Question:
Can I have input from you folks with respect to rapid cycling? I need a full explanation so that I can educate myself in order to be more helpful with a family member. How quick can they be - how long to they last - do they have to be extremes, etc.?
Answer:
I'm bipolar type II (Major Depression with hypomanic episodes) and a rapid
cycler. The additional diagnosis of rapid cycler is if the episodes of
illness occur more than four times a year. Rapid cyclers are more difficult
to treat because the condition tends to be more resistant to treatment and the
medication has more difficulty in stabilizing the mood swings. Length of
stability between cycles and during each cycle vary from person to person.
They can be within hours, days, weeks or take months. I typically can be in a
severe depression for 2 - 3 months, then more stable with mild depressive
symptoms like fatigue for several weeks, then either back into severe
depression again for several weeks or months or sometimes I fly up to
hypomania. My hypomania's only last a couple weeks usually.
I'm on Depakote for about a year and 3 months now and haven't had hypomania in
a year, so I think the med has capped those. My depressive episodes also are
not as severe since the depakote. I'm also on Zoloft but I have to be careful
with AD's because they can cause hypomania in bipolar patients.
I also go to therapy - my therapist does kind of a combination of
cognitive/behavioral and interpersonal therapy. We work on my daily
relationships, methods of coping during episodes of illness, relaxation
techniques for my extreme periods of anxiety and any variety of other things I
feel I need advice about. We discuss a lot about good self care and setting
boundaries of what's in my control, what is not, what I'm responsible for and
what I need to accept.
Your family member is very lucky to have such good support and concern from
you. It's good you want to learn as much as you can, but remember you can't
do it for them either. We have to seek treatment ourselves - I've experienced
frustration with other loved ones in my family that won't get help while I
helplessly watch them struggle. If you need to "talk", feel free to email me.
i'm rapid cycling - and it can last anywhere from 7 minutes to a few
days. they dont have to be extreme - i get hypomanic and dysthymic
sometimes... A rapid cycler's moods may change by the hour, day, week, month,
etc..... To be diagnosed as a rapid cycler your mood must change
four times a year at least. I wonder if your family member suffers
with mixed states/anxiety along with the rapid-cycling?
My moods change very quickly, at least two-three times a week.
Sometimes I will wake up in the morning feeling great, by noon I am a
mess. Also some Rapid-cyclers have mixed-states. I can only
describe this as having a Manic and Depressed episode at the same
time. It seems to includes a lot of anxiety too. These are the very
worst for me. If I am lying down I start to become very anxious and
agitated, when I try to get up and do anything I immediately become
exhausted and 'lost' (not being able to concentrate). I then pace
around or spin circles, then I lay down again, then up again, etc.
until basically I wear myself down and crash.
As a loving, helpful family member - my advice in this situation: do
not ask too many questions - "how do feel?" "what can I do?" "do
you need anything?" - or give too much direction - "sit down" "relax"
"try to sleep" "try to do something to keep your mind off it" - all
these things do is further frustrate the person. For me at this time
my mind is spinning so fast - it hurts to think, I get more upset
trying to answer questions or respond to someone. Sometimes I snap
at them, then I feel bad about this and off I go hating myself. My
husband just takes me, gives me, puts me, etc..
His first defense is usually getting me into the shower, to calm me -
but he doesn't ask if I want to, he just says - time to take a
shower.
Wow, I didn't expect to write so much. I really hope something I
said may be useful.
Mostly - talk to you family member, as them how they felt (or what
they remember). Work with them on identifying signals that their
mood is changing (especially if they are becoming manic). Work out
boundaries and communications, ex: I rely on my husband to let me
know if I am displaying too many manic signs, in return I promise him
I won't get angry if he asks "did you take your meds today?" or "do
think you should do this today?". I rely on him to be patient and
helpful (not a easy job), he counts on me to control my "triggers".
I know he works very hard. He knows I have an illness.
