Q:  Am I Getting Worse with Time

Dear Dr.,
I'm sure you've answered before, but, can you tell me is it my imagination or am I getting worse? I've suffered all my life (43years old) but was not dx'd till 1996 as BPI. In the summer of 2000 I had a manic "spell" followed by a yr and 1/2 of depressioin. Now I seem to wing between the 2. I have depressive periods of 3 to 6 days, followed by similair lenght hypomania. I take 3000mg depakote, 450mg welbutrin, 20mg paxil and Dr. added zyprexia now at 15mg.  Does BP progress as one ages?
Thanks Aidan


Dear Aidan -- 
Now you have rapid cycling where before you didn't.  Yes, bipolar disorder can get worse with time, so that could account for some of this change.  It's as though each episode can make subsequent episodes more likely and potentially more severe as well.  

However, antidepressants are also associated with rapid cycling.  Most mood experts I read are very consistent in recommending that people with rapid cycling gradually taper their antidepressant as a means of addressing that cycling.  However, you need to talk with your doctor about this first, so she/he knows and is able to work with you in designing a plan; don't start down on your own.  

Dr. Phelps