Lithium. I’ve been taking lithium well over a decade now. What does it do for me? Well, there’s the shakes. I have a slight tremor in both hands that prevents me from being able to do detailed work with my hands. I can’t make the pictures I used to make, I can’t put together Blood Bowl miniatures, I can’t hold a camera steady, and about thirty percent of the time I do something on a touchscreen, I miss. Thirty? At least twenty.

Then there’s the weight gain. When I went on lithium, I rapidly gained sixty pounds. I was fat before, but now I’m really fat. So there’s inconveniences all the time when you’re my size, from buying clothing to fitting into fucking chairs. It’s a big stressful hassle.

Then there’s the stupid. Lithium blunts my intellect. I’m still smart, but man, I used to be sharper. Quicker. When I first went on the lithium, there was a noticeable diminishing of my cognitive mojo. Since then, I think my brain has been learning to work with the issue, and there have been improvements. But my mental capabilities have never come all the way back after going on lithium.

So how do I know it’s the lithium, and not the weed, that makes me stupid? Well, I wasn’t on weed when I started lithium. I hadn’t smoked for years, and I would go on to not smoke for years more while I was on lithium. Weed makes me a little stupider as well, but in a different way to the lithium. And it seems to be more focused on when you’re stoned, and then when you’re not stoned, you’re closer to fully functional. But not quite a hundred percent. This isn’t about weed, though.

Lithium fucks with my thyroid. I’m now on thyroid hormones to keep my shit regulated.

Lithium causes increased thirst and increased urination. This manifests by ambushing me when I drink. I’ll nonchalantly grab a water bottle, meaning to get a swig and move on with my day, but then the water feels so incredible going in, and it shoulders its way down my throat, and I let it happen because it just feels so good. Over time I’ve mastered this side effect as well, sort of. I “manage” it by drinking a shitload of water. I’m not sure how much exactly, but I know it’s over a gallon a day. (Incidentally, I know the risks of over-consumption of water, and I know I’m not at risk for that.) And of course, the flipside is that when I’m at home, it feels like I pee every fifteen goddamn minutes. But I don’t mind peeing, for the most part. I do worry some about my kidneys going out. I’m on Risperdal, and that’s hard on the kidneys as well. But this isn’t about Risperdal.

I know there was one other thing lithium does for me, but I’m having trouble remembering it. Oh, right, I remember — IT MAKES LIFE WORTH LIVING. I had occasion to reduce my lithium dosage for six months recently. We were checking to see if I really needed to take 1350mg when 900mg might do the trick. Spoiler: yes, I need 1350mg. With lithium, it takes a while for things to normalize after a dosage adjustment. So for six months I had reduced side effects, but I also had reduced effects. I was a basket case by the end of that six months. I saw a glimpse into 2008 that I did not like at all. In the end I went back up on the lithium, and everything is much, much closer to fine now.

That’s the dilemma of all drug treatments. Weighing the benefits with the negative side effects and making a call. Oftentimes, there’s no clear-cut “good” call. In the case of lithium, I do feel that there’s a good call. And that call is, I’m not willing to go without it. If some force or entity takes away my lithium in the future, it will be done without my consent.