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what exactly is rapid cycling


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Rapid cycling is a real bitch.  You could be happy one moment, then be bawling and hate yourself in a split second for just a little bit.  Then you could be full of rage a little while later, have panic attacks, freak out and be paranoid over stupid things, then start all over again.  Depends on the person.  I am a severe rapid cycler.  My moods change at least, and I'm not joking about this, almost hourly.  Gets worse when I'm about to get my montly visit from "aunt rose".  Which I'm about to start my second week in my birth control pack, so I'm well prepared for this whole disruption in my life to begin.  Sucks.  It really sucks.

Sorry if I'm not all that helpful for ya dear.

Elizabeth

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Some people do cycle weekly, because I'm severe, I cycle daily.  So it really sucks.  My best friend's neice, who's only seven, cycles faster than me.  I was babysitting her the other day and observed her and WOW...within one hour, she went from, I hate you!, I love you!, I hate me!, screams, bawls, throws things, cleans things, I couldn't keep up with her.  One thing is, I felt strangely drawn to her.  And almost bawled with her when the local boys started picking on her and she told them her "Aunt" Karen...yeah, my real name, was gonna kick their butts if they kept picking on her.  I was like, don't say that!!!!  But I came to the rescue and we tried to play kick ball, and me and my big feet and baggie jeans made me lose my balance and I fell down right on top of her and she smashed her poor little head off this little sidewalk in the backyard.  She cried and I cried.  I held her and told her everything would be okay and "Please don't hate me, sweetie, please don't hate me."  Poor kid is Bipolar.  We make a great pair.  I ran inside and talked to the girl who lived there and got some ice for my "neice".  She immediately stopped crying and hugged me and said, "I don't hate you.  I know it was an accident."  That made me cry all over again.  Talk about an eventful day.  And the goose egg she got from it.  Damn!  When my best friend and his sister came back from the store, I told them all about it.  I told them both how so so sorry I was and they just said, "Hey, accidents happen."  They took one look at the goose egg and I had to hold my breath because they went, "Holy shit!"  But my "neice" thought it was funny by this point and kept saying, "Hey this goose came along and laid an egg on my head, wanna see?"

I hate it that we can't mention names on here because it's so damn hard to try to tell stories like this.

Anyway, so my so-called "neice", just makes me smile that she actually thinks of me as an aunt, is doing better.  But my point is, rapid cycling is different for everyone.  Just watching how fast my "neice" cycles proves that my cycling is nothing in comparison.  And her mother won't put her on meds because she's just a little girl.  The doctors want her on Lithium.  A seven year old on Lithium.  She was born with a lot of problems.  Liver and kidney problems!  And the doctors don't take that into consideration???  I told my best friend's sister, I would NEVER put my child on drugs like that knowing full well my child was born with liver and kidney problems.  She's still developing.  That would just screw her up even more.  But, her mother is taking her to a therapist.  Which I think, in the long run, would do her some good, at least for the time being.  Wait until she's older before doping the poor kid up.  It's bad enough that this little girl has already experimented with her own sexuality, meaning the great "M" and has gotten caught, she flashes little boys and doesn't care.  I told her mother, you've got one hell of a ride to go on before she get's in her teens and when she does get there, God help you.  She's gonna be a more than a handful.

Just thought I'd share that with ya.

Elizabeth...or Aunt Karen who likes to trip and fall on her favorite "neice"

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I think cycling through the week is called ultrarapid cycling and cycling continuous throughout the day is called ultra ultra rapid or ultradian rapid cycling.

In all the research I've done, dr's pretty much seem to have no idea what the best way to treat it is.

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Even though for us, rapid means like, RIGHT THE FUCK NOW MY MOOD JUST CHANGED YOU MOTHERFUCKING DOCTOR PIECE OF SHIT, in reality...it's not that way.

I had this question a while back myself so I went and looked it up. This was last year when I was (still) having a hard time coming to terms with my (sixth) diagnosis of bipolar disorder.

