Dealing with Rapid Cycling Bipolar Moods in Everyday Life
Garden variety bipolar disorder consists of moods that typically last weeks to months if not treated. People with bipolar experience a mood and settle in for a long ride. However, people with rapid cycling bipolar disorder experience moods that typically only last weeks. People with ultra-rapid cycling bipolar disorder have moods that only last days to weeks and people who have ultradian bipolar disorder may have moods that last from hours to days.
[It worth noting that when severe moods last only for a few hours this may be considered a mixed mood episode rather than a cycler, per se.]
So, if your mood cycles quickly and spontaneously, how do you live with it?
I Have Ultra-Rapid Cycling Bipolar Disorder
I, personally, have ultra-rapid cycling bipolar disorder. At least, in some respects. My depressions tend to last forever by my hypomanias last for only hours or days. And within that my mood symptoms also cycle. For example, during a depression I may experience very strong, unquenchable anxiety for a week and then it will mysteriously disappear. This isn’t a formal bipolar cycle, per se, but it sure feels the same as a mood cycle to me.
The Unknowns of Rapid Cycling Bipolar Disorder
I think one of the things that people with bipolar have trouble with, especially those with rapid cycling variants, is that one never knows what is coming next. How will you feel this afternoon? Well, if you’re really a serious rapid cycler, then you probably don’t know. If your moods are primarily spontaneous, then you know even less. These unknowns are hard to deal with. Humans like things they can predict so they know what to expect. It’s just normal, rational, human psychology.
Treating Rapid Cycling Bipolar Disorder
It is critical when treating rapid cycling bipolar disorder to first treat the cycling before the mood. In other words, focus on stopping the cycling and then deal with whatever mood symtpoms still remain. In my case, this has mostly worked. I rarely cycle into hypomania now and when I do I know how to stop it before it gets unmanageable.
This mean: no antidepressants for people who rapid cycle. Really. It’s not me saying that, it’s the International Society of Bipolar Disorder. In the recommendations for bipolar treatment with antidepressants they set out last year they were very clear that in people who rapid cycle and in people who were experiencing a mixed mood episode antidepressants should not be prescribed.
Mood stabilizers need to be given to people with rapid cycling bipolar disorder to stop the cycling. This may mean an antipsychotic and a mood stabilizer is needed. It varies depending on the person. And then to manage lingering symtpoms (like depression) agents that are not formal antidepressants are preferred.
How I Live with Rapid Cycling Bipolar Disorder
You can live with rapid cycling variants of bipolar disorder. Really. Each person is going to have their own challenges with this but one thing that plays to the advantage to someone who rapid cycles is this: the mood won’t last forever. Unlike some people who get depressed and stay that way, people who rapid cycle may cycle out of that depression quickly. This can be a source of hope when a mood feels too extreme.
Of course, always going up, down and sideways is incredibly exhausting. When I tried the EMPower Plus stuff I found that I was constantly cycling and it was brutal. For that, PRN (pro re nata (latin), meaning as needed) medication can be helpful. Some people take an antipsychotic only when they feel a hypomania coming on, for example, and then they may only need to take it for a few days to level out. People also commonly have benzodiazapines (anxiety medication) or nonbenzodiazapines (sleep medication) prescribed PRN. These can be hugely helpful when a mood suddenly appears.
Handling Rapid Cycling Moods at the Onset
For me, when I become hypomanic, I tend to do so at night. The feeling builds throughout the day until at night, I experience full, hypomanic symptoms. This is easily handled for me. While the hypomania wants to make me stay up all night, I fight that urge and take some extra sleep medication that sends me off to the land of nod. After a good night’s rest, I find the hypomania has been quelled. If, on the other hand, I hadn’t had that rest, the hypomania would have remained and likely gotten worse.
The secret to dealing with a mood swing is nipping it in the bud. The reason the above works is because I handle the mood right at the beginning of the hypomania and not after days. A similar technique can work with depression. When you feel the symptoms of depression becoming apparent, stop what you’re doing and rest for three days. That rest may be what your body needs to fight that depression.
And, of course, when you feel an extreme mood swing coming on and a quick fix doesn’t do it, call your doctor. It’s critical that he or she know what you’re experiencing early because that is the best time to treat it.
Does Rapid Cycling Bipolar Disorder Get Better?
As I said, I don’t cycle so much any more. I have daily bipolar mood cycles, which are a bit different and I do cycle occasionally but, in general, the medication keeps me pretty stable so I can say that yes, rapid cycling of moods does get better.
Additionally, as you learn about your disorder and develop better coping techniques (such as through cognitive behavioral therapy) you learn to deal with the moods and recognize them more effectively. For example, the evidence of an early hypomania or depressive episode might be hard to spot for some, but I have so much practice that it’s obvious to me. And it can be obvious to you, too, but it takes time and work.
So don’t lose hope. It may feel like hell today – I get it and that’s real – but that doesn’t mean that it will feel like that forever.
[Remember, I’m not a doctor and none of this is formal, medical advice. Never change your medication without help and advice from your doctor.]