This week we’re revisiting the story of a woman making a very difficult decision.

Jaime Lowe started taking lithium when she was 17, after a manic episode landed her in a psychiatric ward. She was diagnosed with bipolar disorder,and for more than 20 years, the drug has been her near-constant companion. She’s taken it for so long that she can’t say for sure where she ends and lithium begins.  

“It’s hard to know if lithium is actually — like, if it dampens my personality, or if it normalizes my personality, or if it allows me to just sort of be who I am,” she says.

Jaime tried to go off of lithium only once, in her mid-20s, and the result was not good. She developed grand delusions. She would start an organization to defend the First Amendment. She would marry a friend she only recently met. She would change the world. She sent wild emails to would-be employers, adorned herself with glitter and stacks of necklaces, and barely slept.

When she finally pulled herself back together again, Jaime made a resolution. She’d stick with lithium. And that worked — until she learned last year that her long-term lithium use has taken a physical toll. It’s damaged her kidneys. Now, she faces a choice that’s not much of choice at all: an eventual kidney transplant, or going off the drug that has kept her sane all these years.