Bipolar Disorder: Rapid Cycling - secure2.convio.net

1 Bipolar Disorder: Rapid Cyclingand its TreatmentDepression and BipolarSupport Alliance (DBSA)Previously National Depressive and Manic-Depressive AssociationWe ve been there. We can does not endorse or recommend the use of any specific treatment or medication for mood disorders . For advice about specific treatments or medications, individuals should consult their physicians and/or mental health episodeA distinct period of elevated, enthusiastic or irritable mood lasting at least one week (or lessthan one week if hospitalization is required), thatincludes at least three of the following symptoms: Increased physical and mental activity and energy Exaggerated optimism and self-confidence Excessive irritability, aggressive behavior Decreased need for sleep without becoming tired Grandiose thoughts, extreme sense of self-importance Racing speech, racing thoughts Impulsiveness, poor judgment Reckless behavior such as spending sprees,impulsive business decisions, erratic drivingand sexual indiscretions In severe cases, delusions and hallucinationsWhat is Bipolar disorder?

2 Bipolar disorder,also known asmanic depression,is a treatable illness involv-ing extreme changes inmood, thought, energy, and behavior. A person with Bipolar disorder hasmoods that usually alter-nate between mania, orextremely up mood, and depression, or extremely down mood. This change or mood swing can lastfor hours, days, weeks, or even months. Typically, some-one with Bipolar disorder experiences one or two cyclesa year, with manic episodes generally occurring in thespring or episodeSimilar to a manic episode, except that it is lesssevere and there are no delusions or hallucina-tions. It is clearly different from an individual snon-depressed mood with a clear change in activ-ity and attitude, and visible behavior that isunusual or depressive episodeA period of two weeks or more during which fiveor more of the following symptoms are present: Prolonged sadness or unexplained crying spells Significant changes in appetite and sleep patterns Irritability, anger, worry, agitation, anxiety Pessimism, indifference Loss of energy, persistent exhaustion Unexplained aches and pains Feelings of guilt, worthlessness and/or hopelessness Inability to concentrate; indecisiveness Inability to take pleasure in former interests;social withdrawal Excessive consumption of alcohol or use ofchemical substances Recurring thoughts of death or suicideMixed state (also called mixed mania): A period during which symptoms of a manic anda depressive episode are present at the sametime.

3 People who experience mixed statesdescribe feeling activated and revved up, butalso full of anguish and despair. Rapid , pressuredspeech can co-exist with impulsive, out-of-controlthoughts of suicide and self-destruction or aggres-sion. Hopelessness, irritability, uncontrollableswings between racing thoughts and a feeling of being in blackness can all happen over thecourse of gets Bipolar disorder? Bipolar disorder affects more than two and a half mil-lion adult Americans during any given year. The illnessusually begins during a person s late teen years,although it can sometimes start in early childhood or aslate as a person s 40s or 50s. An equal number of menand women develop this illness, and it affects people ofall races, ethnic groups and social causes Bipolar disorder?The exact cause of Bipolar disorder is not known. Wedo know that it is a brain-based medical illness and thatcertain structures of the brain related to emotions,behavior, and thinking are affected.

4 Bipolar disordermay be related to an imbalance in certain chemicals inthe brain, called neurotransmitters. There is a geneticcomponent, meaning the illness runs in families,although genetics does not completely predict who willdevelop Bipolar disorder and who will there different types of Bipolar disorder?Physicians and researchers agree there are several kindsof Bipolar disorder. Most people who have the illnessexperience episodes of mania and periods of depres-sion, but the length, frequency, and pattern of thesehighs and lows vary. Sometimes individuals with bipolardisorder experience frequent mixed states. Some of thedifferent combinations of symptoms may not be med-ically significant, while others are important enough tobe classified as specific types of Bipolar disorder thatmay be treated in very different ways. For more infor-mation, see DBSA s brochure, Guide to Depression and Manic Depression, available by calling (800) 826-3632 or visiting 6 What is Rapid Cycling ?

5 Rapid Cycling is defined as fouror more manic, hypomanic, or depressive episodes in any12-month period. With rapidcycling, mood swings can quick-ly go from low to high and backagain, and occur over periods ofa few days and sometimes evenhours. The person feels like he or she is on a rollercoaster, with mood and energy changes that are out-of-control and disabling. In some individuals, Rapid cyclingis characterized by severe irritability, anger, impulsivity,and uncontrollable the term Rapid Cycling may make it sound as ifthe episodes occur in regular cycles, episodes actuallyoften follow a random pattern. Some patients withrapid Cycling appear to experience true manic, mildmanic, or depressive episodes that last only for a day. Ifthere are four mood episodes within a month, it iscalled ultra- Rapid Cycling , and when several moodswitches occur within a day, on several days during oneweek, it is called ultra-ultra- Rapid , or ultradian , however, someone who experiences suchshort mood swings has longer episodes as individuals experience Rapid Cycling at the begin-ning of their illness, but for the majority, Rapid cyclingbegins gradually.

