[Beezup2]

Question: Do any of you with rapid-cycling just go from episode to episode to episode without any "breaks"? Then my episodes have steadily been more and more mixed than anything for about 1 1/2 years.

I chart my moods and this never-ending undulatuing pattern is clear. Can this really keep up or is it possible to catch a reprieve. More details but that is the big picture I want to share, should anyone else be in the same boat. Thanks in advance for any feedback!

[madisgram]

bee i had difficult rapid cycling at one point. i take a mixture of meds but one is a mood stablizer. it really has helped. i never knew whether i'd be up or down. why not ask your pdoc and please express your frustration too.
from webmd...PAGE 2/treatment for rapid cycling
Antidepressants such as Prozac, Paxil, and Zoloft can reduce depression in rapid cycling bipolar disorder. However, taking antidepressants alone can actually increase the degree of rapid cycling, and also trigger manic episodes.
For this reason, mood stabilizers must be taken with antidepressants. Mood stabilizers include antiseizure medicines (like Depakote or Tegretol), and antipsychotics, such as Zyprexa. Lithium is specifically not indicated in rapid cycling bipolar disorder.
Mood stabilizers are also the treatment for manic or hypomanic symptoms.
Treatment with mood stabilizers is usually continued even when a person is symptom-free. This helps prevent rapid cycling. Antidepressants are generally tapered as soon as depression is under control. Many people need to take two or more medicines daily to control rapid cycling bipolar disorder.
http://www.webmd.com/bipolar-disorde...-disorder?page= 2
hope this helps!

Well, I'm untreated & I go through similar situations to what you go through. I'm not sure if I constitute as rapid cycling, but I do go through mixed spells a lot & I only get maybe a day or two at a time of "normal" before I swing right back into another direction. Usually manic or mixed. For the past 2 years it has been its worst, but I feel it goes a lot further back than that...
From what I understand, there's very little that can be done without professional treatment to minimize the severity/frequency of episodes if they that bad. All you can do is grit your teeth until you can get proper treatment! I know that's what I'm doing!!

[BNLsMOM]

I am a rapid cycler as well with mixed episodes. We are still trying to get the meds situation settled. It's been over two years. I found that Risperdone works really well for me, especially because I suffer from violent obsessive thoughts while in an episode. I thought we had hit it on the head, but the Risperdone is causing my prolactin levels to shoot through the roof, which suppresses my period and puts me at risk for osteoporosis and possibly early menopause. I am tapering off it (with my pdoc's help) and we'll try something else if we determine that I still need an antipsychotic.

Sorry for the tangent... I seems to get breaks that last anywhere from two days to two weeks before I cycle again. I used to get happy manias and I would run off and start a business or something like that. I miss those days. Now I get mostly mixed, toward the depressive side.

[Beezup2]

Originally Posted by madisgram

bee i had difficult rapid cycling at one point. i take a mixture of meds but one is a mood stablizer. it really has helped. i never knew whether i'd be up or down. why not ask your pdoc and please express your frustration too.
from webmd...PAGE 2/treatment for rapid cycling
Antidepressants such as Prozac, Paxil, and Zoloft can reduce depression in rapid cycling bipolar disorder. However, taking antidepressants alone can actually increase the degree of rapid cycling, and also trigger manic episodes.
For this reason, mood stabilizers must be taken with antidepressants. Mood stabilizers include antiseizure medicines (like Depakote or Tegretol), and antipsychotics, such as Zyprexa. Lithium is specifically not indicated in rapid cycling bipolar disorder.
Mood stabilizers are also the treatment for manic or hypomanic symptoms.
Treatment with mood stabilizers is usually continued even when a person is symptom-free. This helps prevent rapid cycling. Antidepressants are generally tapered as soon as depression is under control. Many people need to take two or more medicines daily to control rapid cycling bipolar disorder.
http://www.webmd.com/bipolar-disorde...-disorder?page= 2
hope this helps!

