MDJunction - People Helping People
Ask a Question
09/02/2011 10:15 PM

Bipolar I vs. Bipolar II and Rapid Cycling

Posts: 10

Okay, I have no clue if I am Bipolar I or II. I didn't get diagnosed until I was 45 years old, which tends to support a Bipolar II diagnosis. However, I have been told that I am a rapid cycler, which means I have more than 4 manic episodes a year. I have had more than 4 in a month, which is just not fun as you get older. I have taken Lithium for the last three and half years with marvelous results. However, the 6.5 years before that was a myriad of medications with disastrous results. Nothing worked and the side effects were horrid.

Additionally, before I was 45 I was treated only for depression, which at times could be extreme. I started having suicidal thoughts in my early 20s, but covered them up and denied that I had them for years. My first hospitalization was when I was 45, three more followed until I was placed on Lithium.

The things I remember the most about my manic episodes were the all-nighters where I couldn't sleep and (most of the time) super cleaned the house, talking at super speed, thinking even faster, speeding when I drove and feeling like I was in absolute control of the car, being bouncy (literally skipping sometimes when I walked), and as I got older more and more intense shopping sprees. I still stay up late when I am upset, as I am today.

I don't know which of the 2 categories my symptoms fit into, but I will be forever grateful for Lithium and the doctors who decided to put me on it finally.


09/02/2011 10:24 PM

That you found lithium is wonderful. I don't know about the difference between I and II, but your hypomania, if that's what it has been decided, sounds pretty bright an intense to me. I've been an Eeyore for years it seems.

Welcome here. I'm new, too.

09/02/2011 10:31 PM

The biggest thing is having the proper treatment. Also, I wouldn't get too attached to a specific diagnosis since the DSM-V is looming in the distance. I don't know the full extent of the changes in there, but there will be some significant changes.

09/03/2011 08:37 AM

A big warm welcome to MDJunction and to the group Bluesunshine! We are glad to have you!This is a wonderful place for support of both bipolar I and II. Please make yourself at home and browse around the different forums. Be sure to check out the lounge section as we have several " light" and "fun" threads over there. We also have an " anyone awake" thread that is a chat thread that goes pretty much 24/7.

I have some thoughts on what you posted and here they are:

I agree with JennyT. The most important thing is you get treatment for your symptoms.

I was misdiagnosed for 10 years with major depression. It wasn't until I was diagnosed with bipolar II and put on a mood stabilizer that my depression improved. I am sorry it took so long for your to get a proper diagnosis but like we have said the most important thing is the treatment of your symptoms. Good luck to you!

09/03/2011 07:09 PM
Posts: 10

Thanks everyone for your input and comments, much appreciated. How do you get all these things with the quotes, meds, and comments below your posts. They look like they are permanent.

09/03/2011 08:02 PM
Posts: 14312
Group Leader
I'm an Advocate

BlueSunshine, To put the "signature" stuff appearing below our posts:

On your profile page, go into settings, then into forum signature.

09/03/2011 08:38 PM
Posts: 10

Thank you for the information . I hope I did it right.

09/03/2011 09:01 PM
Posts: 14312
Group Leader
I'm an Advocate

Hi BlueSunshine,

Welcome to MDJ. It's nice to meet you. I am not a doctor and am not trying to diagnose you. I thought I might be able to provide a little information about Bipolar Disorder and Rapid-Cycling that might be helpful to you.

The main thing that distinguishes Bipolar I from Bipolar II is mania, or the manic episode. Only Bipolar I's have manias or manic episodes. So if you've been told you have bona fide manias, you are a Bipolar I. (A true mania usually requires hospitalization.)

Bipolar II's have hypomanias or hypomanic episodes. Bipolar II's never have a manic episode, only hypomanic epsisodes. Hypomanic episodes are similar to manic episodes, just not as severe. This is NOT to say Bipolar II is a less severe form of Bipolar Disorder. In fact, research indicates it is a very different kind of bipolar disorder.

Both Bipolar I's and Bipolar II's can experience very severe major depressions. Only Bipolar I's have what are called "mixed" states. (Bipolar II's have them too, although they are coded differently in the DSM-IV-TR diagnostic system.)

The term Rapid-Cycling, is actually a very precise diagnostic term, according to the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision).

"Rapid cycling" is defined as:

"At least 4 or more episodes of a mood disturbance in the previous 12 months that meet the criteria for a Major Depressive, Manic, Mixed, or Hypomanic Episode.

NOTE: Episodes are demarcated either by partial or full remission for at least 2 months or a switch to an episode of opposite polarity (e.g., Major Depressive Episode to Manic Episode)."

What this means:

1. Daily, weekly, monthly mood fluctuations are NOT rapid-cycling.

2. Each "cycle" must meet the diagnostic criteria for that kind of diagnosis. In other words, a cycle of depression requires at least 2 weeks of depression to diagnose. A cycle of mania requires at least 1 week to diagnose. Hypomanic requires at least 4 days. Mixed requires at least 1 week.

3. There is a minimum of 2 months that separates the episodes.

4. During the 2 months or more of separation, the mood disturbance is in partial or full remission or has switched to opposite polarity (i.e. gone from manic to depressed).

In other words, a "cycle" may consist of mood states other than mania. It is not possible to distinguish one mood cycle from another in less than about a 10-week period, due to the 2 months that must separate one mood cycle from the other.

Hope this has been helpful.

Post edited by: sarahtroy, at: 09/03/2011 09:05 PM

09/04/2011 09:14 AM
Posts: 1313
Senior Member

I wanted to add something... I am bipolar I and have never been hospitalized for my manias, I have had psychotic episodes too but never hospitalized for them. I guess no one knew enough or thought they were bad enough to go, they were also before I understood the seriousness of this illness.

I was however hospitalized just once for depression... I dont think it was helpful enough for me to ever go back though.


Share this discussion with your friends:

Disclaimer: The information provided in MDJunction is not a replacement for medical diagnosis, treatment, or professional medical advice.
In case of EMERGENCY call 911 or 1.800.273.TALK (8255) to the National Suicide Prevention Lifeline. Read more.
Contact Us | About Us
Copyright (c) 2006-2014 All Rights Reserved