Lithium for Adult Mental Health: What Is Lithium Used For?
Lithium is broadly known for its mood stabilizing properties – and even in popular media, such as its mention in song titles and films. But what is lithium used for exactly, and how can it benefit your mental health?
Back in 1949, psychiatrists began using lithium to treat episodes of mania. But it took another two decades before the U.S. approved it for medical use, becoming the 50th country to bring it to market.¹
Lithium occurs naturally as a soft, silvery metal – the lightest one known to science.² In other words, lithium isn’t just a pharmaceutical compound. It shows up in our environment – in rocks, water, some foods, and even inside the human body in trace amounts. ³
In mental health care, it’s used in the form of lithium carbonate, a salt compound that helps stabilize mood. For this reason, it’s often prescribed as a mood stabilizer for bipolar disorder, acute mania, and sometimes depression that hasn’t responded to other treatments.
If you or someone you love has been prescribed lithium, you’ll undoubtedly want to learn more about it. Mission Connection can talk you through the ins and outs of lithium in mental health treatment. This article also works as a useful guide, as it discusses:
- What lithium is used for and how it works
- Signs that lithium is working
- Side effects of lithium
- Signs of lithium toxicity
- Lithium dosages
- How to stop lithium safely
- Where to get professional advice for lithium and mental health treatment
What Is Lithium Used For?
You may hear lithium called one of the “oldest medications” in psychiatry, and for good reason. It’s been around since the 1940s and still holds up in modern care. But what is lithium used for, and what does it actually do?
In most cases, doctors prescribe lithium to help stabilize mood in people who experience emotional extremes. This usually includes people with conditions like bipolar disorder, though it sometimes gets used off-label for people with depression who don’t respond to other medications.⁴
What’s interesting is that lithium wasn’t always seen as a psychiatric drug; it was originally studied for its calming effect. Yet, decades later, formal research confirmed it could reduce the intensity of manic episodes, and even lower suicide risk by 10% in people living with bipolar disorder.⁵
Let’s take a closer look at the conditions lithium is commonly used to treat.
Lithium for Bipolar Disorder
The first thing to know is that bipolar disorder involves a nervous system that’s constantly trying to regulate energy – too much in manic states, and too little in depressive ones. ⁶ When doctors prescribe lithium for bipolar disorder, it’s to help bring this energy level back into a stable range.
Lithium helps regulate mood by affecting how brain cells send and receive signals. For instance, it changes the flow of certain ions (like sodium and calcium) that neurons use to communicate.⁷ It also alters second messenger systems inside the cell, which influence how the brain responds to stress, emotion, and stimulation over time.
There’s also a potential long-term benefit of lithium for bipolar disorder: it seems to increase levels of a protein that protects brain cells.⁸ This benefit isn’t just helpful in the moment – it may actually reduce some of the cognitive decline that can occur with unmanaged bipolar disorder.
Off-Label Use for Depression
Sometimes, antidepressants for depression aren’t enough. When someone’s had little response to traditional medication, a provider might add lithium to the mix – not to replace the antidepressant, but to strengthen its effect.
There’s research suggesting that lithium makes the brain more receptive to serotonin, one of the chemicals most involved in mood.⁹ It also seems to regulate emotional responses, especially when there are a lot of internal ups and downs.
And while lithium isn’t officially approved for depression, its use in this way isn’t unusual. Clinicians sometimes reach for it when other treatments fall short, especially when there’s a pattern of relapse or long-standing mood instability.
Signs Lithium Is Working
The signs lithium is working aren’t always obvious right away, especially because it’s not a sedative or a fast-acting tranquilizer. Most people start to see the signs lithium is working within three weeks, but everyone’s experience is unique. However, there are a few key changes people might notice once their body begins to respond to the medication.
For someone with bipolar disorder, one of the biggest signs is that mood swings become less intense. For instance, episodes of mania may feel less sharp or urgent, and depressive lows may feel less overwhelming. Sleep also often improves. So does focus. Many people describe feeling more emotionally “even,” as if their reactions aren’t running quite as hot or cold as they used to.
Providers usually monitor progress over time with both symptom tracking and physical assessments. Lithium levels are typically measured through blood tests to make sure the dose is in a therapeutic range; not too low to help, yet not so high that it causes problems. For this reason, it’s not unusual to make small adjustments to the dose early on in treatment.
Lithium Side Effects
Like most psychiatric medications, lithium does come with potential side effects, but not everyone experiences them the same way. Some people tolerate it well. Others may need to try different doses or formulations to find the right fit.
The most common short-term lithium side effects can include:
- Nausea
- Mild hand tremors
- Increased thirst
- Frequent urination
These effects usually show up early and sometimes fade as the body adjusts. During this period of adjustment, it’s important to stay well hydrated, since lithium is processed through the kidneys.
In the long term, doctors pay close attention to how lithium may affect organ systems like the kidneys and thyroid. That’s why regular blood work is part of any long-term Lithium treatment plan. The goal is always to find the lowest effective dose that keeps mood stable without putting stress on the body.
Let’s consider some of these side effects in more detail.
Lithium and Kidney Function
Lithium is filtered through the kidneys, which means these organs do a lot of the heavy lifting in clearing the medication from the body. As such, lithium and kidney function is something of concern; over time, especially at higher doses, lithium can place some strain on kidney function.
This is why doctors regularly check kidney markers through blood tests, usually every few months at the start, and then less frequently once the dose is stable. If there are signs of reduced kidney function, it doesn’t always mean Lithium has to be stopped. Sometimes, the dose is lowered, or other medications are adjusted, to reduce the load on the body.
Staying hydrated is one of the most important things people on lithium can do. Water helps keep lithium moving through the system efficiently and reduces the risk of buildup.
