Monday, July 25, 2011

Increasing Lithium

Several days ago we increased my son’s Lithium dose. Our psychiatrist wanted to move my son’s blood level deeper into the therapeutic range. His hope is that by increasing the dose, we’ll see optimal results and stability, particularly since he’s handling the medication pretty well so far.

The only unusual behavior we’ve seen lately, was an evening where as we were heading up to bed, my son became overwhelmed with an impulse to clean. It started out with him vacuuming the whole house. I thought that after he was done he would’ve released some of that energy and be ready to settle down, but the opposite happened. He went though the house picking up anything he could find, then tackled the playroom with a vengeance. His moves were very fast, almost frantic, he had a clear compulsion to clean. At one point, it seemed like this compulsion was controlling him, he couldn’t stop himself, even complaining of a headache, but said that he couldn’t stop, “I NEED to clean!”

When I asked him what would happen if he stopped cleaning, he said that he would do something bad, he would wake up his sleeping brothers and hurt them, so he needed to keep cleaning.

After about an hour, he started to slow down and agreed to take his evening dose of Melatonin. Thankfully, that put him to sleep quickly.

After this episode, I thought about all I had seen and his response that he couldn’t stop or he would hurt his brothers. It made me wonder... could this be the more mild form of his previous rages? Could all his past rages been a form of “too much energy”, even a short episode of mania? And now with the addition of Lithium, he has greater control of these episodes and is able to choose a better way to burn off this energy?

His therapist agreed that this was possible, but as usual, our psychiatrist didn’t put a label on the behavior. Either way, having him exert energy in ways that don’t hurt others is a step in the right direction.

On a positive note, my son has proudly taken up skateboarding. In the past, he’s always been too worried and stressed out to enjoy this activity with the other kids, but now that he’s feeling better, he’s trying new things and liking it.

You should see his smile!

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Photo Credit:
Brandon Cheeks


  1. Dear Mamabear
    I currently suffer from bipolar disorder. When I was first diagnosed I was put on lithium when I was 15. I know first hand how hard it is to deal with the disease and the medications. When I was on litihum, I was lethargic and fairly apathetic but I did have some episodes when my mania came back. Some of them bad enough to put me into the hospital. I will tell you from experience that the support you get from your family is incredibly important. I know that you see a therapist but something that helped me was going to group therapy. Everyone needs someone to talk to about this. In this capacity, peers can be incredibly important and helpful. Good luck and I'll be praying for you.

  2. Anonymous- How old were you when you started group therapy? How did you find a group?

  3. I just wanted to come out from lurking to tell you we are just beginning our journey down this same road. I find your blog refreshing, I guess just knowing I'm not alone. It is such a lonely (for me anyway) journey. So many around us just don't understand.

  4. Mo4- Hi and welcome! I'm so glad to hear from lurkers! I hope you can feel support from all of those here who know your journey inside and out. I look forward to hearing from you again!

  5. it is awesome he was able to notice he had to much energy and re direct it else where. the lithium won't solve everything but its a huge step in the right direction. i am so happy for him and you. This is one of the longest calmest streaks you guys have had in awhile.

  6. I think your theory about this being a milder form of his old rages makes a lot of sense. Obsessive cleaning certainly sounds a lot better than the alternative. And he showed great self-awareness in realizing he needed to channel his energy another way!

  7. Lithium was a life saver for Caroline, it was the first drug to TRULY make a difference for her.

  8. If you run out of rooms to clean, you can send him over to my house! Wow, that's a side-effect I'd LOVE to see over here!

    In all seriousness, I'm glad he's learning to redirect his rages into something more positive. The constant tweaking of meds is so tiring, isn't it? We're still trying to figure out what's right for Maddox, too, but at least he's doing better than before.

  9. I agree with you that the cleaning could be a milder form of a rage. Very nice that he was able to direct it.

  10. My son will have his first does of lithium tonight. We have tried every medication out there with no real success. I'm hopeful with lithium and praying this is the answer my sweet boy needs. Thanks for sharing...your posts on lithium give me even more hope.

  11. Jewell- I'm excited for you to try Lithium tonight, I know it's very scary taking this step, as it is with any drug, but I also know how great it can work. I really hope you get the same results.

    I remember praying over my son constantly that he wouldn't have a bad reaction, but now I have a peace about it. I still pray every night, but I'm not worried anymore. The doctors reminded me that they monitor the kids closely with blood draws to make sure they're ok.

    Today my son has adjusted to his lithium increase and is doing fantastic! The nausea has gone away and his appetite is increasing a little (he lost his appetite when we increased the dose). He is in a great mood, even cooked pancakes for his brothers!

    Please keep us posted on your son and how he does, I will be praying for him tonight!

  12. Mama Bear, thank you so much for your response to my comment. And for caring so much. We had to delay the start of lithium til tonight. Psych. messed up when calling it in. So tonight is the first dose. I am praying that all goes well with this medication and it makes my son's life so much easier. Thanks again!!

  13. Jewell- You're welcome! I forgot to mention a mistake we made on my son's blood tests. Our doctor forgot to tell us to skip my son's morning dose of Lithium before having lab work done for the Lithium. We didn't know this on the first blood test, but found out the night before the second when I read about it in The Bipolar Child book. Thought I would spread the word so you don't make the same mistake as me because it can effect the results. ; )