My Catch-22 with Medication

By: Natalia Beiser

Most days I feel grateful and blessed. I have a good life. I have friends and people that love me. I am employed part time, even with chronic mental illness. I have a home, and even two great cats. My car is almost paid off. I have much of the American dream.

However, other times, I feel that my life is some kind of punishment that I do not deserve. There are times that I pull out my cognitive behavioral skills and think that I am supposed to be living as an example as to how to live with the trials of treatment resistant bipolar disorder.

I am not strong enough to tell many people about my plight, and end up struggling without enough support. Then I feel guilty that I am not sharing my experiences and living by example. I am not strong enough for the common public to know that I have bipolar disorder because of stigma and stereotypes. I am afraid that putting my picture on this post would cause my employer or my parish to lose credibility.

I often get angry that I am experiencing what feels like a punished life. My adolescence was robbed by bipolar disorder, and the outcomes of the subsequent manias that followed changed the outcomes for many aspects of my life.

Now, I have severe kidney disease from lithium nephrology. And every doctor that I see has to remind me that I am a diabetic (as if I had forgotten) and that I am doing a double whammy on my kidneys by continuing to take lithium for bipolar disorder. I am almost begged by some to quit taking it. Why don’t I?

I continue to take lithium even though it is killing me because I have tried every other drug on the market and none of them have kept me stable. What would you do? It’s a dilemma. Would you quit taking your life saving medication for your brain so that you can remain stable until death, or would you save your kidneys and know that you would spend the rest of your life in a mixed or manic state?

I understand that not everyone with this plight would make the same choice. I had a doctor recently assume that I would not quit taking lithium because she thought that I did not want to be depressed the rest of my life. I had to clarify that I had experienced life without lithium several times and had experienced insanity. I told the doctor that I could not live in a state of insanity for the rest of my life to spare the kidneys.

Another practitioner urged me to change medications. I told her that when my kidney functions were no longer viable, that I would ask to go to hospice and prepare to die. She expressed that she thought that was outlandish. “You could go on dialysis!” she said. I told her that I am not interested in Medicare paying for dialysis in my behalf. And my quality of life would go down substantially if I were to go on dialysis.

Some people would choose a life of dialysis, but that is not a choice that I want to partake in. My idea of living on a life support machine is not the way that I plan to live. One doctor told me that my opinion might change when I turned fifty, because the will to live often changes after age fifty.

The nephrologist told me recently that I need to quit taking the mental health saving drug. I interrupted him and told him that was not going to happen. He clearly indicated in my health report that he did not approve of my decision.

But that’s just it – it is my decision. And I am informed. I am educated. I watch my kidney sparing diet like a hawk, and my kidney function continues to decline, because of the bipolar medicine.

My affairs are in order. It appears that within the next five years or less, I will leave this earth to be with God. And as long as I am mentally stable, I am at peace with that. Most of my friends and loved ones understand and are on board. I wish that I could get the practitioners to understand that I am ok with death. It is a normal life function.

Please note: Not everyone will have the same experience with lithium that I have had. Many people take it for years and have virtually no troubles. It appears that I have had every negative side effect of it, but my long time psychiatrist has indicated that he followed me long enough to see that I cannot do without lithium.

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