Bipolar vocabulary

The "vocabulary problem" refers to the practical consequences of people using the same words but meaning different things in different contexts. Like words that aren't slang/shorthand (T, tdoc, pdoc, sui, SI, etc.) but instead are normal vocabulary words that might be used differently in this context.

So I'm curious what a bipolar glossary would contain because I would like to better understand what people mean when they use certain terms.

The main one I'm not sure I understand clearly is "cycling" - what does that mean to you? When your moods are changing, or have gone completely around from low to high (or vice versa) or...? Is that different from a "mood swing" or are they essentially the same?

I understand "episodes" to mean periods of time where one has particularly severe symptoms, e.g. a depressive episode, a manic episode. Are there other ways that you would use "episode"?

I'm sure I'm missing some other typical phrases around here that might be unclear - feel free to add to the list.

As I am coming to understand it, or think i am, there are two ways of cycling:
Normal--moving from one mood to another through a normal period
Straight--moving straight from one mood to another without passing through a normal period

The other thing I "think I know" is that rapid cycling means changing more than four times a year. My mind expects that if there's a "rapid" then there's a "medium" & "slow" but apparently not...

RR

For me:
pdoc = psychiatrist (as in medical doctor)
t = therapist
tdoc = psychologist (as in non-medical)
cycling = shifting from any mood to another (normal to manic, manic to depressed, whatever)
cycle = the phase of mood (what mood is currently.)
episode = times when a mood becomes sever enough to be disruptive, or an explosive mood happens
mixed = depressed and manic together.

Tha's all I can think of for me.

oh also there is rapid cycling and ultra rapid cycling. Rapid cycling I think is more than 4 cycles of each mania and depression in a year. Ultra rapid cycling is people who seem to be shifting a great deal of the time.

Oh that is so weird, Ani! I've been thinking about this sort of thing lately too! I'm kind of confused when I see the words 'episode' or 'cycling' used, followed by a description of what, for myself, I'd think of as emotions or reactions or mood lability. Or my favorite non-technical word for it: "blip". Like... I could be humming along in a pretty normal mood, then maybe a driver p.o.'s me or something happens that sends me ruminating. I might react in a rather extreme and pretty sudden way, but then that's that. Minutes or hours later I've returned to whatever level I've been humming along at and spending the overwhelming majority of my time. A shift in either direction or even both in a day, still, I'd refer to those kind of things as temporary reactions, even if they don't have an external trigger.

So, to sum it up... Personally, I can experience a very rapid shift, but would not consider it cycling or an episode unless it lasted quite awhile. At least days, but more often weeks till I'd "count" it. To me, it's a significant, persisting departure.

By the DSM's standards, a hypomanic "episode" must last for a minimum of 4 days, a manic "episode" for at least a week, and a depressive "episode" for at least 2. These time requirements are completely arbitrary. A lot of research, actually, has discovered that the mean duration for hypomanic experiences is only 1-2 days.
My mood states vary considerably in duration, from minutes to months, so I have just decided to not use the word episode with regards to my own experience. I think that it is an ugly-sounding word anyway. Edit: I just realized that I do call my depressions that last for months "episodes" sometimes. Perhaps it is because they are lengthier, and I can easily tell which symptoms have changed from depression to depression, whereas if I tried to analyze my faster shifts so thoroughly I would just get confused.

Cycling (a much, much prettier word, IMO ), to me, refers to dramatic mood shifts, regardless of the speed at which the moods change. This, of course, leaves us with the problem of defining "dramatic"...I believe that if the mood changes are obvious enough that the person experiencing them notices them and finds them distressing, then they are "dramatic". My normal mood changes are noticeable to me, but I can let go of them, or distract myself from them. Moods from my bipolar cycling consume me.

Blip is my favorite!!!
My blips are when I borderline psychotic/am significantly off (manic) for a couple days but stabilize without intervention.

Cycling- refers to the general highs and lows- think of pedaling a bike, up and down with them meeting in the middle somewhere.

mixed- that one bothers me. how can you be depressed and euphoric at the same time??? I guess its an extreme middle.

My pdoc loves to tell me i'm mixed... a restless, sleepness, irritable, energetic depression?

I get mixed episodes often haha offending everyone here jk.

When I am "mixed" I am very manic usually, psychosis usually present, don't sleep for days, high energy, irritable, aggitated, and well it's just hellish. Mania definatly does not have to mean "happy".

I like to use the term episode because of a line in a movie " are you having a sode?" I dunno makes me smile. Episode to me is a severe mania or depression.

Cycling to me is the moving between either one episode to another or from stable to an episode. I don't like to use "cycle" because it reminds me of my monthly cycle and that's never happy. So wow, I just use words depending if the feel "happy". Ok.

My understanding is rapid cycling is four or more episodes in one year. Ultra rapid cycling would be within days, and Ultradian would be within a day.

I can usually tell my normal ups and downs from bipolar induced ups and downs. I don't include these as cycling. I think because when I do have an episode it is quite lengthy, usually months. And because the onset is usually very fast. Depression can be harder for me because it sometimes takes it's time setting in and also because I have tools I can use to cope. Then I question it sometimes.

I never had "mixed" episodes until I started on meds. anyone else??
Off meds my bipolar was pretty stable. Extreme mania starting in late june/July. Major depression late sept-feb. Bump into hypomania for a couple weeks late feb/march. Mania in March, major depression april/may/early june. Every year the same. No normal periods between episodes either.

For me...

Psych- Psychiartist
GP- General Practioner
CPN- Community Psychiatric Nurse
SW- Support Worker
Sui- Suicidal
SI/SH- Self Injury/Self Harm

Personally "Cycling" to me would be going from Mania to Depression to "normality" and back again. I would say that is the same as a mood swing. Cause your moods are continulously changing.

