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Random crazy quick cycles?


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So after years of deliberation, I'm officially bipolar, non-specified.

I go through 3 year long gradual ups and downs and my moods can swing heavily, even within the day.

Now it's even on lithium. I am just coming down from a manic, but earlier today I was SO depressed that I tried to get out of the 4 day funk by cutting. Not a good idea, I know. My therapist is going to be upset with me tomorrow.

But yeah, anyway, does anyone else cycle really weird?

What are your cycles like?

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I just asked someone else this same question on a different post, but I'll ask you too.....

When is the last time you had your lithium levels checked. Changes in seasons can actually effect it and you might be out of the clinical range. My doc told me this week that mine is too low and we're experimenting with how to balance it out. 800mg one day 1000mg the next and repeat. I just had blood tests yesterday and will know tomorrow if it is better.

As for cycles, I think I'm just now experiencing mixed state for the first time, but I'm not sure. I need to read more. Sounds like you might be too, but hey... I'm no expert. Normally I just go from bad to worse but hide it with a big fake smile.

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I just asked someone else this same question on a different post, but I'll ask you too.....

When is the last time you had your lithium levels checked. Changes in seasons can actually effect it and you might be out of the clinical range. My doc told me this week that mine is too low and we're experimenting with how to balance it out. 800mg one day 1000mg the next and repeat. I just had blood tests yesterday and will know tomorrow if it is better.

As for cycles, I think I'm just now experiencing mixed state for the first time, but I'm not sure. I need to read more. Sounds like you might be too, but hey... I'm no expert. Normally I just go from bad to worse but hide it with a big fake smile.

I've had them checked twice since I started taking lithium, once just recently (to be discussed with my pdoc on the 4th about the 1200mg/day) and once when I was just starting out, to see if my system was rejecting it or not.

I just know that I swing up and down and have for years, I don't know too much about mixed states, but I want to know more. I'll try and remember talking to my tdoc about it today.

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Hi again,

Do you know what the levels are? My new pdoc told me on Monday that optimum is between 1.0 and 1.1 mM by blood volume. His nurse just called back today to tell me that mine is WAY to low when the same dose had me at a dangerous 1.2 six months ago. It is a royal pain, but you'll probably find you'll need to readjust one or more times in the course of the year.

Let me know if you find anything more about mixed. I looked at the info on this site and it explained some, but I need more.

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Your doctor wants you at a 0.2, a 1.2, or a 2? I'm not clear on your intent from your post. The clinically effective range for most people is between 0.5 or 0.6 and 1.0-1.1. There are occasional bipolar oddballs out there who have fabulously stable mood below 0.4, or feel only good effects and are not toxic above 1.1, but they are far from the norm. This still gives you some idea of what your pdoc might be shooting for.

Lithium toxicity can happen at any blood serum level and any dose, if we're discussing the entire human race, but most people are okay until they get above 1.0. It's still something to keep a close eye on until you know what dose you need to be on and what that dose feels like when it's working correctly, and then you just get to the pdoc immediately if something gets different in a bad way. In all of this the main guage should be how you feel, as the clinical target ranges are not one-size-fits-all.

Okay. Apart from the little lithium tangent, you wanted to hear about other people's cycling patterns, right? When I was still cycling often, depressions could last for what seemed like forever, and euphoric hypomanias never lasted more than a week. They were usually much shorter, actually, and didn't squeak into the 4-days-or-more range specified in the DSM-IV until a few months before I first sought medical help for mental illness. I could have as many as five hypomanias in a month and the corresponding number of depressions, but this was highly unusual. What was more typical was one or two. If there was a precipitating event, it was lack of sleep (leading to sleepless hypomania), high stress, several hours outside exercising vigorously in bright sunshine, or excess alcohol consumption (which was often paired with the stress of a social situation and/or lack of sleep). Sometimes there was none.

I experienced my first recognized hypomania in the spring. Many other people also experience seasonal triggers.

At times I would experience agitated depression. This was more likely to last a week than euphoria. Sometimes it could arise on its own, other times it tagged along after a euphoric hypomania, the energy turning from good to bad. My agitation was obvious, and I was highly irritable. It was never really bad for more than a day or two. Agitated depression (dysphoric hypomania?) segued nicely into depression.

Depression sucks incontinent ass. Mostly physical lethargy, crying, and obsessive rumination over my personal set of downward-spiral themes, but sometimes I'd be more wound up as in dysphoric hypomania. Where do we draw the line?

I'd usually be depressed straight through the late fall, all of winter, and early slushy spring, with two or three hypomanias punctuating the bleakness.

Since starting lithium in spring of 2005, I have not experienced hypomania. In the early days, there were a couple of little ones, but that's it. I have okay periods, I have slightly crappy periods, and I have horrible periods, all on the depressive scale. I haven't figured it out yet.

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I know exactly what you mean about heavy mood swings throughout the day. This is very common for me. While I have longer depressed/hypomanic episodes (and some mixed episodes too) that can last maybe up to a month, particularly the depression; within that are the several strong mood swings that happen virtually every day. Even now, when I'm feeling relatively 'normal' I'm still very up and down even if it's just for a few minutes at a time. This scares me a little in case it turns out to be the start of a proper episode. I had one of each kind last academic year and it really messed up my work, not to mention my mind!

Last night I could not sleep at all (seems to be happening tonight as well), and felt a great rush of euphoria mixed with an anxious feeling of lack of control. Luckily I retained my logic and didn't squeal and giggle, or go off and dance outside in the dark and the rain which I had the urge to do. I finally got to sleep at about 7am, slept until midday, and woke up depressed and slightly agarophobic.

With sleep, I've noticed a pattern in recent years. I get high at night, can't sleep and make plans about what I will do tomorrow etc. then wake up feeling down and decide that everything I did/thought of doing the night before is rubbish.

Does anyone else get this?

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doc wants me at a 2.0 last I remember. I'll be double checking with him because I've recently hit a new low in my depression: haven't been this way since before I was put on my first ADs. blah.

Yeah, my depression can last for months and months, and I just get manic blips here and there.

I get like that with sleep nearly every night. I try and force myself to sleep, and then I try using some relaxing visualizations that my dad taught me. Sometimes it helps.

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doc wants me at a 2.0 last I remember. I'll be double checking with him because I've recently hit a new low in my depression: haven't been this way since before I was put on my first ADs. blah.

What system of measurement is he using? 2.0 mmol/L is NOT a safe target. If he's aiming for that straight off from the beginning, he should not be allowed to hold a pen, much less write prescriptions. I hope there is some alternate explanation from the fabulous world of mathematical measures.

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