A Reader Question for Julie Fast

I just received a comment from Reanna about her rapid cycling that won’t stop. I have been there so I understand! She asked a question about bipolar disorder treatment. Here is the question and my answer:Julie,Reading your posts has been very helpful–thank you! I have been having a horrible time with “mixed episodes” in where I will be up for a few hours, then out of no where, boom, I am down, then up, then down! My dr. ordered blood tests, but any suggestions on coping methods until the tests kick in?Reanna

Hi Reanna, Oh yes, I certainly understand. I have done that rapid cycling. It’s hard to get all of the terms straight with this illness! When you go up and then down- that is rapid cycling. A lot of rapid cycling. We are similar. I can have five or more mood swings a day. I always say it makes me feel like a rag doll someone is throwing up in the air over and over again!A mixed episode (also called dysphoric mania) is not up and down in discrete mood swings- it means that you are depressed and manic at the same time- which is also called dysphoric mania. The best way to describe this is that instead of the rag doll being thrown up and down, it’s begin yanking from all sides. It hurts inside and out!

It’s interesting that you’re getting a blood test- that is always important. It is used to rule out thyroid problems as well as to check the levels of meds you may be on such as checking lithium levels. There is no blood test for bipolar disorder. One day there will be!Also, if you have rapid cycling like this- it’s rarely a good idea for you to take anti depressants- and if you ever do, they absolutely must be with a strong mood stablizer such as Lithium, Tegretol or Depakote- or with an anti psychotic such as Zyprexa, Risperdal or Serequel- you can take them with Lamictal- but Lamictal is often not strong enough to hold back the rapid cycling caused by anti depressants. Also, anti depressants in people with rapid cycling have a chance of causing suicidal episodes. I just went through this with Zoloft! I’m glad you have a doctor to help you with this!

These drugs help- but they can have a lot of side effects- so the right combination at the right dose is essential.As for tips, I really love my Health Cards Treatment Plan, but as you are going up and down so much- I think that Take Charge of Bipolar Disorder is your best choice for now. It has a lot of explanation, but also a lot of tips. It’s an easy read. Remember, even if you just implement a few changes- you can get a lot better.  I use my treatment plan every day- and I stay well enough to have a good life. You can defintely do the same!

Julie

There is more information on rapid cycling and mixed mania in the categories to your right.

  A Reader Question for Julie Fast  

Hi, I just received a question from Sandra asking if it’s normal that her depression seems to show up every two months- oh, yes it is normal! Here is my answer:  

 hi Julie,

I have a question.  Looking back at about eight months of journaling, I noticed that every two months or so, my entries suggest that I was depressed.  It would appear that this is cycling every two months.  Could this be accurate?  Anything I can do to correct it?  Yes, I will bring it up with my psychiatrist at the next appointment.

Thanks!

Hi Sandra,

Bipolar disorder is an episode illness- as compared to psychotic or personality disorders which are more stable over time. This means a person can have a few severe episodes and then none for a few years- or someone, like myself can have mood swings every day for years and years. I had 23 mood swings from the last part of April and all of May. It was not pleasant. I have rapid cycling bipolar disorder II with psychosis. Though the psychosis has been absent for a while.

If you’re cycling every two months- that’s pretty regular- so you should be able to pinpoint what is going on. There are a few things- hormones, the weather, triggers, medications or just the illness itself. This may be your pattern. I just did a podcast with my friend Sherri- I will put it on the blog soon- she talks about how she gets manic ever spring and depressed in the winter- like clockwork. I am definitely happier in the summer.

What matters is that you chart it. If you see a definite pattern of depression interlaced with mania- talk with your doctor about rapid cycling and make sure your meds are correct. Anti depressants can cause this rapid cycling.  Also, mania can look like stress when it’s actually agitated mania. There is a lot more information on this blog about the different types of mania. There is a mania tab on the right that will take you to all of the entries.

It’s great that you’re seeing the patterns- it’s the best way to manage the illness. I have my Health Cards Treatment Plan- I know you have them as well- I would get out your depression card and write the times you see the change into depression and what you think, say and do right before it starts. That is how to prevent yourself from going down. Julie

Too Many Mood Swings to Count in Just 24 Hours!

I turned in a large, important and wonderful project on Sunday night. It’s now Tuesday. The project is a proposal for my new book. This is a big undertaking, so I know I have to be extra careful about my health.
I was careful! Early to bed early to rise! No late nights- decided to put a hold on a daily phone call I often have with a very stressed and negative friend, etc. I am really working hard to stay stable.

This certainly helped me finish the proposal. I was so elated to have it done! Real pleasure. 

Then I went up.. .and down.. and up.. then WAY down and finally back up. That was just on Sunday!