It really bothers me when the literature available to us on bipolar disorder presents the information as fact rather than admitting that there is no real agreement.

Rapid cycling means: the presence of four or more major mood episodes (depression or mania) within a given year.

Not very rapid, eh? On this there is agreement because this is what it says in the DSM-IV. That, however, is where the agreement ends.

When it comes to "ultra-rapid cycling," "ultra-ultra-rapid cycling," or "ultradian-cycling," there isn't agreement. In fact, there isn't even any real agreement on the definition for the terms "cycle" and "episode." Some of the literature uses the words interchangeably while there are some doctors who propose that they should have separate definitions. (Episodes should be defined as a two week period of one discrete mood, depression or mania whereas cycles should be defined as switches in mood occurring daily or every few days. Or something like that.)

Some say that ultra-rapid cycling is when your mood switches every few days whereas ultradian (or ultra-ultra rapid, which sounds kind of silly to me; what's next, ultra-ultra-ultra rapid cycling?) is when your mood switches daily. Basically what JBella said.

Some say that it's difficult to distinguish ultradian cycling from a mixed state, which is kind of hard to disagree with. Unless you've experienced both at separate times. In which case, you might have a strong opinion on whether or not it's difficult to tell the difference.

Some say that anti-depressants cause ultra-rapid and ultradian cycling but taking the patient off anti-depressants causes withdrawal, which just leads to depression, which just leads to more anti-depressant prescriptions. Vicious cycle ensues and fun is had by all.

(An interesting note: There is a psychiatrist working for NIH who says that you should never prescribe anti-depressants for people with bipolar disorder except as a last resort. If a shrink has prescribed a mood stabilizer and the patient is still depressed? Prescribe another mood stabilizer! This is how firmly he believes that anti-depressants are bad news for BPs. And I believe this guy knows what he is talking about.)

Some even say that there isn't any such thing as ultra rapid or ultradian cycling. That, in fact, what the patient is suffering from is a personality disorder, such as Borderline personality disorder. People with Borderline personality disorder can often switch moods from minute to minute depending, of course, largely on external factors. (Which we know is not the case with bipolar disorder because BP is largely a disease of the brain although of course it can be triggered by external factors.)

As with anything the "authorities" tell you (be they teachers, doctors, parents, preachers, gurus, cops, etc.,) don't be afraid to question what they've told you. Nothing is fact. Not even history. Even history has two stories for every "fact" that's written down in a textbook. Everyone has their prejudices.

My own prejudice is that I think psychiatry is pseudo-science at best and dangerous sideshow quackery at worst and the only thing psychiatrists really do is listen to you for fifteen minutes and then prescribe drugs based on two factors: 1) what the DSM-IV tells them you have based on what they've just heard you say; and 2) what the pharmaceutical reps tell them will fix the problem that the DSM-IV tells the shrink you have.

So if you think psychiatry is, like, the greatest thing ever, you might not want to listen to me.

Here are some links for your own edification:

http://www.neurotransmitter.net/rapidcycling.html (see the abstract titled "Definitions of rapid, ultrarapid, and ultradian cycling and of episode duration in pediatric and adult bipolar disorders: a proposal to distinguish episodes from cycles.")

http://bipolar.about.com/od/rapidcycling/a...srapid.htm?nl=1

http://www.mhsource.com/expert/exp1082701c.html

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Alright...I am supposed to be borderline, but I mood cycle like hell on fire all day every day. I can be ok one minute, confussed and overwhelmed the next, ten minutes later I'm having a killer insecurity fit, then I'm raging and that may just go away and leave me feeling flat or I might get into a depressive ennui or a bout of I'm ugly and fat and I hate myself and need to hurt myself. My best mood is neutral, energized and able to focus and think.  Given a choice between happy or calm and functional, I'd take the latter any day.  Is this Normal for Borderlines?

