Summary
A person believes they have a mood disorder but hesitates to seek treatment because they fear lithium-related weight gain. They ask for the name of an alternative medication before seeing a doctor.
The response recommends psychiatric assessment to clarify whether the difficulty is bipolar or another depressive condition before choosing treatment.
It notes that alternatives exist but does not name a medication or establish which option would fit the reader.
The central recommendation is to address the suspected mood problem with professional help rather than delaying evaluation because of anticipated side effects.
Question
Reader · Identity withheldI’m sure I have either Bipolar or Unipolar. I know I require treatment. But I refuse to take Lithium due to weight gain.
Is their something else I can take? If so, what is the name of it. Then I will see my regular doctor for help.
Answer
Mark Vigil Dombeck, Ph.D.I hate to say it but you’ve got your priorities quite backwards, possibly in a misguided effort to maintain a sense of control over what must feel like an out of control situation. You believe you have a serious illness, possibly even a life-threatening illness (as both unipolar and bipolar forms of depression are associated with suicide) – but you won’t take a medicine that might help because it could cause you weight gain? That just doesn’t make sense to me.
It seems more important to my mind at least that you get your mood disorder under control and then worry about weight. Lithium, by the way, is a mood stabilizing medication which is used pretty much exclusively to manage bipolar type mood cycling. You won’t find it prescribed for unipolar depressions.
There are plenty of medicines for unipolar depression that are not particularly associated with weight gain, and several alternatives to lithium for bipolar disorder (although none more effective to my knowledge) which are also not particularly associated with weight gain.
If you have a serious depressive disorder you owe it to yourself and to those who love you to get yourself to a specialist mental health physician – to a psychiatrist – for diagnosis and treatment. A regular ‘general practitioner’ doctor quite frankly is usually not qualified to treat a serious and potentially lethal condition like bipolar illness, and probably not a complicated unipolar major depression either.
Subject matter expert
Simone Hoermann Ph.D.
Personality disorders, anxiety, and depression
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