My experience is varied. I developed psoriasis on lithium (a rare side effect) that doesn't go away off treatment. I put on about 50lbs over 4 months, so fast I didn't even realize it until I stepped on a scale. I've been off and on it about 3-4 times over 4 years. When I am hurting I think it really does help to stabilize my mood. But with the tremor, thirst, frequent urination, and worsened psoriasis while on it - it rates high on a misery index for me and I just can't take it long term. This greatly disappoints my pdoc and we have had to work things out over it to continue our therapeutic relationship.