This is an old post but I will go ahead and comment. I do agree that inpatient care is needed most of the time when mania or chronic depression hits. Staying on the meds is also important but more often than not it is a tendency to stop the meds completely which I do a lot. I am back on my Seroquel now and it is really helping.
This is the first time I had attempted to "come down" off a manic episode without inpatient hospitalization. It is so much harder that I thought it would be. After spending time with people I feel energized with feelings of playfulness and connectedness, and then I feel kind-of down and awful. Also, the meds are strong and I hate feeling pulled down by Zyprexa and lithium. I would encourage all to 1) take lithium or mood stabilizer so that you do not become manic and 2)go to the hospital if others are telling you you need to be there, you need to be there. Going it alone as an outpatient is incredibly difficult and not so good.
I think the rapid cycling is what I was having right before I went manic. I think the depressive mania you are talking about is like a mixed state...I think it is also called disphoric mania...maybe??? It does help just to be able to talk to others that can relate to these issues. I sometimes feel very alone in my struggles, and talking to others that can understand helps me to feel not so alone. I know I am trying to take it easy...I went and pampered myself a bit today and got out of the house and it helped me feel better. Everyone needs a break sometimes. :-)