5 Things I Didn’t Know About Taking Mood Stabilizers

Written by Sally Buchanan-Hagen

Mood stabilizers help keep my bipolar symptoms in check, but they still affect some areas of my life in unexpected ways.

In a previous blog, ‘6 Things I Didn’t Realize About Taking Antipsychotics’, I wrote about some of the impacts that taking antipsychotics can have on your life. But I don’t just take antipsychotics for my <a href=”http://DON’T GIVE UP, MARY! I have had so many bad days, weeks, months, and years even, but when you stick it out, things always get better–sometimes much better than you ever imagined. I encourage you to contact the SUICIDE PREVENTION LIFELINE at 1-800-273-8255. They also have an online chat here: http://chat.suicidepreventionlifeline.org/GetHelp/LifelineChat.aspx. I’ve been in that space before, Mary, and it gets better. I PROMISE! Depression tricks us into believing the world is better off without us, but I PROMISE YOU, THE WORLD IS BETTER OFF WITH YOU IN IT! Please stay…and please stay in touch. bipolar disorder. I also take mood stabilizers. I have been taking mood stabilizers since my diagnosis, but it took two years to get the combination right. 

I now take two different mood stabilizers and am happy to say that I am euthymic. Although I experience few side effects from mood stabilizers, taking these medications still impacts some areas of my life.

In a previous blog, 6 Things I Didn’t Realize About Taking Antipsychotics, I wrote about how antipsychotic medications have affected my life. But antipsychotics aren’t the only medications I take for bipolar disorder — I also take mood stabilizers.

It’s worth noting that while mood stabilizer is a commonly used term among clinicians, it’s not an official classification of medication. For bipolar disorder, this category typically includes anticonvulsants and lithium.

1. Tremors

In the beginning, the tremors caused by my mood stabilizer really bothered me. I was on such a high dose of one particular medication that I had to choose between managing my maniaor dealing with wild tremors. It was frustrating, but at the time, the higher dose was necessary to keep my symptoms in check.

I remember being a student nurse on my mental health placement and meeting a young man my age who was on the same mood stabilizer. His tremors were so severe that they made daily tasks — eating, brushing his teeth, writing, brushing his hair, and even getting dressed — incredibly difficult. It took him so much effort just to do things most of us take for granted.

I had no idea then that, just a few years later, I would be struggling with the same challenges — while also trying to write a thesis and work as a nurse in the emergency department. The tremors exhausted me, and I was embarrassed by them. What was hardest was that I couldn’t play the piano or cello, something I truly love. On top of that, the constant tremors felt like a visible reminder that I had bipolar disorder.

Every time my dose was lowered, I would become elevated. During a particularly severe manic episode, I was prescribed an additional mood stabilizer. That second medication, combined with my original one, finally helped keep my mania at bay. More importantly, it allowed me to reduce the dose of my first mood stabilizer without destabilizing my mood. As a result, my tremors are now very mild.

It’s important to point out that the tremors caused by mood stabilizers are different from tardive dyskinesia, a potential side effect of antipsychotics. While both involve involuntary movements, they have different causes and feel distinct from one another.

2. Thirst

Need I say more? Mood stabilizers make you really thirsty. As I mentioned in my previous post, antipsychotics can cause a very dry mouth. Combine that with the thirst from mood stabilizers, and it’s not exactly a pleasant experience.

3. Regular Blood Tests

Some mood stabilizers can make you toxic if they’re over the therapeutic range. To measure this, routine blood tests need to be taken as the level of medication shows up in the blood. I don’t know how many blood tests I’ve had since commencing mood stabilizers, but there have been lots.

When first starting on mood stabilizers, blood tests have to be done very frequently while the dose is titrated up to a therapeutic range.

When I’ve been hospitalized for mania, I would get a blood test every morning. Once the optimal dose has been established for the individual, the blood tests become less frequent, but levels still have to be monitored. I usually get blood work done every two months, but if my dose changes, testing ramps up again. 

When that happens, my Saturday morning routine begins with a trip to the local pathology clinic and for a blood test. Fortunately, I don’t mind needles, but I can see how this could be a real challenge for someone who does.

4. Fluctuating Blood Levels

Sometimes, the levels of mood stabilizers in my blood fluctuate. I can always tell when they get too high: I struggle to concentrate, I feel weak, my tremors worsen, and I experience nausea, dizziness, and hot-and-cold flushes.

The first time this happened, I had no idea what was happening to me. I was studying in the university library and seriously considered asking a colleague to take me to the hospital. I didn’t — but looking back, I probably should have. It happened a few more times before I finally made the connection that my medication levels might be too high. Blood tests confirmed it, and my psychiatrist adjusted my dose.

Now, it doesn’t happen often, but when it does, it’s always when I’m dehydrated — which makes sense since dehydration can increase blood levels. Because of this, I have to be extra careful when exercising or on hot days. If my levels spike, it can completely wipe me out for a day or two.

5. Minimal Side Effects

Aside from toxicity — which is extremely serious and requires immediate medical attention — I’ve been surprised at how few side effects I experience from mood stabilizers, especially compared to antipsychotics.

When my tremors were at their worst, I wouldn’t have said this, and I know not everyone has the same experience. But of the three types of medication I take for bipolar, mood stabilizers are the ones I prefer. I owe my quality of life and mentally healthy mind to them.

Sally Buchanan-Hagen

Sally lives in Victoria, Australia. She was diagnosed with bipolar disorder two years ago when she was 22, however she has been dealing with extreme moods since she was 14. When she experienced her first episode of depression, she was too embarrassed to get help even though she knew that something was wrong. Throughout high school she battled depression after depression, each one getting worse. At university she continued to have depressive episodes and when she wasn’t depressed she was extremely happy, incredibly driven and unusually energetic. Everyone thought this was her normal mood, herself included and so the elevated times went unnoticed. The turning point was in her final year of university when she was referred to the university counsellor. She was diagnosed with depression but after many failed treatments she saw a psychiatrist who diagnosed her with type II bipolar disorder. However that quickly turned into a diagnosis of type I bipolar disorder after a psychotic manic episode. She is currently completing her honours degree in nursing and works as a nurse in the emergency department. She blogs for The International Bipolar Foundation and has written for several publications. She also volunteers for a mental health organization where she delivers presentations about mood disorders to high school students. Although relatively new to this world, she is passionate about mental health promotion and thoroughly enjoys writing about mental health.

Melinda

Reference:

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