Rapid Cycling???

I am not very clear about what rapid cycling is and I have not bothered to look it up. Here is what is going on with me.

As some of you may know I started on my new meds back around Feb. March. Within three weeks of starting the Fetzima it lifted me right out of the deep depression I had been in for so long. Meds have never been so great for me but here was one that was obviously working very good.

I was pretty hypomanic on it for two months but I rather enjoyed that even though it wasn't totally comfortable. At least I had energy and motivation again. Then things balanced out and I felt actually "normal".

Here is my problem though. Four times since I started these new meds and have been doing good I have went into a three day deep depression. I am there right now since thursday. i feel like total crap. all the usual symptoms.

I keep a mood log everyday so I looked back and the first time it happened was Easter and I wrote that off as some situational stuff because I couldn't make sense of it. But since then the exact same thing has happened three or four more times. Three days of deep depression out of the blue and then I am back to doing good again. This one I felt hit me thursday and today is saturday and i am still deep in it. I took on a job that will last a week next week so I have to be able to do that. It is a definite pattern. And it is one I have never experienced before. Are the meds pooping out already???

What the hell is going on with me???

I am already in the position of having no idea what the future holds for me or what my place in this world will be. At least for most of my past by natural depression cycles were predictable and they didn't last terribly long. In recent years they have become much worse and much longer lasting with addition of major anxiety with paranoia that i had never had. Then miracle of miracles a med that actually works better than anything I have taken........but will it last??? why these mini depressions??? what does the future hold for me???

Hello, zinco14532323. Have you asked your psychiatrist?

Not yet. Monday I will see my case worker and pdoc so it will all be discussed. I am glad my appointment is so soon.

I have discussed this in other threads but the reason I say I have no idea what my place in the world will be is that things had gotten so bad my doc and T suggested I apply for social security disability and they thought I was severe enough to get it. now I am doing good so should I get it??? should I go to work at a real job??? how long will i be doing good??? In limbo in my head.

I wonder if the stress about whether or not you can or should work, and what the future holds and the disability issue is causing some of this. I wish I could help you. I, too have taken meds that work great at first and then stop working. I am on a new medication now and I hope and pray it works. I am close to your age. I don't know if depression hits us differently when we reach age 50 or 52? I also deal with the paranoia and inability to trust people, especially at work. I would definitely see your pdoc and social worker and tell them what is going on. Best of wishes to you.

I am tending to think the nature of this disease does change with age, at least in my case.

You make a good point about the stress of the uncertainty.

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I experienced depression in 1991 or 1992. It was easier to get over that depressive episode than this one. Of course at that time I had two small children to raise so I knew I had to get myself together for them. Now the children are grown, my parents I was caring for passed away four years ago, so there are not people "needing" me in my life. I don't know if that But I wish for you the best. It sounds like you have a lot going on. Take care of yourself

Purpose definitely makes a difference. I think we are not near as resilient as we were when younger. I actually feel like I have PTSD from the depression itself the last five years and the upheaval it has caused.

I should be grateful I am currently doing good and I am safe and my needs are met but I feel battle worn. In my thirties I would just grit my teeth and go back to work and see what happens.

Really I don't have a lot going on just in my head and that is a dangerous place to be. One day at a time and stay in the moment is what I need to do I guess.

Thanks for responding.

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Taking things one day at a time is probably best. That's what I'm doing. I try to stop worrying about losing my job. That was driving me crazy. I think we are more resilient when were are younger. We just do the best we can with what we have.

I would ask a psychiatrist. That said you can look here for a clinical definition: Rapid Cycling in Bipolar Disorder: Diagnostic Issues and Treatment Options | Psychiatric Times

I also posted something about cycling in another recent thread you were involved in.

For me, as a woman, hormones can plunge me back into "mini-depressions", I don't really know if or how much the hormonal balance changes for men but is it something you had considered?

