Lithium
Though the drug lithium is used for a number of disorders ranging
from acute depression to eating and personality disorders (Paykel,
1992), it's primary use is for bipolar disorder, also known as
manic depression. Patients with bipolar disorder "between two
poles: depression and its opposite, mania" (Kalat,2004), often
with periods of normal behavior in between (Jamison,1993). In
addition, the patient is also prone to "mixed episodes" in which
symptoms of both mania and depression are present. Intensity of
these episodes can range from mild to dangerous, as in the case of
a manic depressive mother who severed the arms of her 10 month old
daughter (Associated Press, 2005). Despite its genetic origin
(Kalat. 2004; Jamison, 1993; DBSA, 2005), the onset of symptoms
and behavior is rather late, averaging 18 years of age (Jamison,
1993).
There are two types of manic episodes: manic and hypomanic. The
DSM describes a manic episode as "a distinct period of abnormally
and persistently elevated, expansive, or irritable mood,"
(Jamison, 1993). Symptoms include inflated self esteem, a reduced
need for sleep, increased talkativeness and sociability, flight of
ideas, distractibility, an increase in goal directed activities
(such as work, school or sex), and an excessive involvement in
pleasurable activities (PsychologyNet, 2003). The occurrence of
these symptoms must not be able be confused with a mixed state
(see description below), must impair the individual's ability to
function normally, and cannot be explained by the effects of a
substance (i.e. alcohol, hallucinogenics) or a medical condition
(i.e. hyperthyroidism) in order for the episode to be considered
"manic."
Hypomanic episodes are similar but shorter and often less intense.
Behaviors include "increased productivity, often with unusual and
self imposed working hours," "uninhibited people seeking,"
"hypersexuality," "inappropriate laughing, joking, punning," and
"excessive involvement in pleasurable activities with lack of
concern for painful consequences," (Jamison, 1993). Hypomanic
individuals also have increased creativity, inflated self esteem,
decreased need for sleep and an excess of energy (Jamison, 1993).
As one patient describes it, "At first when I'm high, it's
tremendous… ideas are fast… like shooting stars you follow until
brighter ones appear… all shyness disappears, the right words and
gestures are suddenly there… uninteresting people things, become
intensely interesting. Sensuality is pervasive, the desire to
seduce and be seduced is irresistible. Your marrow is infused
with unbelieveable feelings of ease, power, well being,
omnipotence, euphoria… you can do anything… but, somewhere this
changes," (Bipolar Disorder Manic Depression Support Group Chat,
2005).
Depressed periods often follow manic and hypomanic episodes.
Symptoms such as prolonged sadness, changes...
