pay for natural approaches for our teenagers, but will willingly throw lots of money towards the pharmaceutical industry that is drugging our children. Long story short, six months ago, we said yes to medication‘s and things have gone from bad to worse. Granddaughter says the medication‘s make her feel better. But, she is moving into more risky, impulsive and dangerous behavior. The psychiatrist has given her yet another diagnosis, and this time put her on lithium along with the other three meds she is taking. My heart feels for my granddaughter, and for every other young person facing these challenges. Pray, when the storm clouds gather overhead! Sometimes I ask granddaughter to tell me how many clouds are in the sky. We have fun with this sometimes, and it is always noted that the clouds don’t stay forever, but continue to pass on by.
I was just subscribed, I am also on a antidepressant thank you for your video
I was on lithium for 5 years. I decided to go off due to how severe the side effects got. I had to pee once an hour when I was awake, and my need to urinate in the morning would make me get out of bed earlier than I wanted to. My tremors were affecting my handwriting and I couldn’t hold things with one hand. Going off of this medication as well as Olanzapine was the best decision I ever made in my life. I can go a few hours without peeing now and my tremors are gone (or they’re so slight I don’t notice them). I was also experiencing pre symptoms of tardive dyskinesia from the Olanzapine which have also gone away. I’m thankful I didn’t stay on them for life because I didn’t need them anymore and I would have caused permanent damage to my body from taking them.
thank you this helped me alot
Cloudy thinking has caused me to be an underperform in college. Thank you for this video
Thank you.. Lithium doesnt seem to make me gain much weight. It helps me keep a healthy weight because for some reason when i am imbalanced, i cant eat anything because i have no appetite...
Hi there! I read that there can be several different specifiers for bipolar disorder, such as with anxious or psychotic or mixed features. Can you do an in depth video about these and what these may look like? I've never been told which specific type of bipolar disorder I have (one or two or cyclothymia), I only know that I have had at least SOME psychotic symptoms when I was manic. I don't know any "specifiers" that have been added to my diagnosis though. Thanks!
"Do you have bipolar?
"I have the CLASSIC "
Lol. Sounds so nice. Lol.
Can you please make a video on how unipolar and bipolar depression differ? I sometimes feel like bipolar depression is more complex and intense than the unipolar depression of my friends.
Dr. Tracey,
I was recently prescribed lithium to treat my previously undiagnosed Bipolar 1.
I have been on a medication regimen that includes the max recommended daily dose of spironolactone for the past couple of years, what are some effects I should watch out for?
Thank you for this video! I had always thought that someone can't legitimately be bipolar unless they're on lithium. I've never been prescribed it so thought I wasn't really bipolar. But I live in mostly mixed episodes so it makes sense that I've never been put on it.
I would like to add that sometimes, changing formulas makes a difference, too.
Merry Christmas!
Same to you Lillian 😊
Thanks Dr. Marks.
May you make a video on the best way to treat BPD?
I’ve been having a hard time. I was prescribed a SSRI and went into a deep depression. I have quit taking those meds and am now going through a bipolar mania. I don’t know what to do from here and I know I’ll be back in the dark soon.
May you enjoy your holidays and thank you for the uploads.
