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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 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.
1. Tremors
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.
RELATED: A Guide to Bipolar Disorder Medication
I’ve been taking mood stabilizers since my diagnosis, but it took two years to find the right combination. Now, I take two different mood stabilizers and am happy to say I feel balanced and stable. While I experience few side effects, these medications still impact certain aspects of my life.
Here are five things no one told me about mood stabilizers:
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 mania or 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.
RELATED: Do You Know These Symptoms of Bipolar Mania?
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.
RELATED: Lithium Treatment for Bipolar Disorder
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.
UPDATED: Originally posted in 2017