I’ve now been on lithium for 12 days. It hasn’t helped at all so far. In fact, I think it’s making things worse. I feel even more tired than usual, and my thinking is fuzzy and confused or obsessive and self-destructive.

This is what it’s like to live through my today:

You wake up just before 9am. Immediately, you feel overwhelmed by the hopelessness of everything. You feel it’s all completely unbearable. You pick up your phone, thinking “I’ll distract myself by reading the NY Times.” You forget that there is no way the news is going to make you feel better about anything.

Greet your husband when he comes in the bedroom. He has already been up to make his coffee and let the dogs out. He brings your tea and asks how you are doing. You grunt a response. You have explicitly told him before that a grunt means, “not good” but you aren’t sure if he remembers.

“Do you want some breakfast?” he asks. “Eggs or oatmeal?”

Yuck, no. Typically you love breakfast, but since starting the lithium, your stomach is in a tight knot every morning and eating sounds horrible.

You read a couple of articles in the NY Times, but that feels like a lot of effort. You play a game of Candy Crush, wondering how many hours of your life you have wasted. And does it matter anyway?

The phone rings. It is, to your surprise, the depression coach from your insurance company. You last talked to her on your birthday, oh day of joy that was. You have left two messages for her with no response until now. She asks how you are, and you tell her, without the details. She agrees that the list of psychiatric options on the insurance website is unusable and promises to get you the names of a couple who are genuinely available. You appreciate that but feel more discouraged talking to her, as you realize, yet again, that no one can really do anything about this.

After you hang up, you lie in bed for a while, doing nothing. You decide you will make an effort and tell your husband you’ll eat an egg. It’s almost noon, and you think a little protein might be a good idea. You eat a piece of toast with the egg. That was exhausting, so you go back to bed.

You lie there a long time, thinking this is how people gradually become catatonic. They stop moving and stop caring. You close your eyes and everything seems to be green. You wonder what it feels like to hang yourself. You aren’t planning anything specific, just thinking about it.

You remember you need to email someone. You have a freelance contract (that you aren’t working on as you should be), and part of it involves being out in the field all day tomorrow. Damn, that sounds demanding. But you are obligated. So you grab your laptop and send the email. You see the depression coach already sent the name of a psychiatric nurse. You call the number and get the nurse’s voicemail. You leave a message.

While you have the laptop open, you google the process for buying a gun in your state. You find out it is one of the easiest states in which to buy a gun. You think that is stupid poicy though helpful to you should you ever get to that point. Then you look up ‘lethal dose of lithium.’ Then you tell yourself that this is not helpful and shut the laptop.

You doze a bit and then you stare at the wall a bit. You get up at 4pm. That’s a record, even for you. You call an old friend of yours from grad school, who fortunately has time to talk and is willing to hear how you really are. She wants to fix things for you but of course she can’t. She says, “Would it help if we talk more often? How about I just call you everyday, and if you don’t feel like talking, that’s okay?” You think that is a very good response.

You husband asks if you’d like to watch TV. But TV seems like it will be boring, or too hard to concentrate on, or to something. You pick up a piece of paper to draw something but don’t know what to draw, so instead you write down things your dad used to say:

  • I can’t be an alcoholic, because I only drink beer and wine.
  • It’s only a few glasses of wine, so it doesn’t do any harm.
  • I’m a big guy, so this is not really very much alcohol for my size.
  • I once gave up drinking for a while year, so that just shows I’m not an alcoholic. I don’t need to drink.
  • I can quit whenever I want. I just don’t want to right now.

But you get tired before you finish the list. You husband brings you a plate with a taco. He is spoiling you. He bought the cilantro just because he knows how much you like it. While you are talking to him, he sees the burn on your arm from the other day. He is very sad and concerned. You feel both ashamed and irritated, “It’s not a big deal, okay?” This somehow seems like something your father might say about his drinking.

After the taco, your husband brings you a piece of fudge with marijuana in it. It’s his own recipe. He got intrigued with the culinary possibilities after pot became legal in your state. You’ve tried this fudge before and think 1) you can’t tell there is anything in it and 2) it needs more sugar. But ever since you and your husband read the article about the woman with treatment-resistant depression getting complete relief from a very low dose of LSD each day, he’s been all for experimenting with marijuana. It’s his way of feeling he has something to offer you.

You text a little with E about having a hard day and deciding not to take any more lithium. She is nervous that you are doing this without having a psychiatrist to work with. But you know that adding more lithium to your system is not going to be helpful and will probably keep you from doing the field work you are supposed to do tomorrow. She also writes something about listening to your precious self, but it’s not straightforward and you feel confused. You can tell you are not thinking too straight.

You go back in the bedroom and crawl back in bed (you’ve only been up for four hours, but so what, this is a wasted day anyway). You text E to say you aren’t thinking clearly enough to do much of anything. You write that you’re just in survival mode for the time being. You can’t think about using any strategies. You are just going to try to stay safe, and that’s good enough for now. Right?

Right, she texts back. That’s good enough. Be well.

Fuck, why does she do that, you wonder. She signs off a texting conversation with something chipper when it doesn’t fit the tone at all. I am having flashbacks and can’t sleep, you might text. And she might respond, That sounds really hard.  Enjoy the sunshine!  You know it’s partly an issue of texting (losing all the facial expressions and body language) and partly that she’s an upbeat person. But it feels like she didn’t hear a thing you just said.

You think you should just shrug it off, no big deal. But it feels important to you. If you don’t say anything, you will spend the evening fretting that she doesn’t really care and you just bother her with your whiny emails.You remind yourself that you are not shielding her from your reality anymore. You want to stop minimizing what you feel. So you answer her: Oh crap. I know this is picky, but that “be well” does not feel at all attuned to where I am right now. It would be so helpful if you could take that part back.

She responds a few minutes later: I take it back. Be kind and care for yourself as best as you can.

Better, you think. You think what you’d really like to hear is Oh my dear Q, it breaks my heart that you feel this way, let me come over and brush your hair until you fall asleep. I’ll tuck you in and make you feel loved. But even in your lithium-induced stupor, you recognize that this is too much to hope for.

You wonder if you ate something with nuts in it (since you have a very strong allergy), if you didn’t throw up violently and didn’t use your Epi-pen, maybe you would die and your husband wouldn’t know it was intentional. And then he’d be sad, but it wouldn’t feel as unbearable. But it still leaves the problem of your son with autism, who needs you.

And so, another day has passed, and you are still here.