I also get this thing where I am being overwhelmed by huge gigantic nameless emotions and try to  :)   deal with it by cutting or burning myself...I used to drink and beat my forehead on the carpet until I blacked out, but I'm trying to deal with this with out the booze, so I haven't developed good coping skills yet. Is this part of rapid cycling too? Panz is so confused.

Do Borderlines rapid cycle? I am rather sure that I don't have what has been described as Bi-polar, I don't get the mania bit

MI is a confusing evil labyrinthe and it is markedly unfair to inflict it on those of us that have it ;)

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I agree pretty much exactly with what Teddy said.

The one thing I would like to add though is that according to the DSM-IV none of the above posts technically describe rapid cycling. The reason being is that the DSM-IV requires that 4 major mood episodes occur in a year. And by definition a major mood episode is either 2 or more weeks of depression or a week of mania. I think the term rapid cycling was used to distinguish people who have many mood episodes a year each lasting a few weeks, from people that only have a couple episodes a year with each of them lasting a fairly long time.

I dont know though, you should probably ask a doctor.

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I dont want to offend but I think your might not have a mental problem but more of a mother problem.

About your boyfriend, maybe you have Borderline Personality Disorder. I say that because that is what my sister has and she sounds like you. But I also think that you have a right to get mad at people and maybe you are perfectly fine.

I dont know though, I am severely sedated at all times and never get angry.

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I think the term rapid cycling is much abused and over used.

The term that I believe appropriate is  "Emotional Lability".

As others have clearly stated above, hourly or daily changes do not meet any consensus defined criteria for moods changes. A mood is an overlying or prevailing tone, not something that changes with the wind.  By definition.  Emotions change rapidly, not moods.

I too have been astounded to find myself variously despondent lying on the couch one hour, beating the freezer into parts another and laughing in fun another. I think it is anothre facet of the disease.

A.M.

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I'm am SO glad someone pointed that out!  Here, for the past several years, I thought my rapid cycling was due to my BP and here it's due to my BPD.  THANK YOU!

Erika, have you ever hurt yourself without the intention of commiting suicide...other than the head banging on the floor bit?  If you have, I would talk to your doctor.  Borderline Personality Disorder is a real bitch for one, and we have our great and wonderful moments of self-injury.  Me, I cut my arms up,  pull my hair, punch walls, beat my thighs until they're numb, and a new one to add to the list, I now bang my wrists on hard surfaces.

My sister used to binge drink, the sleep around, do drugs, shit like that.  It's all self-injury, according to my therapist.  Killing the "pain" without killing yourself.  If you've done anything like this, tell your doctor.

Here's a little something I found when I was doing some research for someone about Borderlines and Parasuicide.

Parasuicide, sometimes called Deliberate Self-Harm, occurs when one mimics the act of suicide, but does not have the initital intent to die or end up killing themselves.

Parasuicide is not necessarily manipulative in any consciously-planned way. It is often a cry for help in the only way that many people know how to cry out for help.

I remember your post a month or so ago about you counting your meds.  You didn't do anything, which is wonderful, but it scared me to know you were counting how many pills you had.  Bipolars do often try or even commit suicide, but so do Borderliners.

I don't really know much about your past, but if your mother was like the way she is now, and she treated not only you, but your sister this way when you were little, you could very well be a Borderline and so could your sister.  I'm not saying you are.  I'm not a pro.  From all the info I've read, and from what my therapist has told me, BPD stem from being abused as children, whether it's sexual abuse or verbal and physical abuse.  It's messed up. 

Here's a link for you to read more on Borderline Personality Disorder.  But I would definitely mention this to your doctor.

http://www.borderlinepersonality.ca/bpddefined.htm

Take care sweetie,

Elizabeth

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This author has been blamed for being an 'affectophile' who tends to overdiagnose affective disorders (57). The real problem, however, is that BPD criteria encroach so much upon the phenomenology of affective dysregulation, that in the end these criteria lose their discriminatory power from affective spectrum disorders. The proposal to re-label BPD as 'emotional dysregulation disorder' (53) will be a step in the right direction, but I understand it has the resistance of BPD experts, who despite their avowed dissatisfaction with BPD on both terminologic and discriminatory validation standpoints, continue using it (55, 58).

