When You Sacrifice Your Physical Health for Your Mental Health

Sometimes I find myself in a dark corner waiting anxiously and afraid. Depending on the day or week or even month, these moments manifest when I’ve lost sight of all the positive things in my life. When I’ve let down my guard and allowed negative thoughts consume my mind. I believe this debilitating anxiety is a by-product of two chronic illnesses I live with.

Chronic kidney disease (CKD) and bipolar disorder have brought numerous struggles throughout my 59 years on this planet. And you might be surprised how intertwined these maladies really are, at least in my case. Chronic kidney disease has been top of mind lately as I have been on a new path anticipating a kidney transplant. Every couple of weeks or month, my kidney functioning is monitored through simple blood tests and evaluated by my transplant team at UTSW (University of Texas Southwestern), where I will ultimately have my kidney transplant surgery. Medical personnel hone in on creatinine levels and an eGFR (Estimated Glomerular Filtration Rate), which represents the percentage rate my kidneys are functioning.

As I get labs drawn, I experience an ample amount of anxiety waiting to learn the results. Every. Single. Time. The number can either mean I’m ready for surgery or I need to wait longer and have more lab tests. And, of course, everything initially relied on securing a donor, preferably a living one. So that brought its own set of worries and anxieties. We’ll get back to that later.

But let’s go back a minute. How and why did I get kidney disease when I was a relatively healthy 37-year-old? Well, that brings me back to the correlation between bipolar disorder and chronic kidney disease. Once I was officially diagnosed with bipolar, I was 21 years old, and the OG “magic pill” for the illness was (and still is) lithium. This little chemical element has the power to stabilize moods like no other drug on the market.

I started taking lithium right away and suddenly I was in remission; actually, I thought the illness was completely cured. I had no idea it would rear its ugly head again years later. But, for 16 glorious years, I embarked on my advertising career, married, and had a lovely daughter. All was bliss until one day, I returned from traveling to discover I had about 20 voicemails from my psychiatrist. She urged me to stop the lithium immediately and make an appointment with a nephrologist (kidney doctor).

It appeared the lithium use had injured my kidneys, and I began a long path of doctor visits and tests while my kidneys gradually deteriorated over the years. Now, please know there were known risks with ingesting lithium, one of which was damage to the kidneys. So yes, I jumped on the band wagon of lithium while well aware of the potential side effects. But I never imagined in my wildest dreams I would embark on a long, treacherous journey with both my kidneys and my mental health.

For my bipolar, I was offered an array of options to keep the disease at bay. However, what I had jumped into translated into decades of trial-and-error with different medications, treatments, a couple of hospital stays, and even a 30-day stint at a residential treatment center to little or no avail. I did experience occasional relief from the highs and lows of the disorder, but I never found a “magic” solution like I had in lithium. I believe I have tried every possible anti-depressant and mood stabilizer available to man.

When the drugs didn’t work, I alternated with a myriad of treatments to accompany the medications, like TMS (transcranial magnetic stimulation), ECT (electroconvulsive therapy), and ketamine nasal spray. They all proved worthwhile, at least for a while.

The only harrowing side effect I encountered from the treatments was from the ECT. I experienced major memory loss throughout the years surrounding those treatments. To this day, my husband continually reminds me of past trips and experiences completely erased from my memories.

By the time I was 44, as I had met significant setbacks in my career and my personal life, I experienced several losses. I retired at that age from my advertising career, my 17-year marriage ended, and I was forced to sell my “dream house.”

Around this time, I also found out I had stage 1 breast cancer. So, another challenge to face, but after seven surgeries including a double mastectomy, reconstruction and a hysterectomy, the cancer was gone. I am a 14-year survivor with no recurrence. Thank goodness!

But the bipolar illness was still my dark passenger and brought chaos to my life. I was on a roller coaster ride of moods causing major emotional stress, which far outweighed any physical pain I endured, including cancer.

When the bipolar symptoms crept back, I would experience the exhausting hypomania and devastating depressions. The down times were more prominent, and I would basically shut down and isolate from the world.

This wreaked havoc on my job, and I missed a lot of work as a result. Little by little the time away from work progressed, and I started taking longer absences from my jobs with short term disability leaves. In fact, by 2017, I left my last full-time job and applied/was approved for social security disability.

In addition, all social activities and family get togethers became nearly impossible. I also found myself canceling doctor and dentist appointments, pushing them back indefinitely until the darkness lifted.

Now, back to my CKD:  My kidney function wasn’t too bad in 2002 when I first discovered my kidneys were adversely affected from lithium use. Over the years, my kidney function declined very slowly. So, I just kept getting labs done either annually or every six months.

It wasn’t until March of 2022, at 58, when my nephrologist sat me down and told me I would need a kidney transplant soon to sustain my life. I was shocked, devastated, and scared. For some reason, I didn’t anticipate my kidneys would actually fail one day.

When my doctor broke the news, I wasn’t very healthy and weighed the most I’d ever weighed! One of the mood stabilizers I took the year prior revealed a side effect of constant hunger. But I cannot use the medication as an excuse — I was the one who put too many sweets and salty snacks in my mouth.

At this point, my kidney functioning was at about 18%, and donor recipients need to be at 20% or lower for the transplant to be scheduled. Well, I decided I wasn’t going to go down without a fight, so my journey of weight loss and exercise began. I cut back on food overall, ate more healthy foods, and started walking as much as possible.

My results varied between 18% and 21% for about a year, staying very close to the 20% or below eGFR necessary for the transplant. Meanwhile, my search for a donor didn’t last long at all — my sweet and selfless husband was a match! But he began a 10-month journey of his own with rigorous donor testing. By the time he was finally approved, my numbers had increased above 20%. So, once again, I couldn’t schedule the transplant. This seemed like another setback.

However, it truly was miraculous timing that upon my husband’s approval, my labs had crept up over the mandatory 20% functioning mark for transplant. Because at this point, it kept increasing every time I tested! My most current lab results toward the end of May 2023 put my eGFR at 27%, which is a 50% increase from my functioning of 18% mere months earlier. My nephrologist was thrilled, explaining how I will most likely keep improving or sustain my kidney functioning. The necessary transplant might be in six months, a year, or more. My attitude swiftly changed! I am buying more time and there is a good chance I will be able to keep the transplant at bay indefinitely.

The increase in functioning was attributed to my weight loss over a little more than a year and my exercise regime. I am very happy to be in much better physical shape, and if/when I do receive my husband’s kidney, I will resume my new life as healthy as I can be. I feel like I’m on the right track, as living healthily is critical for my after-transplant care as well!

So if I could go back and do it all again, would I utilize lithium knowing my kidneys would ultimately suffer? The answer is YES. Those 16 years of stability I experienced brought me a rewarding career, husband, and a precious baby. I wouldn’t trade anything in the world for those milestones! I might not have been able to handle any of the accomplishments or reached the same life goals if I hadn’t initially accepted lithium as my drug of choice.

Fortunately, some positive things started popping up in my life around 2007. That year I met and subsequently married my fence guy four years later. (Yes, you read that right!) We’ve had 12 years of wedded bliss. I also experienced the transition of my daughter to my son. His strength and bravery exhibited throughout those first years simply amazed me and continue to do so. I am over-the-top proud of him and support him 100%.

Perhaps without either of these chronic illnesses, my life would have turned out quite differently. Even with all the physical and mental struggles over the years, I find myself very grateful for my life journey so far and realize hard work and determination can sometimes shift the trajectory completely. I’ll keep taking one day at a time, with every effort to stay healthy, and continue to find happiness and joy along the way.