I want to love the summer...but mental illness keeps getting in the way.
The hot summer months can play havoc on anyone with mental illness
Summer was always my time. I’d watch as the trees sprouted newly formed leaves, the sun setting later and later with each passing day, and I’d relish the thought of months of warmth. Gorgeous sunsets sat in the park or at the beach. Camping out with friends, music festivals dancing until my feet hurt and the sun comes up, pub gardens and water gun fights. I still adore the summer, but something has changed, and I’m not happy about it.
Last year I started taking lithium. Now, I’m not going to go into detail about dosage, when I take it and all of that because I’m not a medical professional, and what works for me probably won’t work for you. The side effects compared to other medications were pretty tame (again, this is my experience, and it won’t be the same for other people) until summer hit. I didn’t know much about lithium toxicity other than that you don’t want it. Turned out I had a mild case of it, but it felt anything but mild. It hit me hard, with all the subtlety of a sledgehammer.
My social media now is full of posts and messages warning about the dangers of the summer heat if you’re mentally ill and taking medication. This isn’t without tangible evidence. People with schizophrenia can experience difficulties with body temperature regulation, and temperature changes can change symptoms of mood disorders. Some psychiatric medications, including some antidepressants and antipsychotics, can affect how the body regulates temperature. High temperatures are linked to a lack of sleep, exacerbating mental illnesses. Research has also linked high temperatures to problems with memory, attention and reaction time. There is also evidence of increased mental health emergencies during extreme heat among all demographics.
Back to my experience. I’ve had lithium toxicity twice now; once last year on holiday in Crete and this year during this summer’s first heatwave. In both situations, I was not prepared for the heat and how taking lithium would affect me. I believed I was at least coping. I was wrong. Very, dangerously wrong.
The first change I noticed was in my behaviour. I got ratty, irritable, irrationally angry. The change felt instantaneous like someone had pressed a button for ‘grumpy human’, and there I was. My partner noticed immediately, but seeing how I can be randomly irritable and grumpy at the best of times, he ignored the behaviour - at first. Then there was the pounding headache, dizziness and feeling unsure on my feet. I felt drunk, the kind of drunk that could quickly spin out of control if I didn’t try and sober up. It got worse. I was clumsy. My phone or whatever I held would randomly fall out of my hands. I wasn’t slurring my words, but I had to think harder about what I wanted to say, and forming words felt more like an effort. When I told my partner it felt like I was slurring my words and described the rest of my symptoms to him, he realised things were serious. Luckily I didn’t need to go to the hospital, and slowly drinking water and taking it easy helped me feel better. We were close to taking me to the hospital and would have if my symptoms hadn’t started to subside.
If I have any advice to share for anyone taking lithium during the summer months is to stay hydrated. Drink that water even when you don’t want it. I think I’ve finally realised this too, and that I really need to start taking my own advice. The summer months really do play havoc on anyone with mental illness, and with more extreme weather events and heat waves, we all need to look out for one another.