Axis II with its borderline construct was a concession to the neo-kraepelinian reconceptualization of the traditional mental disorders on axis I. A quarter of a century later, if one were to judge BPD on the basis of the validating principles of this paradigm (59), BPD (as currently operationalized on axis II) will in the main emerge as essentially similar to the bipolar spectrum in phenomenology, course, laboratory findings, family history and treatment response (13, 27, 33, 34). The question of diagnostic overlap with other axis I disorders (17) is beyond the scope of this commentary. Suffice it to say that such overlap pertains largely to anxiety, eating, addictive, and impulse control disorders, all of which are well-known 'comorbid' features of bipolar II (26).

To paraphrase what Michael Stone told me a quarter of a century earlier (60), BPD as a nosologic construct, like some of the patients it describes, will eventually self-destruct itself. This is certainly true of the DSM-IV construct (61, 62). On the other hand, I am on record (17) for having endorsed the Kernberg psychostructural approach as a more sensible conceptual and clinical framework for BPD patients  who could then be diagnosed on axis I (e.g. mood and anxiety disorders) and a new putative independent axis VI for psychodynamic formulation. Psychoanalytic understanding and descriptive nosology are complimentary to one another  they should not be collapsed into one another. The latter is the fatal mistake of those who gave birth to BPD on axis II.

http://www.blackwell-synergy.com/doi/full/...47.2004.00461.x

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I beleive someone else hit rapid vs ultrarapid vs ultraultrarapid vs ultradian rapid cycling earlier in this thread (bear with me, I'm sick and drugged.)

As for moods vs emotions--a mood is not really what's going on congruent. It also more has a tone of "I have always and always will feel this way". You are not depressed when you fail a test. You are sad. You are not manic when you serindipitously find 50 dollars in your pocket, you are happy. There is a difference.

Mood lability is a trademark of borderline personality disorder. It is NOT a trademark of bipolar. And the emotion switches, IIRC, are waaaay out of proportion to the precipitating event. In contrast to ultradian rapid cycling (I've been there, I'm a beleiver. I was cycling like mad. A family from another gym was going to take me to Nationals. I COULDNT STOP CRYING at state. THIS IS A MOOD, people. I was depressed. Low energy not having fun etcetera. An hour later I was mixed as hell, pissed off. A girl I coach had won her division and I was agitated and ticked off. FOR NO REASON. MOOOOOODS. Not emotions. One example of many.) there are external triggers and the emotions are seen as that. Plus, SI isnt seen as an escape from bipolar moods, the way it's often used as an escape from the emotional ride in BPD (all from academic knowledge, I have very basic knowledge of BPD).

Therefore, the emotional lability does not equal ultradian cycling, but emotional lability and crankiness (bipolars get it too, everyone does from time to time) is often mislabeled ultradian cycling by those experiencing it.

And yes, it is possible to have both bipolar and a personality disorder.

Kassiane

<{POST_SNAPBACK}>

Thanks for the difference again Kassiane for shedding light in to the dark scary basement . I am trying to learn all that I can about being Borderline. And thank you Elizabeth for the link

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Some say that ultra-rapid cycling is when your mood switches every few days whereas ultradian (or ultra-ultra rapid, which sounds kind of silly to me; what's next, ultra-ultra-ultra rapid cycling?) is when your mood switches daily. Basically what JBella said.

Ok, so I seem to clearly fit in the Ultradian corner of the multiverse.

