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Mixed state....rapid cycling
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Mixed state....rapid cycling

I was just wondering about mixed states and how that works. I am in a very low period right now. This morning, I am at work but that is after three separate crying jags and the faint desire to drive into a brick wall. At the same time, I am getting agoraphobic tendencies.....I am aggressive and or irritable...I am all over the place. My pdoc wants me to do some research and tell him what I think I am.....he gave me hints of course...saying I am rapid cycling...but ....my GP had said bipolar 2....but it feels like it is getting worse...alot worse....what exactly is mixed state feel like?

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I cannot believe that your pdoc is asking you to do research in order to self diagnose yourself - that is terrible - he is the professional, he is the one who should have all the research in his head - he should be diagnosing you.

A mixed state can vary from person to person and is not the same as rapid cycling.  A mixed state is difficult to describe, personally I get a feeling that I have masses of energy bubbling inside of me but I'm also feeling aggressive and melancholy at the same time, I lurch from one task to another never completing them and not doing a very good job of the ones I started.  Rapid cycling is where you go from one feeling to another, from happy to depressed, to angry, to crying, to euphoric, back to melancholy etc this can happen within a few minutes or within a few hours and is very difficult to deal with - I hate it.

Have you been started on any mood stabilizers yet?
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573297_tn?1304712740
Hi, thanks for the reply. Yes, I have been on lithium for 10 months already. I am on effexor as well from my GP but my pdoc is taking me off effexor because he hates it for bipolar but I am having a terrible time of that.....and he is boosting up the lamictal that he put me on a month ago.

I feel like I am rapid cycling for sure. He says he knows what I am but wants me to do the research. I just want the friggin dx although I can see that won't help me know if I am coming or going.

Is it just me, once I got on the pills and if I miss a day, I am a hundred times worse than what I was before I started it all.....I mean I lived with Bipolar for a long time....before medication.....

Now, I am doing so well on the outside world they don't know what is going on on in the inside and I am having a hard time finding help. I am still working a full time job, juggling my son's football schedule and dealing with his issues as well (he is going for his assessment to pdoc next week so that he can start school with a clear idea as to what is going on with him).So people think I have it all together....but I really don't. I feel like I am falling apart one stitch at a time....is letting go.
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I know exactly where you are coming from, I sometimes think my whole life is one great big PRETEND.  I also think I am worse now when I don't take a tablet whereas I did survive before medication, but then I did hit a point where I was no longer "bouncing back".

I think a lot of people on here will agree that some ignorant people think we are somehow faking it because we can at times appear so "normal" on the outside, but they don't know the turmoil going on inside and how that erupts in the privacy of our own homes/thoughts.

It sounds like you could really do with something that will help with the rapid cycling, I'm not sure what meds are good to take alongside the lithium, I think seroquel is one.  I don't know what your home situation is, but would it be possible for you to stop work or go part-time.  I only say this because I found that giving up work reduced so much stress.  Stress is such a big indicator in BP symptoms.  It does mean that financially things can get difficult but the stress of that is far easier than the stress of holding down a job and pretending I was ok when I wasn't and having to cover up mistakes I'd made because I wasn't functioning right.  Some things can't be changed, ie, looking after children etc so try and remove the stressors that you can.  If you're not in a position to give up or cut down on work then I would suggest posting another question and asking others how they cope with work etc.

I wonder if your pdoc just wants to hear you acknowledge that you know what i wrong???  When you see him say "I am def rapid cycling and experiencing mixed state and I need help".  Also keep a mood diary, I find this helps, not just to track my moods but also to vent my feelings.  It's also good to look back on and see whether I've improved.  The tracker on here doesn't allow for rapid cycling tracking so its worth keeping a separate one for that.  

Has the lithium helped in any way do you think?  If not it could be that you need to change the mood stabilizer as well.

I'm always here if you need to talk, vent etc.  I know what its like being a mom and trying to hold it together.  Take care.
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573297_tn?1304712740
Thank you SO MUCH....that is exactly what I am doing....pretending....that i am fine, that I am happy, that I sometimes despise those who's lives seem so happy and easy and of course they have easy lives because....fill in the blank.....

I am a single mom. I am in the process of getting permenancy in the federal government. If I don't win this competition and get in, I won't have benefits for my pills and so on. I am hoping to get in ....they have a great disability plan!!! But if I don't win, I made this secret pact with myself that I will go on ODSP again....which is the government (like welfare) but I have been on it before for fibromyalgia. Because I don't think I can take the stress of losing and trying something all over again. Work is a big stressor for me...I am through an agency where I do not get paid if I don't go...and it is very hard to go some days!

