Q: Having Twitches When Cycling - Any Ideas?
Dear Dr. Phelps,
I have been diagnosed Bipolar1 since 1995, After much struggle and experiments
with various medications, I was able to get my life to a place of normalcy and
relative stability. I am not currently on any medication, and have not been for
over two years. The Disease has been in remission for three years.
Recently I have quit smoking, and I have started cycling again, I intend to
wait this out for a few months to see if my body can adjust to this new
My question is not so much related to this as to the nature of my symptoms this
occurrence. In the past I would often have severe twitches when depressed, and
when I would cycling, which i do rapidly.
The twitches are becoming more pronounced now. And I can find no mention of
them in the literature on bipolar, unless they are what is implied by
psychomotor agitation. They feel like short seizures during which the left
side of my face scrunches up and my arms flex beyond my control. They are
short lived but come in waves of various frequency for an hour (give or take).
They are more pronounced and difficult to control when I am upset. When they
are more pronounced I almost feel a location for them in my brain( left
hemisphere mid-brain ) They look very similar to reactions that I have seen
mentally retarded people make. When the hand is scrunched up by the chest and
Needless to say it is a little embarrassing when it happens in public, which is
seldom. Are you familiar with such symptoms? As I have been experiencing them
with more regularity, I have begun to wonder more about them, and the
possibility that there is something else going on with me, perhaps even that I
had been misdiagnosed originally. I certainly realize the limits of your
ability to give me much insight in this format, so I am not expecting
solutions. I am just wondering if you are familiar with this. I have no
resources for doctors any longer, and I can picture what those conversations
would look like (not very usefull).
I have a great deal of certainty that I will go into remission again. I am
not worried excessively over this, only curious, curious that these twitches
should seem so similar to people obviously facing very different mental
problems. Perhaps there is nothing to this, and perhaps I am creating the
similarity myself seeking to physicalize my mental turmoil in a recognizable
form. Anyhow whatever information you could offer would be appreciated .
I would also like to thank you for this format if such a thing had been
available when I was younger, perhaps I would have come to terms with my illness
sooner. You are doing a great service by providing it.
Dear Mr. B. --
There are several interesting things going on here. The first is that you would
have been able to do well for two years on no medications. Then, that these
symptoms would return when you stop smoking, which of course must have made
staying cigarette-free more difficult.
But this phenomenon of "twitches" which you describe is also interesting,
although concerning. Interesting, in that you recognize the connection between
these symptoms and the mood symptoms you used to have; but concerning, and that
one of the explanations which must be considered is that these represent some
kind of "seizure" phenomenon. In calling them this, or at least invoking this
possibility, I do not mean to alarm you nor imply that you have a condition
which needs immediate medical attention. The course of these symptoms so far
would actually suggest that they pose no risk to you.
However, if indeed this was some sort of seizure-like phenomenon, there is also
a possibility that it could worsen or evolve into something more dramatic and
worrisome. If you had access to medical care, the usual approach would be to get
an "EEG", an electroencephalogram. If you were under medical care, someone might
even suggest that you not drive an automobile until this was investigated.
I am glad that you are certain your symptoms will remit
again. You might even discover that by reducing caffeine use in making sure that
you get regular sleep that even these "twitches" go away (as both of those can
sometimes worsen both bipolar disorder and seizure disorders, and are relatively
easy to try out).
I'm glad some of my writings have been of use to you. I hope perhaps this one as
well. Good luck with that.
Published May, 2007