Posted by Scott L. Schofield on April 18, 2000, at 15:44:29
In reply to Re: Any happy, stable rapid cyclers out there? , posted by Jan on April 18, 2000, at 11:49:18
Hi Jan.
> I am not cycling today, but I can answer your questions if you are curious.I guess I am less curious than I am interested to help. It's really cool when people here help others and these others help them right back.
> I rapid cycle for about a week at a time.It goes from manic->depressed->manic->depressed...
The order in which these phases occur has importance:
1. Normal -> manic -> depressed is the usual presentation.
2. Normal -> depressed -> manic is infrequent, and may respond differently to treatment.
After a period of euthymia (normal mood), which is the first phase to appear? Which occurs more abruptly: mania -> depression or depression -> mania?
> It goes from manic->depressed->manic->depressed... lasting from minutes to hours. I feel like Dr.Jekyll and Mr.Hyde. I can be sitting, enjoying a "hypomanic moment" and WHAM, depression hits me like a blanket of bad news and I've suddenly lost all interest in life, for no reason.
This is familiar to me. I can see how it would be difficult to discern a discreet period of euthymia that might occur between the depressed and manic/hypomanic states. My "up" periods never reached the point of mania or hypomania. They actually fell short of euthymia, as I learned in retrospect when I first responded to an antidepressant. However, the cycle was strikingly obvious - 8 days of severe depression followed by 3 days of near-euthymia. The switch from one state to the other occurred over the course of 30 - 60 minutes. This cycle never varied by more than half a day, and only skipped once. It skipped over my "up" period - figures. This presentation is considered to be ultra-rapid cycling.
Would you say that your cycle displays this sort of regularity?
> I'm still fasinated by the oxymoron of "mixed state", but I seem to experience that also.
Whether or not one experiences a mixed-state instead of a euphoric mania is another important criteria for guessing at a course of treatment. Nothing you have described here resembles this.
Perhaps this is a better question: Are you a happy manic, or are you an angry, irritable, impatient, or unhappy manic?
> I was hospitalized for
1. full blown mania.This is what I had guessed.
2.threatening to put myself into a coma by overdosing to avoid the rapid cycling.
Understandable.
3.being suicidal which comes at the drop of a hat with depression, no matter for what length of time.
The initial drop into depression is precipitous, and can be the time when it is most severe.
> It is so weird, because today, suicide is furthest from my mind, I feel normal, like I'm not on drugs. But every time I stop them, I start going crazy immediately.
Starting and stopping drugs is worse than taking no drugs at all.
> > Do you feel that Tegretol is contributing to the improvement in your condition?
> I started it recently and had 3 bad rapid cycling days about 3 weeks into it, so it is too early to say.I've lost some weight already, just never hungry, nice change !
You seem to display episodic ultra-dian (ultra-ultra) rapid-cyclicity. You experience several dramatic mood-switches during the course of a single day.
How long have these cycling periods generally lasted in the past as contrasted to the three-day period you describe above?
Are the periods of euthymia between these episodes variable in length?
Since adding lithium, have the euthymic periods between episodes become longer - have the cycling episodes become less frequent?
> Your expertise and concern surprises me. I've gone to lots of psychiatrists and they don't ask many questions and think they already know what I need, like I'm a generic patient. thanks
Doesn't that suck? There are people here with far more "expertise" than I can offer. I hope you see more replies.
Sincerely,
Scott
poster:Scott L. Schofield
thread:30276
URL: http://www.dr-bob.org/babble/20000411/msgs/30466.html