If you have experienced rapid cycling, how did your pdoc deal with it?

I have come to a point in my diagnosis where I am rapid cycling. My pdoc seems to be OK with it because she said it’s not harmful. It isn’t, but it drives me crazy. One day I wake up on a high and the next day or even hours later I can crash. Or I crash one day and the next higher than a kite.

If you have experienced this, how did your pdoc deal with it?  Did she adjust meds or just let it go? She’s an awesome Dr. and this is the first of my rapid cycling ever.


If you experienced rapid cycling how did your P-Doc handle it?

I’m glad you asked this question because in the process of answering it I’ll be able to provide more insight and education on this particular subtype of Bipolar Disorder.

Rapid cycling can often be complex and problematic for the patient as well as the psychiatric care provider. To complicate things even further another form of rapid cycling has been identified and recognized by the Psychiatric Community, ultra/ultra-ultra rapid cycling.   (*Just knows reader is conjuring up images of all these bipolar folks riding on bicycles equipped with nitrous oxide*)

Rapid cycling is defined as having 4 or more episodes of major depression, mania, hypomania or mixed episodes required to have occurred in a 12-month period.  Ultra/ultra-ultra rapid cycling is defined by distinct shifts in mood over a 24 to 48 hour period.

Some facts about rapid cycling;

  • It is more resistant to treatment
  • It is seen more frequently in women
  • It occurs in 10 – 20% of people who have Bipolar DO
  • Women comprise 70 – 90% of rapid cyclers
  • Lithium is not an effective treatment
  • It was identified as a subtype of Bipolar DO just shortly after Lithium was introduced
  • MAOI’s & tricyclic antidepressants are not effective treatments

I am a rapid/ultra rapid cycler.  It can be extremely difficult to deal with and handle. Sometimes I can see and feel the signs of a rapid mood change. When this happens I’m much better prepared to deal with it. Most times however, my mood changes just appear out of nowhere and I’m pretty much blindsided.

The ultra rapid mood changes are the absolute WORST! My poor mind and I get so confused. One minute things are fine…not perfect…but ok. Then WHAP! Out of nowhere I can tell, my whole world is falling apart! I can’t stop crying, I can’t stand myself, I think everyone hates me and I’m just a huge burden! A little while later I’m planning family night…pizza, movies…I’m so physically exhausted after one of these episodes. Oh…and let’s not forget my poor family! It’s very hard on them, they walk on eggshells and I feel so guilty for putting them through these episodes.

Now to finally answer your question. (*Hears muttering, “it’s about time”*)

Many Psychiatrists are finding that Lamictal works quite well as a treatment for rapid cyclers.  Tegretol and Trileptal seem to be choice medications for many Psychiatrists as well. Some doctors are finding if their patient needs just a bit more help, they’ll sometimes add an atypical antipsychotic such as Zyprexa, Seroquel, or Abilify. These are just a few examples and in NO WAY meant to be medical advice or a substitute for professional help.

The best thing to do when you’re experiencing symptoms or you feel like something is wrong is to talk to your doctor as soon as possible.

I hope this information and answer has helped.


3 thoughts on “If you have experienced rapid cycling, how did your pdoc deal with it?

  1. Great post Cat!!!
    I know I, personally, experience ultra-rapid cycling way too much… When it gets really bad, though, I call my PDoc’s office and they get me in as soon as they can-usually within a few days… I know that’s not typical, though, that you can get in that quickly… If only it were!!! My PDoc will asses me and decide whether or not I need to be hospitalized for my own safety (which has happened…) or just change my meds around some… But she (usually) figures something out!!!

  2. OK–the intro sounded exactly like something I had written to Marybeth asking her about rapid cycling. My pdoc has let it rest just like I pointed out in the intro statements. I HATE it! This Friday if she can’t seem to FIX the problem or take steps to do it I think I will go nuts! I have been in the crashed state since Monday, but I can feel myself going up right now. I called today and asked for more Xanax which is a bandaid and not a real fix. I will let you know what she does. She is an excellent Dr. and we have a great working relationship. Now, she needs to tweak, add or do something about my meds! Sorry to complain! 😉

  3. Shari, I know it’s a pain to tweak and/or change/add meds…….but if it works isn’t worth it in the long run? My bipolar1/mixed episodes w/rapid cycling has been an ongoing battle for me. I’ve had to have several tweaks and change over the last 16 – 17 yrs. Do I like it? Of course not? If my pdoc has to change or tweak my meds again b/c my symptoms are bad and I’m not improving will I do it? ABSOLUTELY!!! I hate change I’m just a tad OCD and I don’t like my routines etc, changed, but I will continue to keep marching on b/c I want to live…not just exist.

    So you asked what could be done and we answered sweetie……I’m so sorry you’re going through this. Rapid cycling can’t be cured but it can be managed, you just have to be willing to do what it takes to help get it under a bit more control.

    I sincerely hope that you get the help and feel better!
    ~~~<3 Cat <3~~~

Thoughts? Questions? Leave your feedback here!