‘It’s a process of trial and error’

Alan Velecky’s struggles to find suitable medication will strike a chord with many bipolar sufferers.

“It’s just so trial-and-error,” says Velecky. “What works for one person can negatively affect someone else. It’s infuriating because you can take something and be fine while the meds are seemingly doing their job, then you have an episode and you’re back to the drawing board. It’s a long process to see what works for you.”

Today, Velecky combines three different types of medication, including lithium – one of the most common medications for bipolar, as it reduces the frequency and the severity of mania. It works by acting on a person’s central nervous system to stabilise mood and prevent them from entering a highly excited and overactive phase. It is taken in tablet or liquid form.

While its benefits are widely lauded, it does come with a risk of side-effects including sickness and diarrhoea. Moreover, those who take lithium have blood tests every three to six months to monitor the level of lithium, while their kidney and thyroid function is also checked.

What about its effect on cycling performance? “Lithium is not an easy drug to take for athletes,” psychiatrist Alan Currie explains. “It isn’t incompatible with training and racing, but it can make it harder.”

Velecky adds: “If you get too dehydrated, that can result in the lithium in your body becoming too concentrated, leading to lithium toxicity. I was very worried about that initially but as I experimented with increasingly strenuous runs and rides, I found I could push my body as hard as I had before.”