“I don’t really believe in God, but I believe in lithium.” So declares Jaime Lowe in recounting her 20 year struggle with bipolar disorder in Mental: Lithium, Love, and Losing My Mind. Yet as the subtitle suggest, Lowe also examines the treatment of choice.
Bipolar disorder, once known as manic depressive illness, usually first appears between the ages of 15 and 30, with 25 being the average age of onset. Lowe was an overachiever, with her first hospitalization for the condition occurring at age 16. Mental opens with a recounting of her first episode of extreme mania. As with other accounts, one wonders how someone who, to put it colloquially, is “out of their mind” can accurately describe what happened. Lowe, though, says that because the experience was “real for me,” she does remember and the incidents leave a feeling that “never fully dissipates.”
While hospitalized, she was started on lithium, the first line treatment for bipolar disorder. What is more striking about this first hospitalization is not necessarily what led to it but the existential state in which she was left once well enough to be released.
Who was I if my actions and thoughts didn’t represent me? What if they did represent me? What if they were extensions of me, rooted in a subconscious realm? What if the me from before I was on lithium is the real me?
Lowe recognizes these questions were too deep for her teenage mind to ponder for long. At the same time, she says, “I no longer had a baseline for reality or even a way to fully trust myself.” And those existential questions, or at least their undercurrent, would not disappear.
Lowe was fortunate because lithium worked for her, allowing her to live and work without being overwhelmed by her condition. In late 1999, Lowe tapered off lithium after having taken it for six years. She began slipping into a manic state even before stopping the drug entirely and once full blown, it would take several months to convince her to go back on the drug. Again, she returned to comparatively normal life.
Still, her “normality” reflects one of the problems with the psychiatric memoir. As a college student, she lived in Edinburgh, Scotland, for a year studying art history. She’s traveled to Turkey, Germany and Japan and enjoyed the nightlife and other things New York City had to offer while living and working there. To date, the memoir authors largely have been white and relatively privileged.
We aren’t hearing the experiences of those, minority or otherwise, who struggle to obtain treatment, let alone those who lack the resources, or the deinstitutionalized. Granted, this is not a problem cause by Lowe. In fact, near the end of Mental, she discusses the fact that while she spent more than $100,000 on outpatient psychiatric care in 18 years in New York City, some 43 million Americans don’t have that option.
In 2014, Lowe encountered something many others who rely on lithium face — kidney damage. Routine blood tests by her primary care physician ultimately revealed that two decades of lithium left her kidneys with only 48 percent function. “I had to choose between my kidneys or losing my sanity,” she writes. Her need to search for a replacement treatment leads her to explore lithium itself. In doing so, Magic is uncommon.
As if infatuated by it, Lowe travels to lithium production sites in Nevada and Bolivia and spas with lithium in the water. She ultimately weaves together concise summaries of the history of treating mental illness, what lithium is, where it comes from and the history of its medical use. And, Lowe says, the nature of lithium creates a problem for patients. Lithium is one of the first three chemical elements created by the Big Bang. That means it can’t be patented so, according to Lowe, there’s no financial incentive to continue studying its effect on the brain. Lowe fortunately found another treatment that has worked, although the book recounts that it was far from a simple process.
As noted, Magic comes from the view of a privileged, white American, which is heightened here by a sense of New York City bohemian cool. Perhaps related to the latter, at times the tone is one of hip casualness and there are occasional clunkers (“temperament itself is so tempestuous”). Lowe also tends to wander or be a bit wordy in the last third of the book, delving into family history and other topics. The flaws, though, do not leave the book or its scope hollow. By going beyond the personal aspects of bipolar disorder, Lowe provides a rare perspective.