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    How is Rapid Cycling Diagnosed/Determined?
    BipolarDisorder2 posted:
    Hey guys

    So this goes out to any more experienced Bipolar patients than me (and that is essentially all of you); how is rapid cycling diagnosed/determined? Myself and a good friend of mine have a strong suspcion I am a rapid cycler, but my psychiatrist won't give me any feedback as to what his specific diagnosis was (as far as type) or what he thinks about me being a rapid cycler, so I'm kind of left to figure it out myself right now.

    Thanks muchly!
    BipolarDisorder2 responded:
    I am also asking because I am considering asking for a specific medication that is supposed to be responded well to by rapid cyclers at my psych appointment Tuesday, but I kind of want a better idea first.
    Joseph F Goldberg, MD responded:
    Dear BipolarDisorder2, rapid cycling means having a full manic/hypomanic or depressive episode 4 or more times in a year. episodes are separated -- not just one long episode that waxes and wanes. rapid cycling has nothing to do with mood swings alone. it is fairly rare -- about 10 % of people with bipolar disorder. unfortunately it has no specific treatment. Dr. G.
    BipolarDisorder2 replied to Joseph F Goldberg, MD's response:
    Dr. G= Greatest. Thing. Ever. Thank you!! I get more answers and feedback and all that stuff from you than I do from my own that a bad thing? LOL
    BipolarDisorder2 replied to BipolarDisorder2's response:
    Dr. G: Is there a specific tactic I should use (wording or other) when reqesting meds from my psych? Like I want a prescription for a generic Ativan cos anxiety is still a huge issue in my life, and always has been...He tried BuSpar alone for me, but it made me manic for 4 days and I didn't sleep. Do you know of anything else that would help, or ideas for dosages of Ativan? I'm on 600mg of Lithium right now and it is likely that will continue. I'm working off the Ativan my MD gave me 8 months ago so I can have I think a pill and a half (I think it's a 1mg pill but I can break it to be .5) every 4-6 hours as needed.
    IrwinsLady replied to BipolarDisorder2's response:
    im a true rapis cycler and it stinks but im not on any specific medication for it.
    The voices in my head and my 2 imaginary friends got into a fight and I had to break it up by hitting my head on the wall and telling then CALM YOUR ASSES DOWN! ( my friend posted this on fb)
    Joseph F Goldberg, MD replied to BipolarDisorder2's response:
    Dear BipolarDiisorder2, I think it is the doctotr's job to recommend medicines to the patient, not the patient's job to request specific medicines from the doctor. Dr. G. n
    BipolarDisorder2 replied to Joseph F Goldberg, MD's response:
    I'm all for him recommending to me, but I'm still part of a treatment team, and I think it's within the patient right to ask to be put on something, given we have a rationale for it. He can of course tell me no, and why, but I don't see an issue with saying "Hey, I read about this med, and I have this condition that it treats, what do you think?"

    I don't boss him or tell him what to put me on, but I do sometimes make suggestions or ask about meds, and he will tell me yes or no, at least most of the time. He's old school so I don't get a ton of feedback period.

    Mostly I just get handed a prescription and get told to take medication. That doesn't work for me. I want to know what the drug is, why I'm gonna be on it, how long it takes to work, the top 3 side effects (the big ones you should worry about) and that kind of thing.

    I don't have huge faith in my psychiatrist right now anyway- he put me on BuSpar for anxiety 3 weeks ago and it sent me manic for the entire 4 days I was on it...even though I told him about the symptoms I was having and how awful it was, he continued to insist that I keep taking it.

    I'm properly medicated on Lithium now, but that's just an example of some issues that we have had regarding meds and properly treating me, which is why I intend to ask questions more often now and ask for a rationale of treatment. I'm putting chemicals in my body that alter my brain, I have a right to know what his plan is. That's my point
    Joseph F Goldberg, MD replied to BipolarDisorder2's response:
    I would think of treatment as informed consent. the doctor's job is to provide a diagnosis and explanation to best make sense of the problems a patient describes, then outline the options for treatment, including the relative pros and cons of a particular approach, and the alternatives. i agree that if a doctor does not spontaneously offer sufficient information, it is wise to ppress for enough detail to be able to make an informed decision. Similarly, surgery patients should make sure they understand what the surgeon proposes to do, and why; but the patient isn't in much of a position to advise the surgeon on what instruments to use and where to cut (even if the patient is by coincidence himself a surgeon too!). Dr. G.
    BipolarDisorder2 replied to Joseph F Goldberg, MD's response:
    I'm pretty much saying the same thing you are, LOL Maybe I come off more aggressive than I mean to (I am a pretty aggressisve person, LOL), but yeah. I'm not trying to tell him what to put me on, but I'm tired of just being told 'here, take this' and that's it, and then when I do ask questions, not getting a response from my psych.

    That doesn't involve me in my treatment, it's like he's keeping information I'm entitled to as a patient, and as the recipient of care, a big huge mysterious secret. I feel left out and I don't like it.

    But no, I don't plan on ever advising him on medication choices, cos I don't know much about meds, other than what I'm taking (I research the meds I do take extensively). But like you said, I do want to have the options and rationales described to me,and to be as informed as I feel I need to be/can be. You said it, Dr. G I wish you were my psychiatrist....
    nopoin replied to BipolarDisorder2's response:
    May Trigger Some...........................................................................

    BIPOLAR DISORDER2>>>> Don't mess with the medicines
    I know first hands I have done it more than once, Part because I thought I only needed them part time, and also thought that I could mentally be able to live with out having to take them 4 times a day. I learned the hard way 2 weeks ago when I was told by my counselor that I needed to go to the er and then to the crisis center. At first I didn't think I needed to, but I went. I found out later that day in the ER. how bad I had gotten, I sat in my ER examination room and cut on my arm with a coke can. I spent the next 6 days in the crisis center, I had a hard time being there and admitting the reasons i was not taking all my medicines and how I wanted to harm myself cause I couldn't take life centered around medicines 4 times a day. Well I have been out 2 weeks now and I can tell you when they change your dosage or all together change your meds while your in a short term crisis center, Life gets more manageable toady I'm done to 3 meds a day. Remember it's always your choice to be informed on what meds your putting into your body. I'm having more good days than bad ones. keep trying things will get better, or get a second opinion.

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