Thanks Madisgram - also the difficulty of my up/downs and treatment is b/c it's against a background of a moody temperament...another kettle of fish! Yes, the mood-stabilizer is the foundation hence the lithium and tegretol. I went off 10 years of depakote to be on tegretol. I do not know about the lithium, as I've read comments like the one you sent about it (?)
I cannot EVER take an antidepressent b/c of past manias. Atypical anti-psychotics, which I have been on 1-2 years total, were bad for me and weren't worth it. Like so many, other drugs too.

So, TMI, but I feel boxed in. And I thank you for spotting my frustration. Yep.

[Beezup2]

Originally Posted by BNLsMOM

I am a rapid cycler as well with mixed episodes. We are still trying to get the meds situation settled. It's been over two years. I found that Risperdone works really well for me, especially because I suffer from violent obsessive thoughts while in an episode. I thought we had hit it on the head, but the Risperdone is causing my prolactin levels to shoot through the roof, which suppresses my period and puts me at risk for osteoporosis and possibly early menopause. I am tapering off it (with my pdoc's help) and we'll try something else if we determine that I still need an antipsychotic.

Sorry for the tangent... I seems to get breaks that last anywhere from two days to two weeks before I cycle again. I used to get happy manias and I would run off and start a business or something like that. I miss those days. Now I get mostly mixed, toward the depressive side.

Thanks for the reply and I hope you work your Risperdone out. That's one I haven't tried. Yes, OCD is an ongoning problem and like I mentioned elsewhere a temperatment thing. Like you my mania is NOT that giddy, happy kind! Your "breaks" seem short to me as in maybe my expectation as to how long a remission "should" be is just unerealistic.

[Beezup2]

Originally Posted by Shayatanica

Well, I'm untreated & I go through similar situations to what you go through. I'm not sure if I constitute as rapid cycling, but I do go through mixed spells a lot & I only get maybe a day or two at a time of "normal" before I swing right back into another direction. Usually manic or mixed. For the past 2 years it has been its worst, but I feel it goes a lot further back than that...
From what I understand, there's very little that can be done without professional treatment to minimize the severity/frequency of episodes if they that bad. All you can do is grit your teeth until you can get proper treatment! I know that's what I'm doing!!

Thank you for sharing. I've been with an excellent pdoc for 9 years who admits I am very treatment resistent. You gave a reality check: sometimes you have to just grit and bear it. Even with treatment!

Sorry to hear you're so treatment resistant. I hope that, by the time I get treatment, it won't take years upon years to find the right combination for me. But I think having to patiently deal with nasty situations is a reality for everyone, mental issues aside. No one likes unpleasant circumstances, but we're all human, so it comes with the territory.

[Beezup2]

Originally Posted by Shayatanica

Sorry to hear you're so treatment resistant. I hope that, by the time I get treatment, it won't take years upon years to find the right combination for me. But I think having to patiently deal with nasty situations is a reality for everyone, mental issues aside. No one likes unpleasant circumstances, but we're all human, so it comes with the territory.

Yiou have a good outlook, I can too - til I have an episode (LOL!) Another thing, there are new meds coming out very frequently so...And there's always ECT for me but I am 100% against it at the moment despite it's success rate. You know I've found it's not only the RIGHT combination, but it's the right one applied at the right TIME. Ugh!

HAHA same deal with me. I know that by the end of last night, all of that positivity in me was not to be found. Blah!! But I mean it, either way, even though I don't apply my own advice when necessary.
Wow, ECT sounds so scary but I can understand where it would have its place. Some people just need that therapy in order to get to a point where their medications can work for them. It's kind of like reversing the damage by creating new damage? Idk, but honestly, whatever will put you in a place where you can become stable.

[sugahorse1]

I am on a mood-stabiliser (Lamictin) as well as an antidepressant. I'm ok with having to be on meds. My depression used to be crippling.
I still have bad days where I question if my meds are really working, and I just want to stop it all, but I usually keep it together.

I guess that over time we become more 'mature' and learn to ride out the cycles.

Hang in there

[BlackPup]

It had been so long since I had been normal that I had forgotten what it was like!!! I got a good med combo eventually but finding it was a trial. Sorry that you are treatment resistant, that sucks. Maybe some alternate thearparies like light therapy or something will work if the meds don't. Therapy can help take the edge off things...

