Day Zero

Saw my psychiatrist today where – and I can’t believe I admitted this then or now – I told him that it was now or never for lithium, the atom bomb of all mood stabilizers.

I’m on three psychiatric medications now: Abilify, Vraylar, and lithium. I’ve been on Abilify ever since the earlier diagnosis of Bipolar 2 in the early 2010s. Vraylar and me have been buddies for a few months now; it took the edge off the mania a bit, but not nearly enough stabilization overall on its own to save me from myself. So yeah, here we are, lithium day. Wooooooooooooooo [sad pac-man noises].

The psychiatrist is correct, we have more data about lithium, first prescribed in the 50s, than we do any other drug that combats bipolar (or any psychiatric illness for that matter). The data says that I should be with hope that it will finally chill my mood swings out. The data also says that I risk my heart and kidneys, among other organs, if we don’t play this just right. But, I cannot deny that Bipolar 1 is ruining my life, especially with its comorbidity with my Borderline Personal Disorder. I’m a dysregulated emotional mess flinging back and forth between darkest abyss, highest spire, and the borderlands in between.

I’m scared. Truthfully, I’m terrified. I know we can back out if my kidneys or heart start showing irregularities, so that’s not what I’m scared of. I’m terrified of the implications should the addition of lithium fail. It would imply that I’m perma-fucked, lost in the bipolar void where souls go to die. There are literally no other options if this fails. Even electroshock, which I would never consider again, is thought to have only diminishing returns at this point.

I’m the prototypical tortured artist, making music and other art born from the unholy marriage of trauma and madness. I do want that to change, but I also know that I cannot will my way out of the bipolar component of this all.

I can only hope that in the weeks ahead, we see meaningful improvement. I shudder to think how my hand will be forced should it not.