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I was diagnosed as bipolar 4 years ago, and for the first time, I'm taking a look at my episode patterns. But I'm wondering if they even make sense. I've divided them up into mixed states, hypo/mania, depression, and ultra-rapid cycling. Does the following pattern seem abnormal? In 2007, I was mixed in March and April; manic in May; ultra-rapid cycling in June (started an ineffective dose of lithium at this point); and depressed in July and August. In January of 2008, I was given a higher dose of lithium that seemed to work better. That year, 2008, I was mixed in January; depressed in August and half of September; and hypomanic the rest of September and October. In 2009, all I can remember is a hypomanic episode in March. In 2010, I was mixed for January and February. And for the past few days, I've been ultra-rapid cycling. Is this a normal pattern? I've never heard of so many continuous transitions between so many different kinds of episodes before.

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replied March 24th, 2010
Bipolar Disorder Answer A10899

Hi, welcome to the ehealth forum and I am glad to help you.
You seem concerned by the so many transitions between states of depression, mania, hypomania and mixed episode with the diagnosis of bipolar for the last 4 years.
Bipolar spectrum disorders are recurrent illnesses characterized by episodes of depression, hypomania, mania or the appearance of mixed states. Great variability is evident in the frequency of episode recurrence and duration. In addition to regular circannual episodes, a spectrum of cycle frequencies has been observed, from the classical rapid cycling (RC) pattern of four or more episodes per year, to those with distinct shifts of mood and activity occurring within a 24-48 h period, described as ultra-ultra rapid cycling (UURC) or ultradian cycling. Rapid cycling has a female preponderance, and occurs with greater frequency premenstrually, at the puerperium and at menopause. Tricyclic antidepressants and MAOIs, both of which increase functional monoamines norepinephrine, dopamine and serotonin, are known to precipitate mania or rapid-cycling in an estimated 20-30% of affectively ill patients. The use of mood stabilizers like lithium and sodium valproate in appropriate dosages may decrease this cycling.
Hope this addresses your query. Take care.
Note: This post is not to emphasise final diagnosis as the same cannot be made online and is aimed just to provide medical information and no treatment suggested above be taken without face to face consultation with health care professional.

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