Mixed State vs Rapid Cycling

Today has been a particularly difficult day. I’m one of those people who goes up and down (rapid cycling) throughout one day. I started the morning not really wanting to get out of bed, then quickly ramped up to giddines and several posts and tweets. Then agitation set in, and I was hoping if I just laid down with an audiobook I could calm down enough to get something accomplished. That lasted less than 5 minutes. I went downstairs to burn off some mania with WiiAerobics, but I couldn’t stay focused for more than 10 minutes, so I decided to work on my recipe collections and then go to Target. By the time I finished one section of the recipe project, I had slammed down, gave up on the day and took a nap. Now I’m cruising along hovering just above bottom.

It occurred to me that it might be helpful to post information about both Rapid Cycling and Mixed State. As usual, I found an article on the DBSA website which clearly explains the two, as well as providing some good information about bipolar disorder.

Rapid cycling is defined as four or more manic, hypomanic, or depressive episodes in any 12-month period. With rapid cycling, mood swings can quickly go from low to high and back again, and occur over periods of a few days and sometimes even hours. The person feels like he or she is on a roller coaster, with mood and energy changes that are out-of control and disabling. In some individuals, rapid cycling is characterized by severe irritability, anger, impulsivity, and uncontrollable outbursts. While the term “rapid cycling” may make it sound as if the episodes occur in regular cycles, episodes actually often follow a random pattern. Some patients with rapid cycling appear to experience true manic, mild manic, or depressive episodes that last only for a day. If there are four mood episodes within a month, it is called ultra-rapid cycling, and when several mood switches occur within a day, on several days during one week, it is called ultra-ultra-rapid, or ultradian cycling. Typically, however, someone who experiences such short mood swings has longer episodes as well. Some individuals experience rapid cycling at the beginning of their illness, but for the majority, rapid cycling begins gradually. Most individuals with bipolar disorder, in fact, experience shorter and more frequent episodes over time if their illness is not adequately treated. For most people, rapid cycling is a temporary occurrence. They may experience rapid cycling for a time, then return to a pattern of longer, less frequent episodes, or, in the best case, return to a stabilized mood with the help of treatment. A small number of individuals continue in a rapid cycling pattern indefinitely.

Mixed state (also called mixed mania): A period during which symptoms of a manic and a depressive episode are present at the same time. People who experience mixed states describe feeling activated and “revved up,” but also full of anguish and despair. Rapid, pressured speech can co-exist with impulsive, out-of-control thoughts of suicide and self-destruction or aggression. Hopelessness, irritability, uncontrollable swings between racing thoughts and a feeling of “being in blackness” can all happen over the course of minutes.

Staying calm on the roller coaster

I’m a rapid cycler. No, that doesn’t mean I ride my bike real fast, nor does it mean I go to a spinning class. Come to think of it, I’d rather do either one of those instead of what I and many others go through.

Here’s my non-clinical and unprofessional description of being a rapid cycler: In the morning, I climb onto my own personal roller coaster. If I’m lucky I’m on the one designed for little kids. It calmly goes up and down, maybe a few curves and then gently stops. The kind of daily ups and downs to which “normal” people can relate.

Every now and then I get on the white-knuckler. Imagine the scariest roller coaster you’ve ever seen or experienced. The one that goes up so high people look like ants, and comes down so fast your heart is pounding up in your throat. It goes up and down, around and around, more times than you’d like, then without warning ejects you from your seat at some random point in the ride and you crash on the ground.

Some people seem to be able to accomplish quite a bit when they have manic highs, but I generally cannot. When I’m on the high part of the roller coaster, my mania generally manifests itself as agitation and an inability to focus on one task, with a little side of bad decision making. This is when I plug my mp3 player into my head, and pull out my colored pencils and pens. This usually helps me to become calm, rolling slowly down the tracks, and then I can get a few things accomplished before the roller coaster takes off once more.

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“All God does is watch us and kill us when we get boring. We must never, ever be boring.” Chuck Palahniuk (1962 – ), Invisible Monsters, 1999