Rapid Cycling
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Rapid Cycling
Bipolar Disorder

And We're Not Talking Bicycles!

The cycles of Mood Swings in Bipolar Disorder can vary widely.  Initially, episodes of depression and mania tend to occur closer together and more frequently.  In time the interval between the extremes of mania and depression may stabilize and become longer as a part of the normal progression of the disorder.

Rapid Cycling occurs in approximately 5-15 percent of the Bipolar community, and is defined as "having four or more distinct periods of  depression, hypomania, mixed states, or mania in a time period of one year."   Women are affected more commonly than men (75 per cent are women).  Rapid Cycling is a relatively new diagnosis, having been identified by psychiatrists and researchers shortly after lithium became available for use in bipolar disorder.  Since then, more terminology of Rapid Cycling has been added.  In ultra rapid cycling episodes may last no more than 24 hours.  In ultra ultra rapid cycling several switches of mood occur in a 24-hour period, and in continuous cycling an individual swings back and forth between mania or hypomania continuously with little or no period of identifiable normal mood between the swings.

The idea that rapid cycling bipolar disorder is a specific type of bipolar disorder has been all but dismissed.  Currently it is thought that any bipolar can "switch" to a rapid cycling pattern, but that in nearly all cases (as shown in a recent study) most return to their normal bipolar pattern in time.

There have been several areas studied in an attempt to discover why rapid cycling affects some individuals with the disorder and what might be done to improve treatment for these individuals.  Some of the things studied included that these individuals seemed to have a thyroid problem, were not helped as efficiently with lithium and had all taken antidepressant medication…and addition were primarily female.

The only one that has been positively proven is that women predominate.  Clinicians still feel that antidepressants may play a role in the development of rapid cycling but they have no proof.

At this point in time there is no known cause for rapid cycling, nor is there a specific treatment.  Hopefully soon one will be found soon.

When I was diagnosed in 1979 my episodes were so stable I could almost plan on them…once a year, every year in late Autumn and over Christmas to January would find me in hospital.  After that I went for a period of eight years with no hospitalizations. 

Beginning again in 1988 the episodes (mostly depressive) began to recur…a little more frequently until 1994.  Between 1993 and 1995 I was diagnosed as a rapid cycler.  My episodes were frequent and severe…in those two years I lost my job and was put on a disability pension, made several attempts at suicide (one was severe), was in and out of psychiatric hospitals both locally and out of town and had short and rare occurrences of normal mood.  My episodes were all severe  - no half measures for me - and would last 2 or 3 months before switching to the opposite state.

Then with treatment the swings slowed down and stopped for two years.  In January 1998 I was again in hospital for a mixed episode, which was incidentally unlike anything I had ever experienced before.  Up and down at the same time, laughing through my tears and audio hallucinations are three of the features I most remember.   Quite a difference from what I was accustomed to.

Since then, any mood swings have been comparatively mild.  I obviously am no longer a rapid cycler, at least for today.  One thing about having bipolar disorder is that I've learned not to make predictions for the future.  Until a cure is found, Bipolar Disorder is for life, and I for one plan to enjoy the times of peace and contentment to the fullest extent, and let tomorrow take care of itself.





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