I have not considered that. Maybe I have manopause. Lol

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So asked my pdoc about the mini three day deep depressions I have gotten 5 times since april. Other than those I have been doing great.

He says - I am so treatment resistant and severe depression is so ingrained in me that there is a battle waging in my brain. Sometimes when I am burned out or stressed the depression wins for awhile. Then the meds and me battle back. Sounds like a good theory. I think he is right. It is when I have just finished something and feel kind of a let down, like what is next, that is when they seem to hit.

That's interesting zinco, thanks for updating us. I have definitely experienced break-through depression on my meds and wondered if it was situational or if it was the meds pooping out. I had never heard of rapid-cycling before you mentioned it, so I am glad you shared what it was (as far as you understood).

I take the generic variety of Cymbalta. I've been on Cymbalta, or it's generic equivalent, for about 2 years. It's not great. But it's helpful enough that stay on it.

The thing I notice, that perhaps relates here, is I still cycle down into depression. But it seems the medication only allows me to dive so deep. Then, at some point, it seems to stop me; & it hauls my useless butt back up! It's sort-of like a tether. So I still have the depression to deal with. But, at least so far, it has not gotten so bad again that I have made any further suicide attempts.

So, perhaps Zinco, you're having a similar kind of experience. Perhaps your med isn't going to eliminate your depression entirely. But it may prevent you from diving for the bottom. If that is the case, & if you can depend on it to do that, then you can develop coping techniques for the periods of depression you do experience; knowing that the medication will prevent you from sinking too far. It would be great if we could find a med that eliminated our depressions altogether. But, until such a thing comes along, what I've described is not a bad place to be!

Similarly, I find with myself it's those in-between moments in life that create undue anxiety or stress which eventually leads to a depression of sorts. Whether that depression is a short lived or deep drawn out kind, will likely depend on my actions. I made the mistake of switching my primary AD to another, based on my pdoc's feedback. It made things worse. I should have just increased dosage of my current AD & AP. But how do we determine best course of action when it hits and we are desperate? I would think that's what our pdocs are for, unless our own instincts tell us otherwise for a particular situation.

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I believe the pdocs are throwing darts and we can throw them just as good and I have learned to go with my instincts and my pdoc usually goes along.

Yes Skeezyks I think you are right. If I can rely on the meds are far as things are going now I would be really happy with that. They don't dip deep enough where I can't take action to help myself get out. It is when they go to the bottom that I can't do anything at all.

Same ole thing. I had a real good week last week. Did a side job all week with a buddy and made pretty good money. that helps a lot as I have been totally dependent on my parents for some months now. My birthday was Sunday and had a really good day. I usually hate my birthday but this year I looked forward to it. Then on Wednesday I crashed big time and slept all day. All the symptoms of major depression. Plus ruminating and non stop worrying. Today I feel a little better but want to go back to bed. There is a definite pattern and it seems to hit after one little phase of something is over and I feel a let down.

The big thing that triggered it was my car over heated and I don't know why. It has been fine. I could not stop worrying about it and I was frozen to do anything about it. It triggered me or else it just coincided.

I have had some very good weeks. I would even say approaching happy weeks. Then these mini depressions keep coming and it has me really worried.

Hello Zinco: It sounds as though, in general, you're doing pretty well. It's these periods of depression that keep popping up that concern you. It seems like you're pretty self-aware. In other words, you're conscious of what's happening in your life & how you're feeling at the time.

I wonder if it would be possible to do sort-of a diary, or some type of chart, that you could use to keep track of what types of things are going on when the depressions come on, such as your car overheating. This may well have been what triggered this most recent downturn. If you can begin to discern the types of events that are triggering you, perhaps you can develop ways to head off, or at least minimize, the depressive downturns. Perhaps there is something you really enjoy doing that you could do whenever you anticipate a depression coming on, based on what you know has triggered you before.