The lithium did help yes....I felt it almost...but I don't know about the lamictal...I don't feel that is helping whatsoever....maybe depakote would help. I read that was great with mixed state and rapid cycling. IF my pdoc wants me to research (and your theory could be right) he will see I will research everything....

I was keeping a journal but when I reread it I felt insane! I worried about myself too much and sounded insane!

Thanks so much for your advice though.....keep it coming.....
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Keep going with the journal!  I know sometimes I read back through mine and can't believe it was me that wrote it!  I really hope you manage to get the permanency thing (I'm sorry, not coming from the US I don't understand about that) but if you don't then yes go on the ODSP, it wont be for ever.  I was on depakote and to be honest that didn't help with the rapid cycling, it slowed it down but it didn't stop it enough so now I take tegratol and so far so good - Lamictal is a new drug, whereas tegratol has been around for yonks.  Agency work is so hard, like you say not getting paid if you don't go in and you need the knowledge of having a certain amount of money each week.  I was so glad when I was able to claim disability it has made a big difference not having to work.

Oh and don't feel angry at those that appear "normal", bp and other mental illnesses are prevalent in the majority of society and I bet half of those you look at are also pretending!    The ones I hate are those that try and tell me to get on with it, go get a job there's nothing wrong with me I'm just lazy blah blah - now those people I really hate!!!  How I would love to be able to work full time in the career I trained for and still be there for my kids evenings and weekends, but I feel like a bad actor on the stage of life and I can't keep up the pretence.

How soon will you know about the permanency?  Oh and ring your pdoc to let him know you really are reaching the end of your tether and see if you can get to see him sooner.
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573297_tn?1304712740
I will know in about three to four weeks. It is torture...It is like doing dead time in prison! I hate this job by the way. And my boss does not understand when you miss work. AT ALL! He almost fired me. I was able to prove myself again...but I think he still has the first impression in mind.

My parents are the ones that don't understand ....even though my father has bipolar 1...he self medicates ...with cocaine, crack and any sort of pill and booze he can get his hands on. Right at this moment, he is doing well....but he has an overnight job so I am worried about him. I know that is hard for him and plus he is 56....he isn't 20 anymore!

My mom says that I used to be so strong and what happened. The talk with her was unbelievably stressful and then I had a stressful fight with my boyfriend when he told me that I have to appreciate that it is hard to be with me.

What are your triggers? Mine so far is noise, repeating myself, and criticism....I can't handle whether it is constructive or not. I haven't figured out all of them....but those are the major ones.
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It can be hard when family members don't understand.  My parents knew I was "fragile" (as they put it) but they were shocked when they discovered quite how bad I was.  Friends have always assumed I was the strong one and its almost as if they feel betrayed that I'm not the person they thought I was.  I was always the strong one in my marriage as well and that has meant a period of massive adjustment for my husband, because I can no longer do strong.  I'm sorry to hear about your dad, that must be horrid to see that, but if he won't acknowledge he has a recognizable problem there isn't much you can do - which is even harder I know.

I do appreciate that it must be real hard to live with me but as I say to my husband "you know where the door is if you can't handle it" (not the best advice I know).  At the end of the day we haven't chosen to be like this, we didn't wake up one morning and think, hey I think I'll live a rollercoaster life and be happy one minute and **** the next.

My triggers - noise! (and I have 4 kids), people talking to me (I can no longer pretend to be interested in stuff Im not interested in), criticism (I cry or get really angry), people disagreeing with me, inability to make decisions, too much going on in one day, not being allowed to sleep when I want/need to, people asking me why I'm in a mood!! mess - the list could go on and on.  To be honest almost everything is a trigger nowadays and I don't know from one day to the next what thing is going to trigger me, ie, one day the house can be a mad noisy place and I'm happy to join in, the next day the slightest noise above a whisper and I jump down peoples throats, I'm so inconsistent its scary, I'm unreliable because i never know from one day to the next how i'm going to feel.  The tegratol has stopped the rapid cycling during the one day time frame but hasnt yet touched the day to day cycling but I know that the pdoc will be upping the dose when I next see her as she said she was starting me on a low dose to avoid side effects.

I'm far to sensitive to other peoples moods as well, a bit chameleon like in a way.

Boy, that went on a long time. :-)
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573297_tn?1304712740
YES...decisions, decisions, decisions! I can't even decide what flavour of chip I want and sometimes people are kind of pushing me to make a decision saying things like it won't affect my life forever, we're starving...just pick something, it isn't rocket science.....the pressure to make a decision is overwhelming.

