yet more mood swings and roundabouts

[baratron]

I'm trying to do some research online, but I can't seem to find what I want. It's most annoying.

I've been in a very strange mood for the past couple of days, and it's been going on for long enough that I'm worried. The only way I can really describe it is to say that I seem to have hypomania and depression at the same time. I'm ridiculously perky, and I keep alternating (every few minutes) between having loads of energy and exhaustion. I feel restless and agitated and completely hyperactive. I get hungry but hardly want to eat anything. My indecision's even worse than ever. On the one hand I'm extremely easily distracted and I have next to no concentration span, yet at the same time I'm getting obsessed by things, like playing the same CD or even the same song over and over again. I keep saying things that other people interpret as non-sequiturs because in between what they've said and my reply, my mind's leapt three stages ahead. And I keep getting terrible fits of random guilt about stupid things (for instance, feeling guilty because I haven't read any newsgroups for a few weeks, and then depressed because I don't actually miss reading news).

I feel as though my moods are cycling between depression and elation every couple of minutes. It's not the first time I've felt like this - a few years ago I remember describing my mood swings and asking the doctor about manic depression (which is what it was called then), and being told my mood swings were far far too frequent to be anything like that. I'm used to very rapid changes of mood, but they're usually only from normal to depressed. Now I'm going from elated to depressed without stopping inbetween, and cycling every few minutes. (Think perk perk perk CRASH.) This scares me, because it's all too similar to how I felt last year when I had some sort of nervous breakdown (then, my moods were cycling from suicidal to high about once a minute, and I really was completely off my head). I can't seem to find anything online about mood swings of this frequency, though. I'm vaguely wondering if it's hormonal, but I can't find anything about that either. Has anyone got any idea what it could be?

Comments

[inquis.livejournal.com]

There is something which might account for it - it's called a mixed episode. It occurs in both Bipolar I (Standard Manic depression) and Bipolar II (Manic Depression with Hypomania rather than full blown Mania). From the sounds of things, your talking about hypomania, but for both types, a mixed episode means that your experiencing both swings at once which *is* known as a problem with Bipolar - there are many people I've seen on the net who have this problem - they call it Rapid Cycling but it does appear to be a mixed episode.

You can find a list of links here on About.com and frankly, if you're worried, the whole of the bipolar section is worth looking at. It's a mix of a portal and original information so most of the links are well researched and they have been looked at by a human, so they are usually reviewed briefly before you look at them.

[baratron.livejournal.com]

I agree that what I'm describing sounds absolutely like a mixed episode. What I'm unsure about is why I would suddenly have started having mixed episodes when so far I've only ever shown symptoms of unipolar depression. Having said that, by this description of a mixed episode (http://www.i5ive.com/article.cfm/1073/47790), I have had them before. This description: "I once went through a mixed episode where I was deeply depressed...unable to eat, unable to move. At the same time my mind was racing a hundred miles an hour. I was suicidal, and if my speeding thoughts could have made my body move I would have been in extreme trouble." does sound very much like things I've had before. Hmmm.

I found a web site last night which has helpful little mood charts (http://www.a-silver-lining.org/BPNDepth/dsmiv.html). But according to the DSM-IV (the American psychiatric bible), people with Bipolar II do not have mixed episodes. It's vaguely possible that I have Bipolar I, but in that case how come I've had depressive episodes lasting years, and the closest I've ever had to manic episodes were mild hypomania lasting a couple of hours? It just doesn't make sense.

I wonder if the description of Rapid Cycling that you've heard is a difference between American and UK psychiatric usage, because the description I've heard for it is more that 4 different episodes in a year! Here we go (http://www.fhs.mcmaster.ca/direct/phys/mood.html#_Toc480270534): "A patient is considered to have "rapid-cycling" bipolar disorder if they have had at least four episodes of either mania or depression or both in a 12-month period. Some bipolar patients can have ultra- rapid cycling, and may cycle between depression and mania within a day. This condition is often misdiagnosed or even missed altogether. Fifteen to 20% of bipolar patients will experience a period of rapid cycling. In only a small proportion does the rapid cycling pattern continue life-long."