The same thing happened all day yesterday. Finally, but 11 that night, I was worn out, but up again. I took an Ativan and then another half. That is about my limit unless I want to be really tired the next day. But at 2AM, I realized I was not going to sleep at all, so I took another half. My body doesn’t like that. I got to sleep,  but am very tired today- even after a nap! It’s a drug thing!

Sometimes the facts of bipolar are much stronger than my wish for what will happen. Getting the proposal in was such an accomplishment- but my brain only saw it with stress and say congratulations with rapid cycling?
Have you ever had more than five mood swings a day! What do you do?

Julie

I just went through two weeks of constant rapid cycling.  It sure was tough! I had five distinct mood swings in one day last week. Three were hypomanic, one was mild depression and the other was a severe crying suicidal depression. They all lasted a few hours. I’m doing a lot better today, but I’m tired. 

I wrote other blogs about how I handled the mood swings and was able to keep working and do my regular routines. Then I had about three days of terrible OCD. I told my therapist it was a bipolar perfect storm. I had a tight work deadline, my mom went out of town, a guy at a party started flirting with me and that freaked me out  ( I keep away from flirting these days!), my brother forgot about a concert we were supposed to go to – the tickets were not cheap!-  and then I got some disappointing news about a book that just came out that used my ideas without giving me credit.

And most importantly, I was having trouble with my Lamictal. 

 A perfect storm. It happens even when you have worked hard to lead a stress free life. My main goal when I get this sick is to stick to my routine.  That’s especially hard to do when I get manic. The mania just feels so good I want to partay! I didn’t though.  And now I’m better. I’m very tired physically, but I can deal with that. I’ve worked hard for over 13 years to have a system in place that helps me manage these kinds of mood swings that seem to come out of nowhere. My goal is to help others have a system that works as well! I am thankful for my Health Cards.  They especially help with the flirting issue!

Julie

PS: I actually wrote this a few weeks ago- it was sent out as a newsletter first- I am doing a lot better- though the hypomania keeps showing up! I removed some of the stressors in my life- to become even more like a monk! but it’s working.

Five mood swings in one day!

I doubt that is a record, but it sure wears me out. In that past week, I’ve had at least 20 mood swings. They are mild, but certainly strong enough to chart. Yesterday I had three distinct upswings. The day before that, I had a few upswings and an intense hour long downswing where I immediately started crying. I’ve also been twitching a lot which means there is something not right with my Lamictal dose.

What is causing this rapid cycling? Though I’m glad it’s on the manic side instead of being constant depression, I know it’s not good for me. I can feel my adrenaline pumping and I feel like jumping out of my skin.  The chemicals are racing through my brain much faster than they normally do. I feel like talking to strangers

So, what’s going on?  I have to be a detective to figure this out. Here are my ideas:

The weather here in Portland, Oregon has been exceptionally beautiful and sunny. We had a dark summer, so this is fantastic. But it’s mania inducing.

I wrote about a guy thing that was happening at the coffee shop where I write that got me a bit flustered. Though the whole thing could be a manic fantasy in my mind.

My Lamictal isn’t working correctly.

I’m sure it’s a combination, but I’m leaning towards the Lamictal problem. This has happened to me in the past. I took some extra last night to see if I could calm down and stop the Lamictal twitching. I had to take Ativan to sleep.

I will keep you posted.

Julie

PS: If you would like more information on bipolar mania or rapid cycling, you can click on the buttons to your right.

I saw this on a bumper sticker. I had to laugh. That is the epitome of rapid cycling bipolar disorder.

I have had so many mood swings in a day they were hard to count. I look at my mood chart and the thing looks like and EEG- or is it EKG! I should know the difference between the two!

I’m not having rapid cycling like I used to. It shows up sometimes, but when I’m in crisis it’s all day long.

I have been stable for almost a month now. This is the longest stability I have had in six years. I am thankful because I can finally work.

Julie

Bipolar disorder is an illness that affects a person’s ability to regulate their own moods.

There are two types of bipolar disorder: Bipolar 1(one) and Bipolar II (two).  People with bipolar I experience full blown mania while people with bipolar II have a milder form of mania called hypomania. This is the main difference between the two types of bipolar disorder.  All people with bipolar disorder have similar depression symptoms, though people with bipolar II tend to spend more time in depression. Both types of the illness can have a complication called rapid cycling. This is where a person has more than four mood swing a year. I have to laugh at this one sometimes as I have such severe rapid cycling, I can have four mood swings in a few hours! It’s very important that you know if you have bipolar I or II and if you have rapid cycling. Your diagnosis strongly affects treatment choices.  

No matter what type of bipolar disorder you have, it’s a serious illness that has to be treated with a comprehensive plan.  

Julie