Following the commercial success of their debut studio album "Fallen" (2003) and its accompanying tour (2003–04), Evanescence returned to the studio to work on material for a new album. During that time, guitarist Ben Moody parted ways with the band and the group sued their previous record manager. In addition to that, the replacement guitarist for Moody, Terry Balsamo suffered from a stroke during the final stages of recording, which further extended the time needed to release and finalize the album. "The Open Door" was eventually finished and set for release in October 2006. For the songwriting process on the album, Amy Lee mostly collaborated with Balsamo whom she described as a partner who lifted her up and helped her pass the point of refraining when composing. "Lithium" was one of the first songs written for the album, solely by Lee. During an interview with VH1, she revealed that she had written the song on a guitar when she was 16-years old, but never used it in any of her projects despite her liking of its chorus. During the band's work on "The Open Door", Lee rearranged the song on a piano and wrote its verses. Lee describes the song as one "which embraces feeling over numbness". In another interview with MTV Italy, Lee elaborated on the meaning behind the song's lyrics,