Lithium and Thyroid Problems
One of the lesser-known effects of lithium is how it interacts with the thyroid. For some people, lithium can reduce thyroid hormone production over time, leading to a condition called “hypothyroidism.” Symptoms of hypothyroidism might include fatigue, weight changes, or sensitivity to cold, but in many cases, it’s picked up on a blood test before symptoms become noticeable.
If thyroid changes do happen, it doesn’t usually mean someone needs to stop lithium treatment. Most of the time, doctors prescribe thyroid hormone replacement, which can balance things out and allow the person to continue lithium safely.
This is another reason blood monitoring is a routine part of treatment. The earlier any shifts are noticed, the easier they are to manage.
Lithium and Mood Swings
It might sound counterproductive, but some people worry that lithium will make them feel emotionally “flat” or distant, as if their personality will disappear with their emotional ups and downs. This isn’t the goal of treatment, and it’s not usually what happens when the dose is right. What some people find is that they start taking lithium and mood swings they previously struggled with become less severe, or even no longer an issue.
When lithium works well, most people still feel like themselves. They still feel joy. They still feel sad. The difference is in the extremes. There’s more space between emotion and reaction. More ability to reflect before responding. And in relationships or stressful moments, this space can make all the difference.
If someone does start to feel emotionally blunted, this may be a sign that the dose needs adjusting. It’s always something worth bringing up to your provider, because treatment can often be fine-tuned without giving up stability.
Lithium Toxicity Symptoms
It’s rare, but sometimes lithium builds up in the body, especially if something shifts, like a medication change, dehydration, or kidney stress.¹⁰ When levels get too high, that’s when lithium toxicity symptoms become a concern.
Early lithium toxicity symptoms aren’t always dramatic. You might feel “off,” nauseous, unsteady, or a little shaky. Some people notice they’re more confused than usual, or their words feel slow to come out. However, if it progresses, the lithium toxicity symptoms may get more serious and lead to:
- Tremors
- Trouble walking
- Slurred speech
- Disorientation
Providers usually keep a close eye on lithium levels through blood tests, and this helps catch most issues before they escalate. But if something feels wrong, especially after an illness or dose change, it’s worth checking in right away.
Natural Alternatives to Lithium
There aren’t any true natural alternatives to lithium that work the same way. But there are nutrients and compounds that support mood regulation in gentler ways, mostly for people with milder symptoms or as part of a broader plan.
Some look into magnesium. Others explore omega-3s from fish oils or amino acids like NAC. These don’t replace a prescription, especially for conditions like bipolar disorder, but they can help support mood, energy, and resilience in everyday life. Diet, sleep, and stress also play a huge role – often more than people realize.
Still, anything you add to your diet should be reviewed with a mental health professional. Natural doesn’t always mean safe when there’s a full treatment plan in place.
Lithium Dosages
How long does Lithium take to work? Lithium takes a little time to settle in. Some people notice the effects in the first week or two, but it’s more common for real change to unfold gradually over the course of three weeks or more. It’s not about dramatic shifts. It’s more like feeling a bit steadier during moments when energy or emotions used to spike or crash.
For most adults, the starting lithium dose falls between 600 and 900 milligrams a day, usually split into two or three doses to spread the effect across the day.¹¹ In teens over 12, the initial dose is typically lower, starting at 300 milligrams. Lithium in teens is carefully monitored, not just for symptom changes but also through regular lithium blood level tests. These blood levels help doctors see if the medication is building up to a therapeutic range or straying into one that’s too high.
Once someone stabilizes, some providers suggest taking the full dose at night. This doesn’t work for everyone, but for certain patients, it can cut down on side effects like tremors or nausea. Additionally, older adults are usually started at lower doses, since their kidneys don’t process lithium quite as efficiently. The goal is always to balance safety with effectiveness.
When lithium isn’t quite enough on its own, another medication may be added. Some clinicians choose a second mood stabilizer, like lamotrigine or valproate. Others turn to atypical antipsychotics like quetiapine, aripiprazole, or risperidone, depending on the symptoms that are still showing up. There’s no fixed formula here. It’s about what works for each person. A lithium dosage chart is always kept up to date so mental health professionals can keep on top of how someone responds to certain dosages and how to adjust if needed.
Stopping Lithium Safely
Stopping lithium isn’t something to do suddenly or by yourself. The dose should be reduced slowly and under professional supervision, usually over several weeks. Coming off too quickly can trigger a return of symptoms – which can be more intense than before treatment. Stopping lithium safely is about giving the brain time to adjust, not pulling the rug out from under it.
Lithium withdrawal symptoms include:
- Return of manic or depressive symptoms
- Mood swings or irritability
- Trouble sleeping
- Anxiety or agitation
- Fatigue or brain fog
- Headaches or dizziness
Not everyone experiences withdrawal, but when it happens, it’s a signal that the nervous system needs more time to adjust.
How to Taper Off Lithium
If you’re thinking about coming off Lithium, it’s not something to do alone. This kind of change needs to happen with a mental health professional guiding the process. The taper is slow (sometimes weeks, sometimes longer) because the brain needs time to re-stabilize. Everyone’s timeline is different, and rushing it can lead to mood symptoms coming back stronger than expected. The safest way is one step at a time, with someone keeping an eye on how your mind and body are adjusting.
Get Lithium and Mental Health Treatment Guidance at Mission Connection
If you have questions about lithium or want help finding the right mental health support, Mission Connection is here to guide you. Our team consists of trained mental health advisors who understand the full picture—your symptoms, your goals, and the treatment options that fit your life. If you’re ready to take the next step, reach out to us via phone or fill out our confidential contact form.
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