6 Most individuals with Bipolar disorder,in fact, experience shorter and more frequent episodesover time if their illness is not adequately treated. For most people, Rapid Cycling is a temporary occurrence. They may experience Rapid Cycling for atime, then return to a pattern of longer, less frequentepisodes, or, in the best case, return to a stabilizedmood with the help of treatment . A small number of individuals continue in a Rapid Cycling pattern indefinitely. 7It is very important to get immediate treatmentfor this form of Bipolar disorder and work with a health care provider to find the treatment thatworks best, since the longer someone goes without treatment , the more resistant to treatment the person may develops Rapid Cycling ?As many as half of all people with Bipolar disorder maydevelop Rapid Cycling at some time during their there are no absolute rules about who will devel-op this pattern, women may be more likely to do so,even though Bipolar disorder is equally common inboth genders.

7 Use of certain antidepressants to treatbipolar disorder can bring on or worsen Rapid , the Cycling decreases when the antidepressantmedication is stopped. However, when stopping anantidepressant, a person should be aware of the possibility of depressive episodes re-occuring, workclosely with a doctor to find a more effective medication combination, and never stop taking a medication or change a dosage without first talkingwith a doctor about may also be a link between Rapid Cycling anddrug or alcohol abuse. A history of substance abusemay make an individual more likely to have rapidcycling. Studies also show that substance abuse is more common in families of people with Rapid cyclingthan in families of people with Bipolar disorder who donot have Rapid Cycling . It is not known whether this isthe result of a genetic link between substance abuseand Rapid Cycling , or if it is evidence of self-medication among people with Rapid causes Rapid Cycling ?

8 The basic cause of Rapid Cycling remains unknown, butthree overlapping theories exist:Kindling (Sensitization): According to the kin-dling theory, early episodes are triggered by actual oranticipated life events such as the death of a loved oneor an upcoming job interview. Over time, the personwith the illness becomes increasingly sensitive to moreminor triggers or stressors, and becomes more likelyto have an episode in response to these the person may begin to have episodes with-out any triggers. Episodes become increasingly fre-quent and the end result of this process, when the ill-ness is not properly treated, may be Rapid , ultra- Rapid orultradian rhythm disturbances: This theory pro-poses that people with Rapid Cycling have daily biologi-cal rhythms that are out of sync with typical time-giv-ing events such as dawn and dusk. This theory couldaccount for the sleep disturbances typical of mania anddepression and explain other symptoms as well.

9 If bio-logical rhythms are important, a link between rapidcycling and seasonal affective disorder (SAD) may besuggested. It is also possible that abnormal daily biologi-cal rhythms do not cause the illness itself but do con-tribute to the length and seriousness of a manic ordepressive episode. For example, if insomnia is treatedearly and aggressively, mild or moderate symptoms canbe prevented from snowballing into a severe anddestructive episode. 9 Hypothyroidism: This theory proposes that rapidcycling is due to inadequate amounts of thyroid hor-mone in the brain. Most people with Rapid Cycling dohave adequate levels of thyroid hormone in the blood,but they may respond well to treatment with thyroidhormone regardless of their initial blood there effective treatments for Rapid Cycling ?Yes, although it can be challengingto find the right with Bipolar disordershouldn t give up hope ifthe first few medications or medication combinationsprescribed are not success-ful.

10 There are many different treatmentoptions to try. Keep a good record of what has worked, has notworked, or has partially worked to help your doctorwith future medication choices for you. For more infor-mation about medications for Bipolar disorder, readDBSA s Brochure, Finding Peace of Mind: Medicationand treatment Strategies for Bipolar Disorder, avail-able by calling (800) 826-3632 or sure to talk to your doctor before adding any medication including prescriptions, natural/herbalsupplements and over-the-counter remedies to your can be an important part of yourtreatment plan. Not only are people with Bipolar disor-der at risk for further manic or depressive episodes, it s possible to experience difficulty as a result of pastepisodes. Characteristics such as irritability, tendency tocry, racing thoughts or impulsiveness may cause socialproblems. Because people with Bipolar disorder areoften unfairly judged, they may lose opportunities todevelop friendships or romantic involvement, or havetrouble achieving their career goals.