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de414

Rapid Cycling

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Does anyone know much about rapid cycling. I was inpatient for 6 days and asked my doctors about it but really didn’t give much information. They chose to stabilize me on 450mg of Lithium 2x per day and Latuda 60mg once per day. 

Its been almost a week since discharge and I feel “ok” but it’s quite possible that everything hasn’t quite taken full effect.

Im not exactly distraught but I feel like im at last call as far as medication goes. If this doesn’t work I don’t know where we can go from here.

i know medication alone won’t fix the issue, diet and exercise should also be integral to my care.

I guess I just want to know /hear from other rapid cyclers or “ultradians” and see what the word is.

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Rapid cycling is defined as 4 or more mood episodes in a year. The episodes can either be depression or hypomania/mania.

if the dx is depression, it would be considered recurrent, but im not sure if there’s a qualifier for that.

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@de414 What is your specific pattern like? You don't hear much at all about ultradian cyclers. Maybe rare?  I have something similar, every couple months, hormonally triggered. I fail to get a diagnosis for these mixed-like "episodes" They only last 2-3 hours. Not even a day! Talk about Ultra-ultra-radian.

So they call it "mixed NOS" no mania at all, so not Bipolar, it's mixed severe depression/anxiety (without psychosis). Almost like sudden panic attack or like a flashback feeling (an intense depressive one, crying, lability, exhaustion, the works)

I can't tolerate A/Ps, or Lithium on daily basis (too sedating, nor do I need daily). I take a PRN Xanax for them. Which is OK I guess, if I want to just go to sleep. But benzos are sort of a depressant. Anyway, I feel  the pain. Increasing Lamictal has helped in prevention as well as low-dose A/D, so maybe you need to get to the right Lithium dosage? Good luck!

Edited by Blahblah
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@Blahblah I can’t say I have a specific pattern but based on Argh’s definition of rapid cycling I’m definitely in that category. I feel like one day I could be depressed and the next I could be on top of the world in mania. There’s no real rhyme or reason. Sometimes it can only be a few hours. I’ve heard some people say that’s not a “true” bipolar, but mood stabilizers make me feel better. (When I take them and as directed). I kind of feel insulted when I hear that. I feel like bipolar has a huge spectrum. I just happen to be on the rare end.

Edited by de414

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@de414 Definitely there's a large spectrum. Sounds like you have distinguishable Ups & downs (less of the mixed or side-to-side?) Seems most fitting with Bipolar, but with the extra rapid cycling. Maybe tweaking the dosage or experimenting with other mood stabilisers would help - have you tried any others?

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@Blahblah I’m pretty much fine at the moment. The lithium and latuda seem to be doing the job.  I’m just over analyzing and trying to get information on “ultradians” so I won’t feel so alone 

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I might  classify as a rapid cycler, depending on what doctor you talked to and how receptive they were to the idea of the bipolar spectrum. Much like @Blahblah, I tend to have "mood blips" that last several hours, in which I'm intensely irritable, overwhelmed, sensitive to noise, depressive, and otherwise crazy, but they don't tend to go on for days. I did have one in the Spring that lasted for a week that was pretty clearly a mixed episode, in which I was mostly as described above, but also cycled through all the other mood states in one day just for fun. I didn't have a bipolar 2 diagnosis until five years ago, when I had my first clear hypomanic episode (and I haven't had one since of that duration), after years of having an MDD diagnosis. Mostly what I have is a lot of depression. I haven't really talked with my doctor about rapid cycling, partly because it's only in the past few years I started to conceptualize the short-lived blips as short mixed episodes. I don't really have any suggestions for you, but share your frustration. I'm taking Lamictal and Depakote now after a recent stay in the hospital in which they changed my meds, which included Adderall and an antidepressant, remnants that got added on before I had the bipolar diagnosis and stayed because they worked for a while. I also took Latuda to keep the hypomania away, which I guess maybe worked, because I didn't have another hypomanic episode.

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I tend to cycle quite a lot (way more than the four distinct mood episodes a year that's the hallmark of rapid cycling) and I know that, when I first got on meds (I've been diagnosed for going on three years and was lucky to get on a med combo within six months of diagnosis that's worked pretty well for me), it took my meds awhile to really start working. Like easily more than a week, and they were used to treat an acute episode (hypomania) initially. I wasn't hospitalized though.

Hope that helped!

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