[xp1155]

I am totally in the same boat as you. I have mixed episodes, rapid cycle, and am treatment resistant.

[OneDown]

I'm in a similar boat - ultradian cycling (if not full mixed state), prior to going on my meds, there would be no break between episodes and I was going from one extreme to the other all the time. I've noticed that meds will work for a while, and then stop workjing during an episode, so we're always increasing the dosage or trying new meds. Mood charts do help, and I bring mine with me when I visit my PDoc to show her exactly what I'm going through on a daily basis.

I hope you find the right meds soon. This disease is a nightmare when treatment doesn't work, but the right meds can make all the difference, so don't give up!

[kaliope]

i was a rapid cycler. going from suicidal depressions to manias to mixed cycles. it would be a couple weeks going in, a month or so for the cycle and then a couple weeks going out. i might have got a couple weeks of down time before the next cycle took hold. in these later years psychosis kicked in with the mixed cycles. throw in some ptsd to make it all a little more exciting. i finally had a major breakdown that made it absolutely necessary to break down and take the med route. after like 2 1/2 years of trial and error one very committed doc found the right med for me. Haldol. Since i have been on it, no more cycles. None. I have to take another drug to counteract the mild tartive dyskensia i got from it but i am totally free from those cycles. it is like a miracle. every now and then i might get triggered from the ptsd but even that is much better. i still experience anxiety, but that is no longer crippling. i have a hard time still trusting my mental health. still worry that the cycles will come, but they never do.

i hope that you can find something that works. because this truly is an amazing difference. now i just have to learn how to live.

[Beezup2]

Originally Posted by BlackPup

It had been so long since I had been normal that I had forgotten what it was like!!! I got a good med combo eventually but finding it was a trial. Sorry that you are treatment resistant, that sucks. Maybe some alternate thearparies like light therapy or something will work if the meds don't. Therapy can help take the edge off things...

Thanks, Black Pup. And good for you! For me, it's not for lack of trying - I have had light therapy work well and also have it kick me into hypomania in 5-10 minute sessions. As expected, it works better in winter. I agree that psychotherapy is indespensible and have averaged once a week for at least 9 years. Very expensive! Even when I had insurance...

[Beezup2]

Originally Posted by OneDown

I'm in a similar boat - ultradian cycling (if not full mixed state), prior to going on my meds, there would be no break between episodes and I was going from one extreme to the other all the time. I've noticed that meds will work for a while, and then stop workjing during an episode, so we're always increasing the dosage or trying new meds. Mood charts do help, and I bring mine with me when I visit my PDoc to show her exactly what I'm going through on a daily basis.

I hope you find the right meds soon. This disease is a nightmare when treatment doesn't work, but the right meds can make all the difference, so don't give up!

Thanks one down. My pdoc says all it takes is the right one! Guess I'm feeling negative especially when HE himself recently admitted nothing we've tried has really worked. That's in almost ten years! That's a lot of drugs, side effects, money and effort for both of us!

I am getting boxed in on so many meds classes I can't take due to one complication or another. Like you, some things work for awhile and just STOP working! ANd someone close to me has the audacity to keep saying something that has stuck in my head, "My firend the nurse says, if a BP person has the right drugs you would never even KNOW they're BP!" Gimme a break! I just don't believe THAT's possible either! UGH!!!!!!!!!!!!!!!!!!!!!!!

[Beezup2]

Originally Posted by kaliope

i was a rapid cycler. going from suicidal depressions to manias to mixed cycles. it would be a couple weeks going in, a month or so for the cycle and then a couple weeks going out. i might have got a couple weeks of down time before the next cycle took hold. in these later years psychosis kicked in with the mixed cycles. throw in some ptsd to make it all a little more exciting. i finally had a major breakdown that made it absolutely necessary to break down and take the med route. after like 2 1/2 years of trial and error one very committed doc found the right med for me. Haldol. Since i have been on it, no more cycles. None. I have to take another drug to counteract the mild tartive dyskensia i got from it but i am totally free from those cycles. it is like a miracle. every now and then i might get triggered from the ptsd but even that is much better. i still experience anxiety, but that is no longer crippling. i have a hard time still trusting my mental health. still worry that the cycles will come, but they never do.

i hope that you can find something that works. because this truly is an amazing difference. now i just have to learn how to live.

