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A letter to Joy about lithium

Monday, 22 September 2014 Laura

Laura from our communications team writes an open letter to Joy, the clothes store.

Over the weekend, Joy, the clothes store, received a complaint about a greetings card containing the words "Don't get mad, take lithium." Their response to the complaint on social media was described as "deeply offensive and upsetting" by Kate Knightingale, Head of Communications at Time to Change.

Today, Laura from Mind's communications team writes an open letter to Joy:

Dear Joy,

Thanks for your apology over this weekend’s tweets about your lithium card. It wasn’t quite enough. It doesn’t make clear that you’ve really understood why many people are upset by the card and what happened. You haven’t said whether you’re going to remove the card from sale. You haven’t said whether you will provide mental health awareness training for your staff, or whether you will change your social media policy – which I think could do with being a bit less irreverent at times.

Your Twitter ‘dialogue’ was probably worse that the card in question, but I don’t appreciate the card either. Here’s why.

Joking is one of my favourite things; life is better when it’s not taken too seriously. Sometimes, I’ll joke about my mental health. I think that’s ok because it’s my mental health. I know which aspects are funny to me and which aren’t.

Having a mental health problem can make life incredibly difficult in lots of different ways. I wouldn’t joke about someone else’s mental health unless I knew them really well and it was some sort of mutual joke. In pretty much every other circumstance joking about another person’s mental health is a bad idea.

I take lithium because I have bipolar disorder. I put off taking lithium for a couple of years because the side effects worried me. I wanted to try other options first. Lithium is not a drug that any doctor would prescribe or any patient would take lightly.

It has a narrow therapeutic range: below a certain level it doesn’t work and above a certain level it is toxic (which can be fatal), and there isn’t much in between these. So it’s important the level is just right. The level that is just right depends on the physiology of the person taking it. When you start taking lithium you need weekly blood tests and medication adjustments until the level is right for you. After this you need blood tests every three months.

I started taking lithium just over a year ago. I’ve been quite lucky with side effects. I have a tremor in my hands and lower arms which is a pretty annoying at times, but I can live with it. I’ve put on a bit of weight and it’s made my skin spotty, which again is annoying but I can live with these. Sometimes I feel a bit sick and get terrible heartburn, which isn’t nice. And I need to wee more often. Maybe you didn’t need to know that.

In the longer term lithium can cause irreversible damage to the kidney and thyroid, which is something I worry about.

I’m going to keep taking lithium because my quality of life is much better than it was before. Before I started taking it I’d been off work for five months struggling with severe depression, which included feeling suicidal most days. Lithium has stopped me feeling like this. I love lithium. It has changed my life.

None of this is funny. Bipolar disorder isn’t funny. It ruins lives. It kills people.

Psychiatric medication isn’t funny. Most medications have serious side effects. Also, things often aren’t as simple as taking a medication that makes everything fine – a lot of people aren’t as lucky as me to have found a medication that works.

You card doesn’t really make sense. Does mad mean angry? Or does mad mean mentally ill? Bipolar disorder is a mental illness. I don’t identify as ‘mad’. Are you suggesting taking lithium will prevent someone from getting ‘mad’? If by ‘mad’ you mean mentally ill, then you’ve got this the wrong way round. A person would first have to present with symptoms of bipolar disorder (or in some circumstances unipolar depression) before being prescribed lithium. Hopefully lithium would improve the symptoms of their mental illness, but they’d still have a mental illness.

This is getting very complicated for a greetings card isn’t it?

Maybe that’s because it’s not really an appropriate subject for a greetings card.

I would really like to hear whether you plan to remove the card from sale.


P.S. Many people by now have told you that bipolar disorder doesn’t mean a person likes something one minute and hates it the next. If you like to know more about what it really is you can find out in Mind’s A to Z, or from RethinkBipolar UK, or the Royal College of Psychiatrists.

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