When I left the Psychiatric ward of Hôpital Tenon (admittance number duly saved in my iPhone, because they said there would always be a bed for me, should I need one), there was a photocopied pamphlet about lithium carbonate tucked into the inner pocket of my suitcase. It was an in-house, unofficial publication, typed in word with the pages folded, not even stapled together. I’ve dropped it a few times and can’t seem to manage to put the pages back into the correct order – which I find infuriating – and one of the pages was actually missing all along.

It works quite well as a metaphor for the hospital ward in general: their heart was in the right place, but the facilities were pretty terrible (I must write about that shower, one day) and there were some gaps in the service.  But it was free and I am eternally grateful for the month’s care I received as in in-patient that summer.

The leaflet begins with a page where I filled out some personal information, followed by charts where I track my lithium blood levels. I’m taking slow release tablets in the evening, and the therapeutic range for treating my bipolar 2 disorder is ideally between 0,8 and 1,2 mEq/L.  Toxicity can occur if the level in my bloodstream reaches 1,5 mEq/L, which is really not very much higher, so I have to watch out for various fun side effects which could start with, say, fatigue, coordination problems or muscular weakness in the first instance and progress to really cool symptoms like convulsions, distorted vision or hearing or even muscular seizures if lithium toxicity becomes severe. So far, there has been nothing to report on that front. Praise be!

I can no longer take ibuprofen, and anything which would dehydrate me – stomach bug, diuretics like coffee, tea or alcohol, will potentially affect my lithium levels.  Moderation is key here. Nobody needs to be adding lithium intoxication to their usual morning-after hangover symptoms.  Non pharmaceutical recreationals are also probably best avoided.

Under the heading “length of treatment”, it is stated that it might be necessary to take lithium for the rest of the patient’s life. My psychiatrist wants me to take it for as long as it is safe to do so, meaning that in my blood panels we also regularly check for damage to my kidneys and thyroid. The latter was seriously misbehaving – cue a battery of tests and MRIs and a not insignificant amount of worry – but it now seems to have fallen into line.

Under medium-term side effects, aside from the weight gain which seems to be associated with every single medication a person can take for bipolar disorder, the paragraph which interests me most is cut off, mid-sentence.

Diminution de la créativité : Certains patients qui prennent du lithium rapportent que le traitement diminue leur imagination et leur productivité créative. Il est à noter que les épisodes notamment dépressifs peuvent également affecter la-

It’s been nearly two years now, and I have no way of knowing whether lithium carbonate stomped all over my muse or whether feeling low sapped the will to write.

Perhaps it was a combination of both.

But it is a pretty well documented phenomenon. And no, I’m not comparing myself to any of the authors cited in that article, I’d happily just ride Carrie Fisher’s coattails, may she rest in peace.

Aside from the meds and the big black dog in the room, the other thing that has been holding me back, if I’m honest with myself, is causing (extra) (undue) worry to my nearest and dearest.

First of all, there are all morbid, dispiriting thoughts when I’m on a downswing, which I’m not sure I could or should be sharing with anyone. And when I’m just feeling kind of baseline meh? I’ve not been able to convince myself there is a lot of literary mileage to be got out of that mental state.

Even when things are good, it’s not as simple as you might think. Family and friends, who know about this blog because I overshared last time around, now invariably associate me writing, sharing on social media and being sociable with the possibility of subsequent self-harm and hospitalisation.

I know people mean well, but I dread those “you have been posting a lot more on facebook lately, is everything okay?” emails from my mum or from well-intentioned friends.

I suppose the only way to help them get over that fear, is to keep posting regularly. And let them see for themselves that the scary phone call (hopefully) never comes.

So buckle up muse, you and I are taking a ride through the good, the bad and the boring. Let’s see where this journey takes us.