|And We're Not Talking Bicycles!
The cycles of Mood Swings in Bipolar
Disorder can vary widely. Initially, episodes of depression and mania
tend to occur closer together and more frequently. In time the interval
between the extremes of mania and depression may stabilize and become longer
as a part of the normal progression of the disorder.
Rapid Cycling occurs in approximately
5-15 percent of the Bipolar community, and is defined as "having four or
more distinct periods of depression, hypomania, mixed states, or
mania in a time period of one year." Women are affected more
commonly than men (75 per cent are women). Rapid Cycling is a relatively
new diagnosis, having been identified by psychiatrists and researchers
shortly after lithium became available for use in bipolar disorder.
Since then, more terminology of Rapid Cycling has been added. In
ultra rapid cycling episodes may last no more than 24 hours. In ultra
ultra rapid cycling several switches of mood occur in a 24-hour period,
and in continuous cycling an individual swings back and forth between mania
or hypomania continuously with little or no period of identifiable normal
mood between the swings.
The idea that rapid cycling bipolar
disorder is a specific type of bipolar disorder has been all but dismissed.
Currently it is thought that any bipolar can "switch" to a rapid cycling
pattern, but that in nearly all cases (as shown in a recent study) most
return to their normal bipolar pattern in time.
There have been several areas studied
in an attempt to discover why rapid cycling affects some individuals with
the disorder and what might be done to improve treatment for these individuals.
Some of the things studied included that these individuals seemed to have
a thyroid problem, were not helped as efficiently with lithium and had
all taken antidepressant medication…and addition were primarily female.
The only one that has been positively
proven is that women predominate. Clinicians still feel that antidepressants
may play a role in the development of rapid cycling but they have no proof.
At this point in time there is no
known cause for rapid cycling, nor is there a specific treatment.
Hopefully soon one will be found soon.
When I was diagnosed in 1979 my episodes
were so stable I could almost plan on them…once a year, every year in late
Autumn and over Christmas to January would find me in hospital. After
that I went for a period of eight years with no hospitalizations.
Beginning again in 1988 the episodes
(mostly depressive) began to recur…a little more frequently until 1994.
Between 1993 and 1995 I was diagnosed as a rapid cycler. My episodes
were frequent and severe…in those two years I lost my job and was put on
a disability pension, made several attempts at suicide (one was severe),
was in and out of psychiatric hospitals both locally and out of town and
had short and rare occurrences of normal mood. My episodes were all
severe - no half measures for me - and would last 2 or 3 months before
switching to the opposite state.
Then with treatment the swings slowed
down and stopped for two years. In January 1998 I was again in hospital
for a mixed episode, which was incidentally unlike anything I had ever
experienced before. Up and down at the same time, laughing through
my tears and audio hallucinations are three of the features I most remember.
Quite a difference from what I was accustomed to.
Since then, any mood swings have
been comparatively mild. I obviously am no longer a rapid cycler,
at least for today. One thing about having bipolar disorder is that
I've learned not to make predictions for the future. Until a cure
is found, Bipolar Disorder is for life, and I for one plan to enjoy the
times of peace and contentment to the fullest extent, and let tomorrow
take care of itself.