Thank you Kaliope. Everyone is being so helpful. Your story really touched me (like teary). You're showing of how one wants to get out from under the nightmare and can't. In fact, I think after awhile we don't know how nightmarish it is. Others around us probably can't witness it either because so much is internal.

That you broke through is wonderful. You helped me know it is possible. At the risk of going overboard...I too just recently had my mania cause psychosis off and one over about 6 weeks. It really rattled me. Not to sound copycat again, but I also have ptsd. Upping one of my meds drastically did control the psychosis but it is not gone yet.

Let's put it this way, I am throwing my very experienced pdoc just about everything under the sun. So maybe this is my level where little improvement is possible. I wish someone would even tell me that, for sure. I'll read up on Haldol. Thanks.

[OneDown]

Originally Posted by Beezup2

Thanks one down. My pdoc says all it takes is the right one! Guess I'm feeling negative especially when HE himself recently admitted nothing we've tried has really worked. That's in almost ten years! That's a lot of drugs, side effects, money and effort for both of us!

I am getting boxed in on so many meds classes I can't take due to one complication or another. Like you, some things work for awhile and just STOP working! ANd someone close to me has the audacity to keep saying something that has stuck in my head, "My firend the nurse says, if a BP person has the right drugs you would never even KNOW they're BP!" Gimme a break! I just don't believe THAT's possible either! UGH!!!!!!!!!!!!!!!!!!!!!!!

Finding the right combination and dosage is like "finding a needle in a hystack" - "not easy" doesn't begin to describe it.

I often wonder what other people think of me, both when i'm stable and unstable. Do they suspect I'm BP? Do they think I'm just "crazy"? How would their opinions change if they knew the truth? Should I tell them?

My parents seem to think this is all "in my head" and that I could be normal if I really wanted to. I try to keep myself in contact with friends who really support me and know this isn't easy. I'm not sure if I believe that the right drugs/dosage can make it seem like you never were BP; I think after a while I get used to having the mood swings (though I think its impossible to ever get used to the moodswings themselves - they seem to get worse each time) and "normalcy" becomes this odd feeling that "doesn't feel right.

UGH is right!

[Beezup2]

Originally Posted by OneDown

Finding the right combination and dosage is like "finding a needle in a hystack" - "not easy" doesn't begin to describe it.

I often wonder what other people think of me, both when i'm stable and unstable. Do they suspect I'm BP? Do they think I'm just "crazy"? How would their opinions change if they knew the truth? Should I tell them?

My parents seem to think this is all "in my head" and that I could be normal if I really wanted to. I try to keep myself in contact with friends who really support me and know this isn't easy. I'm not sure if I believe that the right drugs/dosage can make it seem like you never were BP; I think after a while I get used to having the mood swings (though I think its impossible to ever get used to the moodswings themselves - they seem to get worse each time) and "normalcy" becomes this odd feeling that "doesn't feel right.

UGH is right!

Many interesting things, OneDown. Wondering what others think when stable or not - I've found they tend to take my unstable times, emotions, behaviors, negatives and fit them to their purpose. So they don't have to face realities about themselves and a scary illness, or provide comfort and give of themselves or maybe they minimize saying something like "Tsk-Tsk, yoo're just having one of the crazy BP hissy-fits."

Saying your parents think it's all in your head...well, not to mock them but - yeah - it IS all in your head and that's the problem because it's a mental illness. Sometimes I get so frustrated I just say," something in my head is broken, I'm constantly trying to fix it just like a person with XXXX mental illness who can't help it." And then to the ones who think if I would just will it away, I say, "Well if this were a matter of willpower then NO ONE would ever have it!" Dealing with all the know-it-alls really make me angry.

I never count on someone becoming MORE understanding if they knew they truth. Maybe I've felt betrayed too many time. I always got to ask what am I expecting if I do tell. I've told very few. And when I told on the job it was an utter travesty.

I really appreciate how you said normalcy becomes this the odd feeling that doesn't feel right. What a comment - and I thank you for that one. It summed up for me just how long I've been away from normacy...sad.