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FluffyDinosaur
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Default Jan 20, 2020 at 03:24 AM
  #1
Over the past few years I've seen roughly a two-month pattern to my moods. It tends to be 2-3 weeks of normal mood followed by 1-2 weeks of hypomania, then crashing into depression for about 1 month. There is some variation; sometimes I get a mixed episode thrown in, sometimes I tend more towards hypomania, and maybe there's some seasonal variation, but overall the pattern is pretty stable. My sleep cycles along with my mood (or is it the other way around?), and there's pretty much a constant undercurrent of anxiety mixed in, although that's worse during depression.


I'm wondering whether this is similar to other folks' experience of rapid cycling. My PDoc knows about all of the above but he's never explicitly used the term rapid cycling with me (my official dx is bipolar 2 without any specifiers). IIRC the DSM-V says that rapid cycling means more than four mood episodes a year, which I think does apply to me, but sometimes the episodes are so close together that it can be hard to tell them apart.


Should rapid cycling change anything treatment-wise? I'm currently off meds, but I am in regular therapy and unless some sort of miracle happens I'll be starting lithium soon.
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Default Jan 20, 2020 at 03:34 AM
  #2
It does sound like you are rapid cycling.
I used to rapid cycle until I was put on my current med combo. I have not had a full blown episode since last May and I’ve been stable since last Aug.
Rapid cycling at least in my experience, responds well to meds.

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Default Jan 20, 2020 at 06:59 AM
  #3
Hey @FluffyDinosaur
Quote:
A manic episode is a period of elevated, enthusiastic, or irritable mood lasting at least 1 week. It will include at least three of these symptoms:

a high mood
high levels of physical and mental activity and energy
increased positivity and self-confidence
increased irritability and aggression
reduced need for sleep without tiring
racing speech and thoughts
overreaction to stimuli
increased libido, or sex drive
impulsiveness or poor judgment, which may lead to reckless behavior
delusions and hallucinations, which may include a sense of self-importance
Hypomanic episode
A hypomanic episode is similar to a manic episode but less severe and without the delusions or hallucinations that can occur in a manic episode).

It is different from a person's non-depressed mood. There is a clear change in activity and attitude and visible behavior that is out of character.

Rapid-cycling depressive episode
A major depressive episode can follow or precede a manic episode. To be considered a major depressive episode, the symptoms must last about 2 weeks or more.

During this time, five or more of the following symptoms are present:

extreme sadness or unexplained crying spells
changes in appetite and sleep patterns
irritability, anger, worry, agitation, or anxiety
pessimism or indifference
exhaustion or loss of energy
unexplained aches and pains
feeling guilty, worthless, or hopeless
excessive concern about failures and inadequacies
reduced libido, or sex drive
inability to concentrate, leading to indecisiveness
inability to enjoy former interests, social withdrawal
misuse of alcohol intake or other substances
recurring thoughts of death or suicide
Mixed state or mixed mania
Some people may experience what is known as a "mixed state" when symptoms of a manic and depressive state are both present at the same time.

He explained that, during mixed mania, a person may experience all of the following over the course of a few minutes:

rapid, pressured speech
impulsive, out-of-control thoughts of suicide, self-destruction or aggression
hopelessness
irritability
uncontrollable shifts between racing thoughts and a feeling of "being in blackness"
What do bipolar mood shifts feel like?
For those who are trying to help their loved ones cope with bipolar disorder, it is important to try and understand what the cycles feel like.

On the outside, they may simply look like extreme highs and lows. The person who experiences these changes, however, may also be having irrational thoughts and sensations.

Rachel Kallem Whitman, who received a diagnosis of bipolar disorder at the age of 17 years, described for MNT her experience of mania:

"My mania comes with feelings of grandiosity, invincibility, and delusions. In addition to my mania making me feel electric, seductive, and brilliant, during episodes I also feel like I'm touched by God and consider Princess Diana to be my guardian angel, which is interesting because I'm a devout atheist."


Bipolar disorder rapid cycling: Causes, who has it, and mood changes
Quote:
Originally Posted by FluffyDinosaur View Post
Over the past few years I've seen roughly a two-month pattern to my moods. It tends to be 2-3 weeks of normal mood followed by 1-2 weeks of hypomania, then crashing into depression for about 1 month. There is some variation; sometimes I get a mixed episode thrown in, sometimes I tend more towards hypomania, and maybe there's some seasonal variation, but overall the pattern is pretty stable. My sleep cycles along with my mood (or is it the other way around?), and there's pretty much a constant undercurrent of anxiety mixed in, although that's worse during depression.


I'm wondering whether this is similar to other folks' experience of rapid cycling. My PDoc knows about all of the above but he's never explicitly used the term rapid cycling with me (my official dx is bipolar 2 without any specifiers). IIRC the DSM-V says that rapid cycling means more than four mood episodes a year, which I think does apply to me, but sometimes the episodes are so close together that it can be hard to tell them apart.


Should rapid cycling change anything treatment-wise? I'm currently off meds, but I am in regular therapy and unless some sort of miracle happens I'll be starting lithium soon.

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Default Jan 20, 2020 at 08:17 AM
  #4
What you've described sounds like rapid cycling. I agree with Pookly; rapid cycling (imo) responds well to meds.

By the way, it's wise to do what you're doing, keeping a mood tracker.

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Default Jan 20, 2020 at 08:38 AM
  #5
Thanks everyone, it's nice to get some confirmation of my suspicions. I'm happy to hear that meds tend to work well with rapid cycling, that gives me hope that the lithium will work (fingers crossed).

I'm hoping to try again without meds once things calm down a little (i.e. when the kids are sleeping through the night and life becomes a little less chaotic). In your experience, does rapid cycling tend to return once you go off meds?
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Default Jan 20, 2020 at 05:26 PM
  #6
Quote:
Originally Posted by FluffyDinosaur View Post
Thanks everyone, it's nice to get some confirmation of my suspicions. I'm happy to hear that meds tend to work well with rapid cycling, that gives me hope that the lithium will work (fingers crossed).

I'm hoping to try again without meds once things calm down a little (i.e. when the kids are sleeping through the night and life becomes a little less chaotic). In your experience, does rapid cycling tend to return once you go off meds?
I don’t know. I’m not willing to go off meds to find out.

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Psych meds: Saphris, Seroquel XR, regular Seroquel.
PRN Diazepam and Zopiclone
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Default Jan 20, 2020 at 09:26 PM
  #7
The reason you are (will be) stable is due to the meds. When you go off a working combination of meds, sure, the life long mental illness will eventually return. The meds are no cure. Either way, I hope it works out for you.

FWIW

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Default Jan 21, 2020 at 12:29 AM
  #8
Quote:
Originally Posted by Tucson View Post
The reason you are (will be) stable is due to the meds. When you go off a working combination of meds, sure, the life long mental illness will eventually return. The meds are no cure. Either way, I hope it works out for you.


FWIW


This ^^^

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Default Jan 21, 2020 at 01:45 AM
  #9
Thanks all, and you are right that the illness is chronic. I realize that, however much I would like to deny it.

However, what I meant is that my episodes didn't use to be this frequent, and I'm still hopeful that with the right kind of stability in my life I could go back to how it used to be, with only a few episodes per year and months of stable mood in between.

What I meant to ask was whether there's a chance of that happening, or whether rapid cycling is more likely to recur if it has happened once. I.e. is this deterioriation likely to be permanent? In any case, if I do go off meds after a while I'll make sure it's with the approval and monitoring of my PDoc.
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