Lithium: What It Is, How It Works, and What You Need to Know

When you hear lithium, a mood-stabilizing medication used primarily to treat bipolar disorder. Also known as lithium carbonate, it’s one of the oldest and most studied psychiatric drugs still in wide use today. Unlike newer antidepressants, lithium doesn’t just lift your mood—it helps prevent the extreme highs and lows that define bipolar disorder. It’s not a quick fix, but for many, it’s the only thing that keeps their life from spinning out of control.

What makes lithium different is how it works inside your brain. It doesn’t target serotonin or dopamine like most antidepressants. Instead, it tweaks the way nerve cells communicate, especially around chemicals like glutamate and inositol. This helps smooth out the wild mood swings that come with bipolar disorder. But because it works so precisely, your blood levels need to be checked regularly. Too little and it won’t help. Too much and you risk serious side effects like tremors, confusion, or even kidney damage. That’s why therapeutic drug monitoring, the process of measuring lithium levels in your blood to ensure safe and effective dosing is non-negotiable. Doctors don’t guess—they test. And if you’re on lithium, you will too.

It’s not for everyone. If you have kidney problems, thyroid issues, or are pregnant, lithium might not be the right fit. But for those who respond to it, the results can be life-changing. People who’ve tried multiple meds without success often say lithium is the one that finally brought them stability. And it’s not just about feeling better—it’s about staying safe. People with untreated bipolar disorder are at higher risk for self-harm, job loss, and broken relationships. Lithium reduces those risks, sometimes dramatically.

Side effects are real, but manageable. Dry mouth, weight gain, and frequent urination are common. Many people get used to them over time. Less common but serious issues include thyroid underactivity and kidney changes, which is why regular blood tests and checkups are part of the deal. You won’t get a prescription without a plan to monitor you closely.

And while lithium is mostly known for bipolar disorder, it’s also used off-label for depression that doesn’t respond to other drugs, and sometimes for aggression or impulse control issues. But its main job? Keeping mood swings from taking over your life.

What you’ll find in the posts below are real-world insights from people managing lithium, doctors explaining how to use it safely, and comparisons with other mood stabilizers like valproate or lamotrigine. You’ll see how therapeutic drug monitoring plays out in practice, what lithium side effects actually look like over months and years, and how people balance the benefits with the daily realities of taking it. No fluff. Just what works, what doesn’t, and what you need to know before you start—or if you’re already on it.