Me too, and haven't had any since quitting meds, but I doubt that they're gone fop good.

I have mixed states quite often. I can tell you how it is. First imagine that you are manic. So you're mind is racing, you have flights of ideas, can't keep hold of anything. Pressured speech, you just can't shut up or if you're not talking you're talking to yourself. Often pacing around in circles. Mind usually becomes a loop of obsessive, repetitive, and intrusive thoughts as well as all your plans and ideas. Tons of paranoia. Everyone is talking about you, or laughing at you. Most of the things going through your mind are negative.

Your body feels like it is vibrating but you have 0 motivation to do anything. You can't concentrate long enough to do any of your ideas. Creativity is shot, even though you have a million ideas you can't function at all. You're speeding and exhausted but can't sleep or rest or relax. You find no joy in what you enjoy normally (like depression.) Your negative thoughts are assaulting you so fast that you are constantly on the verge of breaking down in tears. Everything is annoying and irritating. You're in a barrage of self-hate inner talk, and you can't make it stop. You want to run screaming and yet at the same time just curl up in a ball and not move.

It literally feels like your mind is on full assault mode and it is terrifying and I can say if I ever feel like I'm actually "losing my mind" or "going crazy" that's it. This is when I am in the most danger of myself.

My psychiatrist said another term for mixed state is dysphoric mania, instead of the much more common "euphoric mania."

Ever since I have been treated with meds I very much fall on the dysphoric side of mania. I dunno. Definatly when I am the biggest risk to myself. Only time I have been hospitalized or my pdoc's have attempted to have me hospitalized, not once for depression.

so what is mixed? I doubt I ever have that (I do get ultra-rapid-swinging at times.... several times a day). So is it merely a result of medication. Interesting.

I use the word "surreal". Probably could be viewed as midly psychotic (time lapses and problems with time space continuum (hard to explain... i just seemigly project in time and space or have difficult time at realizing where I am at), hallucinating and all).

I don't think "mixed" is considered to be only the result of medication. My former "pdoc" kept telling me I was having mixed states. Interestingly, I've been with a new pdoc for over two years, and she hasn't seen any! She knows that I joke and laugh as a way of dealing with my physical and emotional pain....

My take on "mixed" is when someone is actually depressed but is at the same time active physically and overactive mentally. It doesn't make any sense to me either.

I have been known to be laughing one minute and crying the very next. Maybe I should enter the Grand Prix of cycling.

I never had any mania at all until I started taking anti-depressants, when I was in my forties.

HAha thanks payne, i'll enter with you! I definitely believe mixed episodes happen without being a result of meds (sorry if my post came off that way). Just my "natural bipolar" (untreated) doesn't include any mixed episodes.

My first hospitalization, before I was taking any medication at all for anything, was due to a really bad mixed state. I think it's just another one of those things that varies from person to person.

Yes, depressed but the mind is overactive. That's exactly it. It is a very explosive mood. But I'm not active physically either, although I can go without sleep and not need sleep. It's weird to not need sleep but also be extremely fatigued.

It litterally feels like my bones are trying to claw their way out of my skin I'm so restless, which brings on the pacing and walking in circles. I remember the first few times I had it I thought I was having a heart attack or something. I remember once my step-mother took me to a GP and we sat there and sat their, and I was rocking and crying and freaking out and pulling my hair. The receptionist and other patients in the waiting area just totally ignored me. Finally I got called back and the doctor did an EKG and it was normal, but it felt like my heart was racing a million miles and hour and so was my brain. At that time I could have sprinted around the block 10-15 times. But it felt terrible. The doctor sent us home saying it was "just all in my head."

On the car ride home I got the "why are you so dramatic, don't you know it costs money to see a doctor. You just want attention." That was the last time I ever told my family when I was in distress like that.

Hm, interesting on the departure between what the DSM states and what people seem to experience. But it's not the duration alone that defines whether an "episode" is hypomanic or manic - severity of symptoms also fits in there somewhere too, right?

Hypomania usually lasts 3 - 7 days for me, depending on how much I'm doing to manage symptoms, nearly always with a couple days of rebound depression before returning to "normal" or whatever else the predominate mood may be. Other than rebounding from hypomania, depression lasts from a couple days to a couple months, though. With occasional "blips," especially if I'm traveling (but those are week long blips!)

hee hee hee

On mixed states. I've seen where "they" say that BPIIs don't have them, but I disagree. I've had them and have talked with others who have as well. The only reason I can figure that they might not count them is some criteria of duration. Which... well, is frustrating, because they are still both extremes happening simultaneously and are extremely dangerous. I've seen the term "agitated depression" used... but this is frustrating to me as well, because I've had that, and it's not the same. It's very unpleasant to be sure, but not nearly as extreme.

Mine happened before I was medicated. They are extremely uncomfortable states. I really can't even describe it. There is no doubt that I'm a huge danger to myself at such times. And unbelievable impulsive. I've often thought, "This. This is what will get me in the end".

Interesting , my mixed states usually start off as manic and then become dysphoric as is continues. It usually lasts for months. My biggest accomplishment while mixed is my marathon pacing. I will pace for about 18 hours straight. Wake up with extremely sore legs. When I was in the hospital the psych unit goes around in a circle. And I remember another lady was already pacing it. I was so upset, what was I gonna do. Have a relay pace-a-thon with her??

I recently had a mixed state and that bumped me from being bipolar II to I which like Innerzone, I do not agree with.

The only thing I really remember was being extremly angry, irritable, agitated like I couldn't calm down enough to sit still longer then two seconds at a time. My mind wouldn't shut off and I hardly slept at all. At the same time I had extremly negetive thoughts of sui, self-doubt, dwelling on things, and a lot of depression in general. Its hard to explain.