[amaviena]

What constitutes an "episode?" The whole "wave?" up and then the down...or individual ups and downs for bipolar. I'm trying to put together my year and I'l filling out therapy worksheets. What's your take on it?

[thinker22]

I think it's considered mixed or rapid cycling if you have extreme mood swings within the same day or week. To constitute either a depressed or manic episode it has to last a week or longer, sometimes can go on for months.

I'm mostly depressed, but I do have at times several hours or a whole day of hypomanic energy/enthusiasm, then swing back the other way. So those aren't truly "episodes", just a mood swing within the overall major depressive episode (going on for well over a year in my case).

Hope that helps.

[Amazonmom]

My episodes don't always happen in a wave. Sometimes I have just depressive episodes by themselves, and very rarely hypomania by itself.
Other times I have depressive episodes with little hypomania spikes.

I would have to say an episode is the individual mania or depression...or mixed.

[amaviena]

That's what I thought, but I'm having trouble with this because I'm reading text books about BP and the labeled me BP I but that says you have "up to" four episodes per year. Is four a happy, magical number? Its seems nonsensical. If I'm rapid cycling, then can I be BP I also? I'm so confused.

[theama]

Rapid cycling is if you experience 4-5 (or more) cycles per year.
Mixed episode is if you experience (hypo)mania and depression at the same time for a week or more.
A depressive episode lasts for minimum 2 weeks.
A (hypo)manic episode lasts for minimum 1 week.
Baseline is when you're neither.

Rapid cycling is a form of BP. But BPers do NOT cycle several times per day or per week, an episode usually lasts 2-3 months.
There are DIAGNOSTIC CRITERIAS for the episodes, specific in regards to time and symptoms.
Being sad one day and happy the next is not an episode.

[amaviena]

The DSM is bnot a diagnostic checklist, it is a guide. Everyone who has bipolar is different. Very seldomly someone exactly fits the criteria outlined in the DSM.

[thinker22]

I think theama is right. I messed up on the definition of a mixed episode and rapid cycling. Also that the depressive phase has to last at least 2 weeks.

But yeah, the spectrum of bipolar is tricky and all kinds of moods are possible, and none of them will necessarily stick around nonstop for a certain period. They'll do whatever they like, but the point is, your mood is not "normal" and it changes at some point when you're bipolar. You may transition from depressed to manic through a mixed stage or not. You may go from hypomanic to either manic or down to depressed. The DSM-IV relies on self reporting, so if people in the depressed phase don't recall a hypomanic time during the two weeks of depression, there's more evidence that 2 weeks is the magic number. Same goes for people in a manic episode for a week or more. I'm sure many of them have had depression or mixed times within their mania, but the mania is the most pronounced, so that's what they talk about.

Just a thought.