I have a BPD playlist where I talk about some dialectical behavior therapy techniques. But DBT is the main treatment for BPD. czcams.com/play/PLazcP3-djRZ13W32JLF6SO2N0NHKl2fxM.html
I’ve taken lithium twice a long time ago. The first time I lost weight and the 2nd time I drank 9-10 Pepsi’s a day and gained weight like crazy. I didn’t eat at all
I’m just thinking out loud here. I was on lithium for 15 years. I was put on it after a suicide attempt. I have borderline personality disorder with bipolar. But after I was put on lithium I was still hitting hard up’s and down’s for like 6 year’s. With therapy I finally started having 6 month or more break’s. Where I felt normal, happy and thought clearly. Then I would I would either drop into a suicidal depression or an out of control mania. My levels have maybe been checked about 10 times in fifteen year’s. Why didn’t any off my doctor’s suggest something else. As a patient I didn’t question it. Then I had to see a spine surgeon. I had been having severe back pain and muscle spasm’s for year’s. I took a lot of ibuprofen. Until I met this guy. He refused to give 800 mg ibuprofen if I continued lithium. My pain was severe. So I told my psychiatrist and we decided to take me off of lithium. That was scary. There are absolutely no physical side effects coming off lithium. But there are mental. I went into mania 3 weeks off. That lasted a month. I then hit suicidal depression I haven’t dealt with in over 10 year’s. The mental anguish was indescribable. I just wanted it to stop. That lasted about 2 month’s. I refused any antipsychotic’s because I wanted to know who I was without out it. I finally came back to normal and happy. I have been stable with just 400mg of lamictal everyday for 5 months now. In the middle of this my liver count was off for months and my psychiatrist was scared because she knew that she had mismanaged my medication for almost 10 years. She checked my lithium levels about 5 time’s during that period. So in my opinion. I don’t think that the lithium ever worked or I just wasn’t on an effective dose because I was never checked. Mental illness is so far behind. I’m now 45 yrs old. The best help I received was therapy. I wonder all the time if the lithium had ever worked. Was I just winging it on my own with therapy for 15 years!? While this medication took its toll on my body! My liver is still off, but my thyroid seem’s to have settled. So that’s good I guess. MY LESSON IN ALL OF THIS. QUESTION EVERYTHING! BE YOUR OWN ADVOCATE AND RESEARCH EVERYTHING THAT IS GIVEN TO YOU! I MAY NEED MEDICATION IN THE FUTURE BUT FOR NOW IAM ENJOYING LIFE WITHOUT ANTIPSYCHOTICS! I CAN NOW HAVE AN EDUCATED DISCUSSION WITH A DIFFERENT PSYCHIATRIST IF MY BP ACTS UP AGAIN.
Been on lithium since l was 52 yrs without it l wouldn’t be here it saved my life l have my blood levels done l am now 76yrs l don’t have any problems. thank god for lithium ,
thank you doctor.
What about when PMDD frequently gets misdiagnosed with bipolar disorder?? I believe lithium and lamictal made me totally unstable.
What about hypomania? Do you need to take anything for this? Thank YOU!
I love your pin striped suit!
Thank you very much @DrTraceyMarks . Your videos are very helpful. Could you talk please about lamotrogine? how it works, the side effects... I have a classical bipolar disorder from when I was 19 years old. I had Several depression episodes and two long periods without symptoms. I had just one mania episode and few hypomania episodes. I take lamotrigine ever since I was diagnosed as bipolar. My psychiatrist thinks I am bipolar 2 and the mania I had was a consequence of a long period with antidepressants without stabilizers. In fact my former psychiatrist thought I was unipolar and he didn’t detecte an hypomanic episode before the mania episode.
Pls reply Dr.marry for my question
Can effect of these meadicine on face overcome because my cousin use bipolar medication and her face become dull and hard black heads rise on her face pls tell me
Oh wow! After starting to take Lithium Carbonate (as prescribed) about 15 months ago, I ended up gaining 40% of my then-weight in a five month period, and when trying to track down the issue ("It's not your thyroid;" it's never been my thyroid), I was told that while I wasn't diabetic, I *was* insulin resistant. Now, my mood has never been better in as long as I can remember - I still occasionally struggle with depression, and I've had a couple of bouts of feeling suicidal, but the manic episodes are pretty much gone, and generally I feel... fine. But the weight gain has been extreme (I've been borderline-anorexic since puberty, but still hugely overweight), and no one has been able to tell me why. The weight gain happened during a period where I was without insurance and *wasn't* on the Lithium, and it plateaued (but did not decrease much) after I went back on it. I don't know if thyroid supplements would work, but I didn't even know there was such a thing, and due to insurance, my Lithium levels haven't been as well monitored as they should be. I also deal with chronic pain (Fibromyalgia) that, in the last year, has become so extreme that I'm now bedbound 23 hours a day, at least.
So, thank you for the incredibly informative video. It's provided me with some key things to discuss with my PCP, psychiatrist, and endocrinologist (when I can find the latter, in this new town). I look forward to seeing more of what you have to offer!
Could you please discuss how lithium interacts with other medications? I have chronic pain but was told anti inflammatory meds can harm your kidneys. How do I stop taking lithium? I'm on camcolit 400mg once a day.