In the past few weeks I’ve been struggling to keep up with myself. My moods, which usually last weeks, if not months, are flipping back and forth between hypomania and severe depression, leaving me feeling entirely out of control. It’s just too changeable for me to get a handle on. Above you will see a HIGHLY SCIENTIFIC graph of my pattern for the last few weeks from 22nd Feb to today. You’ll see that the highs are very mild (yes, I’m a little elated, extra productive and I feel happy to be me, but that’s it) and that I can move from just above baseline down to suicidal very quickly. The graph is too cumbersome to show exactly how fast my mood can dip, but it can be a literally matter of minutes. Somehow, despite being on the maximum dose of quetiapine, I have become a rapid cycler – and not the kind that wins medals in an Olympic velodrome.
The definition of a rapid cycler is actually anyone who has four or more acute episodes in a year, but that depends on how you interpret the phrase “acute episode” – does this mean just about noticeable others, or is an “acute” mood state one that’s severe enough to disrupt functioning? Either way, many rapid cyclers experience moods switches a lot more frequently than several times a year. Some have mood states that last just a few weeks, while others cycle every few days or even several times within a day, earning them the title “ultra rapid cyclers.” According to Bipolar UK, 10-20% of people with bipolar are rapid cyclers and a disproportionate number (70-90%) are women. Despite this there doesn’t appear to be any evidence that hormones are implicated since it’s just as prevalent among post-menopausal women.
What does all this mean for me? I really don’t know, but I am finding all this flipping back and forth extremely different. Even when I feel good, as I do today, I’m nervous. How long with it last? Is it safe to relax into this mood? It’s scary knowing that I could slide down into suicidality literally at any moment. My self-management plan has gone out of the window – why would I want to try and pull myself down out of mild hypomania today, when I was in deepest despair only last night? I have no idea what to do for the best and my psychiatrist’s not around at the moment. During the lows I am just this side of crisis. If things get worse, I guess I’ll have to present myself to the emergency duty team, which is something I really don’t want to do.
In the meantime, I know people mean well in reminding me that my periods of wanting to end my life won’t last long. That’s true. But it’s also pretty much the problem. I have a graph of where I’ve been but no map of where I’m going, and I’m scared of what tomorrow may bring.