I would suspect your worry over these periods of depression is probably feeding into them; & making them just that much worse. This type of thing does tend to become a vicious circle. If on the other hand you can learn what tends to trigger these events, & develop a technique for heading them off or minimizing them, this may help you to feel more in control. And feeling more in control may itself help to reduce the intensity of these episodes... just a thought...

I know you have said that your depression is pretty much biologically originated but, could you identify the circumstances or triggers connected with your "ups"? May the deprivation of these factors facilitate depression coming back?

I don't know. When it happens I am always looking for some negative trigger as an explanation. I don't know that there is one.

Clara22 I had not thought of that. The ups have definitely been due to the meds. But the meds have allowed me to do things that would naturally help with depression. Like doing some work, social things, ordinary life things.

The first one happened on Sunday afternoon on Easter. They seem to for sure happen at the end of some event or completion of a task. Like I had a bad one after I completed a road trip across the country with my daughter. When I got back to Michigan I crashed. The latest is after finishing a good side job last week and having a good weekend and then playing a couple of rounds of golf with my dad and uncle a couple of times, then crash.

Definitely related to that. It is like a big come down and whats next. The more I think about it that is what is triggering it. I all of a sudden have nothing to do and worry worry about my future. I was supposed to have two more jobs coming up but I am relying on people to do their part and they are not doing it. I have no control over it. In my field of plumbing there are always side jobs available but they come and go. Events come and go. Normal fluctuations of life. I seem to not be able to handle the whats next times.

I could anticipate those times and plan something. I have plenty of other things I need to get done. Self motivation is a huge problem for me even when at my best. My best is normally mild to moderate depression although lately it has been better than that. I find it very difficult to self plan and self motivate but I think that may solve the problem.

That is very interesting .. I know when I am well I go through a down too after a exciting enjoyful event .. I know this is normal though even people who don't suffer any kind of issues like we do, have a let down.. I think it's like other things just so much more extreme for us or maybe could we see what is normal and take it for depression ???? Or bring it there I don't know but that has crossed my mind.

Like you say I think it is normal for anyone but for me it seems to be triggering very real depression. I get all the symptoms. Thank god they are short lived so far. I am almost out of this little one. Only two days but yesterday was severe for sure.

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I'm not sure if it's fair to say the pdocs are throwing darts. Although, I sure know how it feels that way sometimes. I have been diagnosed with several different disorders and illnesses in my short life. And then things are complicated by people close to me telling me what they think my problem is.

I think one of the biggest issues is you're dealing with the proverbial "black box." Stack various philosophical and cultural issues on top of that and you can see how dealing with symptomology and causation isn't quite as simple as with something like the flu.
But just because you can't figure out exactly what's wrong doesn't mean there isn't something wrong. I'm sure you're well acquainted with that reality.

And for what it's worth, I've found it personally more useful to devote my time and resources to stacking the deck in my favor rather than diving into the rabbit hole of ultimate answers and causes.

I understand your logic and I can get caught up for sure in over analyzing and dwelling on causes. It is important though to identify triggers if there are any. That way you are more equipped to do some planning and CBT around that trigger and possibly avoid it triggering a depression or at least process it and hopefully make things better.

I have no doubt with me it is deeply ingrained biologically and genetically and i have a life time of experience and evidence to back that up. But situational issues do affect it and trigger it. Those issues I have to focus on processing in a healthy way. That is a part of the solution for me and not really jumping down the rabbit hole.

As far as throwing darts I was speaking specifically to me and my depression. They have no way of knowing whether Prozac or Zoloft will work better for me. There are some genetic tests now on what active metabolites we produce on about 15 antidepressants but those go more to side effects than effectiveness. I have had pdocs tell me to just pick one. That my guess was as good as theirs. The only hint they may have is what class has worked better in the past. Everyone is so different is what active metabolites we produce thus the wide range of experience people have with side effects and effectiveness. I don't see how with depression at least it is not throwing darts unless they did extensive genetic testing and blood work which they do not.