My pdoc told me to check out the book Bipolar Disorder for Dummies....nice....anyway, there isn't one friggin store in Ottawa, Ontario, Canada that has this friggin book. I had to order it! I bought the Bipolar Workbook, and I like it.....but....it isn't always easy to apply these "everyone kind of behaviour".

I am also inconsistent in one day to the next. My mother in fact doesn't think I have anything wrong with me because I laugh at comedies!!!!!! Hello!!!!

I was known as being so strong....now I am known as "ultra sensitive"!

Thanks for your support. Doesn't it mean more when there are others like you and you don't feel like you are crazy.....to feel this way....cause we aren't crazy.....we just feel like we are going there awfully fast!
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212753_tn?1275076711
I just started to follow your  thread.
Please keep you thryoid checked .Lithium will destroy  the thyroid.
Also has your doc tested your thyroid? Wonky thyroids will mimic bi polar symptoms.
Most docs outside of of endocricnologists dont know that the new standard for TSH level is between .3  and 3.0.
A  personal opinion though, I am of the feeling that everyone is different  at different levels. I am at .1 for cancer supression and I feel pretty good.
The same with our head meds, everyone is different and your doc cant just prescribe your "med of the month".with no followup to the right professional .

And as sad as it is we almost do have to diagnose ourselves.
I  just stopped seeing my endo for my thyroidlessness.I have been seeing him for almost 2 years.So when he told me I was testing high for diabetes I believed him.
Then I got to calling around and checking The American Association for Diabetes web site . I am so normal with my blood sugar and I am so upset with the endo.I now wonder if he has been doing my thyroid right .So as my hubby is retired Air Force,we have insurance  where my proimary care facility is the base hospital close to my home and work. and put my primary care doc in charge of everything.for my physical needs.

So now that I have rambled on here.Just keep coming here.We can help you through this.Message me anytime if you want to talk some more.
Love Venora
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483818_tn?1232688372
this is a lot to read, so i havent read it all.. but this is exactly why i dont want to be on these meds... they had me on effexor, not long afteri started them i was having the most vivid and scarey dreams... i wouldwake up like i didnt sleep and like everything that happened in my dreams was real... after that i wanted nothingto do with pills, gettig off of those wasnt very good, i got really depressed, but now i am on nothing, i dont want to be on anything, i am labelled as not wanting to get btter, but that is not the case... I just dont want to be on mes, i want to lern to cope by myself... i think i chose the smart path when i decided no meds was good for me... i mean ya i have some major problems and i d et a little crazy, but i am actually learning to control it so people dont see how i actually feel... i can control the tears so noone knows how bad i want to cry... i think getting off all meds was the best decision i could have made... no sure if others agree, but i am doing my best to cope on my own...
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212753_tn?1275076711
I was the same way whne they put me on luvox. Horrible nightmares . I went right to my doc and told him you gotta put me something else. I still think of luvox as evil but it may work for others.
if you can beat bi polar on your own that is great.I have found in my bi polar experience that healthy diet,regular rest, exercise, meds and therapy work great for me and several others thaqt I know with bi polar. I also take vitamins and some herbal supplements.
Google Julie Fast. She has a web site that teaches you how to deal with bi polar without meds.
Keep coming here too and we will help you get through your bi polar times.
Love Venora
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573297_tn?1304712740
Hi, I actually have congenital hypothyroidism...so my thyroid is getting checked monthly along with my lithium! I hate blood tests too...when I was a kid, they couldn't get any from my veins in my arms, and started taking the blood from my temple!!!
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212753_tn?1275076711
wow so you know whereof I speak. Hypo hell bites. Do you ever get over to the thyroid forum?

My question has always been what came first? The bi polar or the thyroid probs?
I will never know why since I am throidless and bi polar.
OMG did you just freak out when they tried to take the blood from your temple?
Love Venora
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573297_tn?1304712740
Hi, yes I did and I would never take a blood test again without fear! Even to this day I despise getting one.

I was born with a thyroid that didn't work at all...not even a little bit...it is still there but doesn't carry it's weight so to speak....as a child I was convinced that my eltroxin tasted like bananas!!!!LOL