Some even say that there isn't any such thing as ultra rapid or ultradian cycling. That, in fact, what the patient is suffering from is a personality disorder, such as Borderline personality disorder. People with Borderline personality disorder can often switch moods from minute to minute depending, of course, largely on external factors. (Which we know is not the case with bipolar disorder because BP is largely a disease of the brain although of course it can be triggered by external factors.)

However, the more I read descriptions of BPD and stories by people with BPD, the more certain I am that I'm _not_ BPD. I have many other pecularities and mental kinks in my life, but that's just not one of them.

ie. I don't believe Ultradian == BPD. There may indeed be BPD'er who are Ultradian, and BPD may present in very similar ways as Ultradian, but being Ultradian does not mean BPD.

The more I read the (freely) available literature on the 'net, or read stuff in libraries and bookstores, the less convinced I am that the PDocs have the faintest idea of what is and what to do about Ultradian.

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Mood lability is a trademark of borderline personality disorder. It is NOT a trademark of bipolar. And the emotion switches, IIRC, are waaaay out of proportion to the precipitating event.

<{POST_SNAPBACK}>

Hmm, the way I experience it there simply _isn't_ a precipitating event.

Unless you call the passing of time an event.

My day can go flat normal for awhile. I can find myself happily bouncing around like a playful puppy for about an hour or so. I go euphoric. This describes it...

Music. Lots of music. Blues. Schubert. Maybe if I'm not too far gone I can hook my mind onto a Bach fugue and adsorb onto it.

Beauty in art in music in bodies in ideas in nature in love whatever.

HAH! The abstractions flow. I'm flowing in a tide of ideas. Reality is just another abstraction.

Then things start to sour, I go dysphoric...

The abstractions flow too fast. I'm walking midst drooling idiots. The truth is before them and they see it not. The beauty of the world, the beauty of love, the beauty of God, the beauty of the ideas should dazzle them.

They should burst out singing, bursting their hearts and breaking their voices like a raging celestial choir at the beauty.

HAH!

They tramp robot like over it.

I HATE THE BRAIN DEAD MORONS!

Then things go empty.

Just an empty ache inside me. I want to curl into a ball and cry. Nothing has "happened" to precipitate it. The change has occurred by itself. Yes, if shit happens and something bad hits me, I will take it very badly. But I'm already in misery before the shit hit.

Living is like walking through treacle. I have the ideas, but bending the stiffness of details is _so_ hard. Everything is so hard and treacly. I bang my fists against it.

I'm tiring.

Hey?

What is this?

A pen top.

No pen though.

Where did the pen go?

The pen must be somewhere.

What a horrible thought.

The pen is somewhere.

I wish I was dead.

And yes, this happens to me several times a day.

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the DSM-IV requires that 4 major mood episodes occur in a year. And by definition a major mood episode is either 2 or more weeks of depression or a week of mania.

Wow, thanks.  It's been so long since I read any of this basic stuff.  My diagnosis was BPII, mixed states, rapid cycling.  I too thought "rapid" meant quickly and forgot that it meant a major mood event, which means at least 2 weeks long.  I was diagnosed based on repeatedly cycling from depressions lasting several weeks through normalcy into hypomania which crashed back into another long depression. 

I do have mood switches (skin tightening irritability to anxious euphoria to fury to giddiness) not associated to triggers, but usually when I'm overloaded with stress, exhaustion, or anxiety.  But maybe those are all flavors of my mixed state hypomanias and are really all one mood.  I'm also emotionally labile especially when on that cusp between depression & hypo.  Also when I fail to make sure to connect and do mentally healthy things.  If I drift around the house all day I can easily fall into fugue states that quickly go from hedonism (sensually experiencing music or weather or food) to mild detachedness to sudden loneliness to calm to despairing hysteria and back again.  Vacations can be absolutely hellish for this reason. 

So maybe a touch of BPD?  But I do it much more rarely the better my BP meds and therapy work.  I rarely do it now on lamictal.  So maybe BPD symptoms I've learned from childhood and am unlearning?  I obvioiusly need to read more about BPD.

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