*sigh*

[jenett]

Don't know it it'll help, but it's more or less what happened to me when I'm on inhaled steroids for asthma for more than 3-4 weeks (it needs that long to start kicking in for me) I definitely had the fast-cycling stuff (I felt like I didn't know what mood I'd be in in five minutes, let alone what sort of mood I was in at any given moment.) I don't recall about the obsession stuff, but I was in college at the time.

Any chance there's been any medication change within the last month or so that might have been a part of this?

[baratron.livejournal.com]

Any chance there's been any medication change within the last month or so that might have been a part of this?

Unfortunately not, no. I've been on the same asthma medication at the same dosage for um... about 5 years now, and on the same antidepressants at the same dosage for almost a year. The only other drug I'm taking at the moment is hay fever medicine, which is also an inhaled steroid - I have been taking it since May, though, and I've taken it pretty much every summer since I was 13. So that wouldn't seem to be a possible cause :/

[mjl]

no experience myself, but through friends and reading a depression support thingy, what you're describing sounds like a "mixed state", which is usually associated with bipolar disorder, but can happen with unipolar depression too... it can apparently be really nasty... if you've not had it before, probably worth talking to your doctor if you can get hold of him... in the mean time, try googling for mixed state depression and you should find loads of stuff... *hugs*

[baratron.livejournal.com]

Interesting... I definitely haven't heard that you can get mixed states with unipolar depression. *googling*...

[meirion.livejournal.com]

to me, that sounds like some kind of reaction to medication, and you should probably see your doctor about it.

unlike previous commenters here, i don't think it's likely to be rapid cycling bipolar disorder. mainly because you have very little possible history of bipolar disorder, and rapid cycling bipolar disorder is much more likely to occur if you've had untreated bipolar I or bipolar II for some years.

if you're interested in investigating precursors to bipolar disorder, try googling for cyclothemia. i don't think what you're describing sounds like bipolar to me. i've been looking at the pages recommended by inquis and i suspect i'll have comments to make in my own journal.

when i was rapid-cycling earlier this summer i got completely paranoid thinking i had borderline personality disorder, which seems to have a much more rapid cycling frequency than bipolar normally does. that was, of course, until the day i was so far manic that people's jaws were dropping open when i was talking to them.

hmmm, more later. particularly about the hypersexuality link off about.bipolar.com, and how that relates to c's comments about bipolar disorder and polyamory.

-m-

[baratron.livejournal.com]

Yes - cyclothymia was the first thing I looked for yesterday, in fact. However, the DSM-IV criteria for cyclothymia (http://www.a-silver-lining.org/BPNDepth/criteria_d.html#CyclothymicDisorder) specifically says "No Major Depressive Episode, Manic Episode, or Mixed Episode has been present during the first 2 years of the disturbance.", which completely and utterly rules it out for me.

I wish it was a reaction to medication, but I haven't had anything changed for a few months. Mystery :(

[thekumquat.livejournal.com]

Well you've had those period problems recently - could be some sort of general hormone thing? I've had the same sorts of rapid mood changes and concluded that it was me using all my mental tools to hide the depression, succeeding, and then collapsing again - could that fit you?

eek

[jinian.livejournal.com]

That's dreadful. I'm so sorry.

I asked a friend with average everyday bipolar disorder, and the opinion from that quarter is that it could very well be rapid cycling bipolar even if it doesn't match the DSM-IV criteria perfectly, and that you should try to do something immediately. "Something" might include getting mood stabilizers, though I know that new meds would probably be a big deal.

Also, my friend suggested a thyroid function test; I don't know how you are on that, and it doesn't seem like it would cause cycling (certainly not so rapid), but it can produce symptoms in either direction. Maybe you have one problem jerking you one way and another playing tug-of-war with it?

Anyone have some spare sanity? I seem to have mislaid mine.

[baratron.livejournal.com]

Eeek indeed.

I sat down with my doctor today and we went through my medical records. It seems that within the past few years I have had tests for virtually all the possible medical conditions that can cause depression, including thyroid function. So it can't be explained away by that :( Joy.

My doctor pointed out that it's not exactly unlikely that my symptoms wouldn't match the DSM criteria seeing that my depression is completely atypical too. *sigh*. So it's back to randomly throwing different drugs at it and seeing if anything helps.