I talked to my son's pediatrician....who used to be my doctor...and he said it would be the thyroid....because when I went to him I had been diagnosed with fibromyalgia....and so he used the analogy of the body being a house and one thing breaks so because that isn't working well it causes something else to malfunction and so on...I thought that was the best example myself!!!
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573297_tn?1304712740
No, I have never seen the thyroid forum...could you send the link to me or whatever?
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You are probably having these issues because you are being weaned off Effexor. My psychiatrist warned me that this can happen; even missing a day's dose can have this effect.
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hey! I just read that you are in Ottawa, too. Odds are slim, but do you see Dr. Anderson by chance? I have him and I feel like he is useless. I have a 4month old and I've been rapid cycling like crazy including mixed states and I'm on Lithium and Effexor and he keeps telling me it's probably just hormones. He knows I haven't had blood work done since December because I lost my blood req and he didn't give me another one. He knows I don't like taking the meds I am on, but he hasn't suggested alternatives... blah. I'm moving back to Kingston soon, and I am so glad. I hope I can find a better psychiatrist there. Good luck to you with sorting things out!
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212753_tn?1275076711
go to forums at the top of the medhelp page and scroll down to the patient to patient side and left click on thryoid disorders.
There is a great bunch of folks over there. They have got me through the worst stuff with my thryoid cancer,the treatment and hypohell.
Tell em Venora sent ya.
Vee
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573297_tn?1304712740
Hi, no I don't see Dr Anderson, I see Dr Cattan. He might actually be growing on me....a little bit anyway...lol... where is Dr Anderson located?

Hi Venora, I will do that....thanks...
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596143_tn?1226651654
Wow, I learned a lot from that discussion.  long discussion!! Ha!  Someone mentioned noise being a trigger.  I'm soooo glad you said that.  I keep telling my husband that noises bother me.  He hates when I ask him to turn stuff down.  He didn't believe that noises could make you in a bad mood.  My anxiety goes crazy when I hear loud noises, different noises at the same time.  Also, another trigger is movement.  If their is alot of different fast movement i get upset. Example-my babies going fast in different directions, my dog following me, my husband trying to talk to me over the tv, the telephone ringing, noises outside---and all this at the same time, not one after the other.
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439168_tn?1307935340
It's horrible. I'm going through increased rapid cycling bouts now. I hate it. Makes me want to end my life. I won't due to my religious beliefs. I love my family too much. But when I get manic, it's like a devil or monster is inside of me. All reasoning goes out the window. I am really excited. I can't control my behavior or my thoughts. That scares me. And it keeps me in my house. Then I eventually get exhausted, then depressed. Then really depressed. Then I want to sleep...then it starts all over again the next day. It's terrible. Terrible. Sometimes I will rapid cycle in a matter of minutes. I will be normal, then something switches in my brain, like I'm possessed. And I become mega *B*. I'm anxious, snippy, loud, inappropriate, rude...complete disregard for others feelings....Sometimes, I can be really excited, have a lot of energy, can't stop moving....figeting, super happy, I can do anything...and then in a minute or so, I come down off that....and either feel bad about what I did or just slump into a depression. It's terrible.

You feel alone and trapped when this happens.

Ash
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Hey there!  I was diagnosed with BP3 - the new one, which is the mixed state version of BP - it's hell in a handbasket. I can be up and cheery one minute - then hit that anxiety wall - then have thoughts of ways I could indirectly die.  I was told these are passive suicidal thoughts, and I have had them for years.I was told that Lithium was not a good drug for this and can make your hypomanic states worse.  I was put on Lithium when I was 16 - and totally denied I was BP, and a shrink told me I wasn't either as an adult.  I turned into a droolling idiot with tremors with exactly the same symptoms of depression and hypomania when I was a teen, and ended up getting very physically ill, so I took myself off the drug, and almost had to emacipate from my parents as they threatened to hospitalize me.  In the end I felt better off that drug, but I should have been switched to better drugs, instead I didn't get any help at all.

At 25, I fell into a deep depression, went to my doc's, who started me on Luvox, and that pooped out after 4 yrs..so started my drug yo yo, where each drug would only last a finite period of time.  My last one, Cymbalta, threw me into a massive Hypomanic episode with severe suicidal thoughts, and I was planning my own death. I luckily had a moment of clarity and walked into my local hospital, where I stayed for 4 days, until my symptoms eased and they figured I wouldn't hurt myself, which I wouldn't do now. I know have an awesome shrink and a mental health team whom are there at a moment's notice.
This rapid cycling is viscious, down right awful..and every day is completely different.  I have just been weaned off Cymbalta, sister drug to Effexor, and have spent a week in pure hell.. even though I was down to just a few grains.(.it took me a month)  My pdoc gave me some ativan to ease me through it.. and thank god.. or I would be worse then I am. The physical symptoms of BP alone are bad,  but getting off that drug has magnified it even more.
I am now on 75mgs of Serequel and just started Lamactil - 12.5 mgs.  The Serequel helps with the anxiety.. but I still have break through anxiety like today, and it's overwhelming..  my head is spinning and my stomach is soo upset.

I hope this help that others are gong through this too..and can offer suggestions.


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