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My episodes are becoming more frequent.


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I have cyclothymia, which means my bipolar episodes are really short (like 1-3 hours), but I have a whole lot of them.  I used to only have maybe five or six per month, but lately they've been getting increasingly frequent.  In the month of May I had eight manic episodes and a similar number of depressive episodes.  Now I'm having episodes almost every single day, sometimes mania, sometimes depression, sometimes one followed by the other.  My mood is becoming extremely unstable.  What is happening to me?

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I ask, b/c I don't know how it would go with manic because I'm only hypomanic when I got that way, but this thing, or similar, happened to me when I started taking adderall. It took a while, but it suddenly happened, maybe a few months. I am NOT trying to diagnose or analyze, but I see you are taking ritalin, and since what you are experienced sounds exactly like what I experienced, I thought I'd mention it.

 

I hope things get better for you, seriously.

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I can't diagnose you, but cyclothymia is not the set of symptoms that you're describing.  Cyclothymia is defined by mood that becomes both elevated and has depressive symptoms, though neither mood state meets the full criteria for depression, hypomania, or mania.  Once you have had a fully depressive episode or a fully hypomanic or manic episode, you're no longer considered cyclothymic.  You also can't have schizoaffective disorder and cyclothymia at the same time because SZA means you have had a severe depressive or manic episode, or both.

 

What you're describing is called biploar disorder with ultradian cycling, or ultra-rapid cycling.  It's pretty rare (some experts doubt its existence), and there are specific ways to treat it.

 

Obviously, what you're doing isn't working.  Lamictal is a good AD for people with bipolar disorder, but it's not great for the high end, and it's not something I've seen often for this type of cycling.  I don't know how Risperdal works for the type of cycling you're experiencing, but in your case it doesn't seem to be working as is.

 

You need your meds tweaked, and possibly a consult with a doctor who can clean up your diagnosis list and treat you accordingly.

Edited by dianthus
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Well, I don't seem to have normal bipolar disorder, because one of the diagnostic criteria for a bipolar episode is that it has to last for at least a week.  My episodes typically only last for a couple of hours, two or three days at the most.  Maybe I would be diagnosed as bipolar NOS rather than cyclothymia.  The psychiatrist who diagnosed me didn't tell me what form of BP I had.

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I can't diagnose you, but cyclothymia is not the set of symptoms that you're describing.  Cyclothymia is defined by mood that becomes both elevated and has depressive symptoms, though neither mood state meets the full criteria for depression, hypomania, or mania.  Once you have had a fully depressive episode or a fully hypomanic or manic episode, you're no longer considered cyclothymic.  You also can't have schizoaffective disorder and cyclothymia at the same time because SZA means you have had a severe depressive or manic episode, or both.

 

What you're describing is called biploar disorder with ultradian cycling, or ultra-rapid cycling.  It's pretty rare (some experts doubt its existence), and there are specific ways to treat it.

 

 

You need your meds tweaked, and possibly a consult with a doctor who can clean up your diagnosis list and treat you accordingly.

I agree with this! 

 

What you are describing is the Hell I have been living with since the beginnin of March, mixed episodes and rapid cycling.  If that is what you (LordoftheMonkeys) call Cyclothymia, I would get into your Dr. and figure out what is doing on, because it sounds miserable

Edited by Frenetic47
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What you are describing is the Hell I have been living with since the beginnin of March, mixed episodes and rapid cycling.  If that is what you (LordoftheMonkeys) call Cyclothymia, I would get into your Dr. and figure out what is doing on, because it sounds miserable

 

 

You can also have one big episode that changes day-to-day, hour-to-hour.  I had a mixed state when I was pregnant that was like that.   We classed it and treated it as one episode, not many.  It was hell.

 

Good luck.

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I doubt that I'm having one long episode, because I go through long periods of feeling perfectly normal.  But the manic and depressive episodes are so frequent now that they're preventing me from living a normal life.  The amount of time I spend every day in a stable state is getting shorter and shorter.  I would say I'm spending an average of about two or three hours a day in an episode.

 

I'm learning to deal with it somewhat.  I've found that I can lift myself out of depression temporarily by giving it some kind of outlet, like listening to depressing music or writing poetry or song lyrics, and if I get manic I can lock myself in my room and get some serious work done.  Of course I won't be able to do any of this when I'm on the job or in a class.  If I'm depressed I can't focus on anything, and if I'm manic I'm too hyperactive, impatient, and easily distracted to focus on menial tasks like bagging groceries.

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Josie asked this up above, and it bears repeating:  have you had a full neurological workup with an EEG?

 

Spending 2-3 hours a day in some sort of mood episode is exceedingly rare presentation of bipolar disorder, and with a TLE diagnosis, I would want to see if the mood changes weren't related to that or something else.

 

I'd also look into things like stimulant/caffeine intake, sleep patterns, and all that other fun stuff that those of us with wacky brains need to be careful with.

Edited by dianthus
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@dianthus

Can you please explain: "You also can't have schizoaffective disorder and cyclothymia at the same time because SZA means you have had a severe depressive or manic episode, or both." further?

(Sorry to divert this thread slightly off topic).

 

Cyclothymia is defined by the patient never having had a depressive or manic episode that meets full criteria for either type of episode.

 

Schizoaffective disorder is defined by having either a depressive or manic episode that meets full criteria plus psychosis outside of having outside of mood episodes.

 

By definition, once you have an episode that qualifies you for SZA, you are no longer qualified for cyclothymia, if that makes sense.

 

It's a lot of diagnostic nitpicking, but it's really hard to tell what's going on when diagnoses don't make sense like that.

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@dianthus

Can you please explain: "You also can't have schizoaffective disorder and cyclothymia at the same time because SZA means you have had a severe depressive or manic episode, or both." further?

(Sorry to divert this thread slightly off topic).

Cyclothymia is defined by the patient never having had a depressive or manic episode that meets full criteria for either type of episode.

Schizoaffective disorder is defined by having either a depressive or manic episode that meets full criteria plus psychosis outside of having outside of mood episodes.

By definition, once you have an episode that qualifies you for SZA, you are no longer qualified for cyclothymia, if that makes sense.

It's a lot of diagnostic nitpicking, but it's really hard to tell what's going on when diagnoses don't make sense like that.

Thanks for clarifying that dianthus - it makes perfect sense.

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