I understand where you are coming from on the weight gain with lithium. I have been at 900mg for 5 years, and just recently dropped it to 699mg because for whatever reason the lithium went toxic which landed me in the hospital 2 times. Lithium has definitely helped mania and maybe helped a bit with depression. BUT, I gained i gained 35# on it, and now I am on another weight gainer which is seroquel. One part of me is afraid to rock the boat so to speak and the other part of me looks in the mirror everyday and I am so turned off over the weight gain and terrified I will gain more. I have found that weight gain due to meds is different from regular weight gain from overeating, etc. The med weight gain is almost impossible to diet off and the scale keeps creeping up which is very scarey. My weight gain is like you, becoming unacceptable. I have a psych consultation coming up at University of MI Depression Center and weight gain is at the top of my list. Mu regular pdoc thinks I should live with it. Not going to happen. I know abilify is hot and I have had many clients have good success with it. I tried it two years ago and had an awful time with it....mainly causing pyschotic episodes. But each person reacts defferently to meds and my reaction was unsual. Definitely talk to your pdoc about it. The weight gain is obviously effecting your self-esteem and what good is a drug that may control meed swings but puts how you feel about yourself in the gutter? Let me know if you go on abilify
To give a different perspective i like to think like this. Instead of thinking "ive gained weight and look fat, and im losing my hair so i look old" i turn it around and think "Yes ive gained weight, and i lost some hair. But all of that doesnt matter a bit because i am in control and being a good husband." My wife would rather have a fatter me with no hair (I have been just using clippers and cutting it all off) who is faithful and level headed than a slimmer man with a full head of hair who is cheating on her all the time, going into rages almost daily, mishandling money etc etc etc.
At the end of the day i weigh the two sides, weight gain and hair loss vs being in control and being both a good husband, dad, son and friend. In my mind its no contest, even if i gained 50lbs and lost all my hair if i can be the good things then i will pay that price and be glad to pay it.
After all the alterntive is being alone, divorced, out of control, probaly with some STD because i am so out of control.
I guess my way of looking at it is i am happy for what i have, not what i dont.