What It’s Like to Be On Lithium For Bipolar Disorder (From Someone Who Takes It)

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TL;DR 

• Lithium is the "Gold Standard" for bipolar disorder: Despite being underutilized, lithium is a first-line treatment for bipolar.  

• Lithium is known to be superior for mood stabilization. It also has unique anti-suicidal properties.

• The lithium side effect reality: Blurred vision, increased thirst, and tremors are common side effects of lithium for bipolar disorder. Most side effects (like thirst or mild tremors) are manageable and often fade as your body adjusts to the medication.

• Success with lithium for bipolar disorder requires a "partnership" with your doctor. This means regular blood draws to monitor lithium long-term side effects and staying vigilant about hydration to prevent toxicity.

When it comes to managing the complex landscape of bipolar disorder, few medications are as well-known, and sometimes as misunderstood, as lithium. Lithium is considered the “Gold Star” first-line treatment for bipolar disorder. Despite this, it’s underutilized. In part because of the monitoring it requires and the myths that still surround it. 

So, what’s it like to be on lithium for bipolar disorder? I have been on lithium for 1.5 years now. Of all the bipolar mood stabilizers I have taken, this one has been the most helpful for me. Here are some things you should know about it. 

My Journey With Lithium 

For me, the journey to finding the right treatment for bipolar disorder was a winding road. I was given lithium during a hospital stay after I had already tried many other bipolar medications. 

Benefits of Lithium for Bipolar 

Despite its declining popularity, lithium offers many benefits that many other bipolar mood stabilizers do not offer, including: 

• Mood stabilization: Lithium helps stabilize the extreme highs and lows. It reduces the intensity and frequency of manic episodes while also helping protect against depressive episodes. 

• Neuroprotection: Lithium has neuroprotective properties. Recent research indicates that it slows cognitive decline. 

• Suicide protection: Lithium reduces suicidal ideation and attempts in bipolar. 

Here’s what I have noticed since starting lithium for bipolar: 

• Fewer dramatic mood swings: I still experience hypomania from time to time, but I no longer have manic episodes. Lithium prevents mania episodes for me. 

• More predictable emotional days: My mood seems more level overall. I feel calmer and more in control. 

• Improved sleep stability: Since being diagnosed with bipolar disorder, sleep has been a battle. However, I’m finally getting consistent, deep sleep again thanks to lithium and another medication. 

The Lithium Side Effects People Google at 2 a.m.

Have you ever found yourself Googling “Lithium side effects” in the middle of the night after starting this medication? Same. 

Most lithium side effects show up early, especially in the first few weeks, and ease once blood levels stabilize. Still, it helps to know what is common, so normal reactions do not get mistaken for something dangerous.

The most common side effects of lithium include: 

• Brain fog 

• Blurred vision 

• Increased thirst

• Frequent urination

• Mild hand tremors

• Fatigue or low energy

• Digestive issues (like nausea and diarrhea) 

I have experienced increased thirst, increased urination, brain fog, and digestive problems. Fortunately, I have not had to deal with lithium blurred vision. For me, the side effects have been minor. 

Lithium Long-Term Side Effects 

Lithium can have some serious long-term side effects, including: 

• Kidney damage, especially with long-term use.  

• Thyroid damage, or hypothyroidism. 

• Parathyroid gland dysfunction.  
  

This is why careful monitoring of lithium is a must. Your doctor will likely order regular blood draws to check kidney functioning, and more. This can help ensure the safe long-term use of lithium. 

Lithium Toxicity: What to Know 

Lithium toxicity is a real concern when you are taking lithium. However, it is something that can often be prevented with careful monitoring. Knowing the symptoms can also help. 

Lithium toxicity occurs when the amount of lithium in the body becomes too high. Lithium has a narrow therapeutic range. So, even small changes in doses, hydration, or kidney function can affect the levels of lithium in the body. 

Things that can trigger lithium toxicity include taking ibuprofen, dehydration, and other drug interactions. Signs of toxicity include: 

• Vomiting and diarrhea 

• Severe hand tremors 

• Confusion or agitation 

• Muscle weakness and twitches

• Uncontrollable shaking  

In severe cases of lithium toxicity, a person may have seizures, irregular heart rate, loss of consciousness, delirium, and coma. Lithium toxicity can be fatal in some cases. 

If you or someone you love is taking lithium and has the above symptoms, quick treatment is crucial. Some effects can be permanent without immediate medical help. 

Call 911 (in the US) if a person has severe symptoms like a loss of consciousness. In less severe cases, contact poison control at 1-800-222-1222 or go to the nearest emergency room. 

A Reassuring but Honest Note

Lithium toxicity is serious, but it is also preventable and manageable with proper hydration, monitoring, and communication with your healthcare provider.

Knowing the signs can help people taking lithium feel informed, prepared, and safer in their treatment.

My Honest Take About Lithium for Bipolar Disorder 

For me, lithium is not the villain that some people believe it to be. Sure, it requires regular blood tests, and I’ve had to make some changes in my daily life (not taking ibuprofen, for instance). But I have been more stable on lithium than any other medication I have taken for bipolar disorder. 

I have a collaborative psychiatrist who helps me feel informed about lithium. Between regular check-ins with my psychiatrist and routine blood work, I feel supported rather than anxious about taking it.

I am hopeful that with ongoing monitoring, lithium can be a safe and long-term part of my treatment.

Medication like lithium can be life-changing, but it works best when it’s not doing all the heavy lifting alone. Online-Therapy.com provides therapist-guided support that many people use alongside mood stabilizers.

Lithium for Bipolar: FAQs

Here are some of the most common questions that people have about taking lithium pills for bipolar disorder. 

Can lithium help bipolar disorder? 

Yes, lithium is one of the most effective treatments for bipolar disorder. It can help both those with bipolar 1 and bipolar 2. 

Can a person take lithium for bipolar depression?

Yes, lithium is prescribed for both manic and depressive episodes. Its effectiveness at treating both mania and depression is one thing that makes it a treatment of choice for bipolar disorder. 

What should someone avoid while taking lithium?

To reduce the risk of lithium toxicity, it’s important to stay hydrated. Also, make sure you tell your doctor about all medications you are taking, as some medications can increase the risk of toxicity. For instance, taking spironolactone and lithium together can increase the risk. 

Why is lithium less prescribed for bipolar disorder than other mood stabilizers?

Lithium is considered one of the best options for long-term bipolar treatment, yet lithium use in bipolar disorder has declined over the years. Part of that is due to the challenges of managing it clinically. It requires careful monitoring. Some psychiatrists and clinicians may see other medications as being easier to manage.