Sometimes, it’s possible to overthink things. I had a mild toxicity episode after starting what was hoped would be my effective dose of lithium, characterized by nausea, dizziness, a head that felt like a heavy water balloon, bad GI effects, and tremendous sleepiness. The nausea was not the mouth-watering, bile-in-your-mouth type, but pretty close. And throughout that time, it felt like there was 2 pounds of puke pushing up on my epiglottis, just waiting to hurl. (Is there a medical term for that? Imminent pukerizing? Yak-readiness?) After four days on the new dose, and two days thereafter when the nausea and dizziness got more severe and more constant, the little dim bulb popped on over my head– toxicity! I called, I got the blood draw, the doctor said yes, I decreased the dose, and three days later, I was feeling better, physically. I was, however, cranky, because right after (no, really, right after, because never say the universe does not have a sense of humor) I called my doctor to say, “um, toxic, I think I am, and talking like Yoda, too?” (ok, not that last part), my mood snapped into place, like a dislocated joint. It was such a relief that it almost hurt. But the mood dissipated back into okay-not-too-bad- occasionally- laughing-but-usually-just- meh-ness. Fortunately, so did the physical symptoms. Mostly.

See, I continued to have this mild what-I’ll-call-epiglottal pressure. I figured it was some weird malingering effect of the nausea. Or an emotional lump in the throat– something psychosomatic having to do with my telling my mother never to call me again the day before Easter, after she told me that I had no idea what it meant to be depressed and unhappy.   (Insert confused Scooby-Doo noise here.)  But I didn’t really think it was the Mom thing– even though I have sometimes been “all choked up” physically about things I’ve been mad about in the past– because when I hung up on her, I felt five hundred pounds lighter, so I didn’t think I was suppressing anything.

Friday I saw my psychiatrist to check in and discuss alternate dosing options, to see what we could do between 1200 and 1500 mg. to make my baseline mood a bit better. And I mentioned this lingering lump in my throat, along with the relevant bits of the story above. She scooted over, had me lower my turtleneck, and palpated my neck. “Your thyroid is inflamed.” Oh. And hadn’t I complained about gaining weight recently? Double oh.

Why yes, I do have the prescription information on my fridge, along with the warnings about people with thyroid conditions in the side effects section! Why do you ask? Oh, because I’m feeling stupid that it was something that obvious, weird inventions about nausea notwithstanding? (That BLC, she always wants to be unique…) And, why, yes, I am a lawyer who is familiar with medical research, having defended medical professionals on more than one occasion. Why do you ask? Oh, because I could have consulted Dr. Google earlier on? (Hey, just because I’m “smart” doesn’t mean I’m sensible all the time.)

I’ve got my lab slip to get my TSH level done when I get the lithium drawn next Friday, since I’m starting a new preparation and intermediate dosing schedule this week. Probably means more pills. F*ing thyroid.

Sometimes I think that the side effects to treating the crazy are worse than the crazy itself. But then I remember that my thyroid never nearly lost me my job. So, yeah, my latest adventures in psychopharmacology suck, but it could be worse. I could still be speaking with BipolarNarcissistMom.  Bring on the synthroid!