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Cyclothymia?  

post #1 of 11
Thread Starter 
As anyone else here been diagnosed as such? I'm interested in two things: 1) How was it explained to you? Like, was it considered related to bipolar or simply something different. And 2) What has worked to help manage it?

My new doc thinks that this is what has been going on with me, just the hypomania tends to end up in a very irritable state. She is actually fantastic about breastfeeding - told me she would definitely not ask me to stop, asked whether my toddler was nursing at night without considering it a problem. Just a cool lady. Based on the nursing thing she recommends trying an AD as long as I come to her with any change in energy/sleep. If nursing wasn't a question than she would prefer Lamictal.

I'm having a very difficult time deciding whether to try to meds. We worked out that I could take it around dinner and (since my babe doesn't night nurse) and that the peak would be passed by nusring time in the am. But I'm still worried. At the same time I kind of terrified myself last fall and I'm afraid that I have been getting worse over the last 20 years of my life. I don't want to make my kids lives bad because I can't handle myself.

Thanks.
post #2 of 11
I was informally diagnosed with cyclothymia while I was in the nuthouse after my suicide attempt. It was explained as a less severe version of Bi-Polar Disorder, and when I checked the DSM, it pretty much confirmed that explanation.

As it turns out, I have Bi-Polar Type II (in my manic phase I'm extremely irritable), and I'm taking Lamictal (Lamotrigine) to control it.

Good luck.
post #3 of 11
Thread Starter 
Do you mind a few more questions?

Does the Lamictal work well for you? My doc really felt that would have been the best first choice if nursing were not part of the picture. I have been on ADs before and had good experiences but I think I have gotten worse over time.

I'm having a really hard time with the idea that this is any form of bipolar. I've had this illusion for years and years that this was situational, that eventually I would find a way to just be happy. And because I haven't been able to tell anyone close to me how bad I have felt at times I am finding that I am getting a lot of "Oh, it's not that bad, are you sure this doctor knows what she is talking about?" So I'm either making things up because I can't handle life or I can't handle life because I am ill to the point it frightens me. Either way I feel bad about myself and either way I feel terrible about being a bad mom to my kids.
post #4 of 11
This is going to be kind of long... sorry.

I felt the same way as you about this illness for a long time. I thought that if I worked hard enough I could fix it, because it seemed to be situational. I believed my mother and sister when they said I could just suck it up and deal with it if I really wanted to. There were times when I convinced myself that I was just too lazy to be a functional member of society. I didn't recognize my manic phases for what they were, because I thought manic meant the euphoria of BP Type I, so I kept being diagnosed with depression or dysthymia (which is to Major Depression what Cyclothymia is to Bi-Polar).

I refused medication for a long, long time. A few years ago I gave in and started seeing a Psychopharmacologist because the depression was getting so bad that I was bursting into tears for no reason at least once a day. She put me on two antidepressants: Welbutrin and Zoloft. The Zoloft gave me extreme physical side-effects (decrease in muscle control was the big one), so I stopped taking it (gradually). The Welbutrin made me feel emotionally numb, which would make me depressed ("this medicine is supposed to help, but I can't enjoy life when I'm on it... what's wrong with me?"), and the med would kick in and make me numb, and so on. After a few months, I stopped taking the Welbutrin, too, because it wasn't helping. I used my enlistment in the Air Force as an excuse to stop seeing the doctor.

In the six months after I stopped seeing the doctor, I was discharged from the AF because of my psychological issues, I attempted suicide by ODing on my leftover antidepressants, and I was involuntarily committed for about a month. Welcome to rock bottom. It took me about two years before I could trust myself not to try to kill myself with meds again, and I called the doctor. When I told her how I'd passed the last few years, she changed her diagnosis from dysthymia to Bi-Polar Type II. She put me on Lamictal (it took a few weeks to step up to a 200mg/day dose) in October, and I've seen a remarkable change.

Living with BP is like building on sand... no matter how nice a house you build, the foundation is always going to be shifting, and the whole thing might fall down at any moment. With Lamictal, for me anyway, it's like moving that house from sand to stone. The foundation is rock-solid, so I can spend more time working on the house itself.

A lot of the day-to-day stress is situational, and you can learn to deal with it by spending some time in therapy. I've found that the therapy is much more effective now that I'm on Lamictal, because I'm not worried that the next mood swing might undo all the good of the therapy. I can focus on dealing with the situational stuff, and I feel a lot healthier.

My doctor also gave me some Zyprexa (Olanzapine), to take as I need it (which has averaged out to about once a month). It's an anti-psychotic that I take when my brain is racing and I can't sleep. It's very, very strong (I take a half-dose because the full dose knocks me out for about 20 hours), and extremely effective for the times when my mind is running in circles... the same thoughts over and over and over, getting faster and faster. You probably won't need it, and it's not something you should take while breastfeeding, but I figured I would toss it out there. You can ask your doctor if there's a less potent alternative, if you're troubled by racing thoughts.

Whew... sorry that was so long. As you can tell, I have no problem telling people about my experience with mental illness and medications, so ask all the questions you want.
post #5 of 11
Lilith > What IS IT with us bipolar types that continue to try to fix ourselves? - or is it one of those typical stumbling blocks for people with mental illnesses in general?
Anyway, I can relate to a lot that both you ladies are saying. Im new to the dignosis of bipolar and have read a little about cyclo (wondering if THats what the problem is) since it's not that my cycles match any of the 'typcial' mania and depression cycles.
It is very very difficult to 'get over' myself and accept that i have been working to better myself thru many ways,for many years, and it's not that ive failed or not tried hard enough- It JUST MAY BE that all of my best efforts have been short circuited by my ill-prepared brain----by no doing of my own.
I am not sure of that. but I am sure i can not go on trying harder, looking for the 'right' supplement to go with the 'right' modality and the 'right' lifestyle while my life falls apart and I wonder whether my family would be better with me gone and could they eventually forget me and manage to heal and Why cant i just be completely suicidal and not just have 'thoughts' ???
I am on 750 mg of depakote and 125 effexor waiting for the next increase. so far so good.
~L
post #6 of 11
Quote:
Originally Posted by LilithParker
Living with BP is like building on sand... no matter how nice a house you build, the foundation is always going to be shifting, and the whole thing might fall down at any moment. With Lamictal, for me anyway, it's like moving that house from sand to stone. The foundation is rock-solid, so I can spend more time working on the house itself.

A lot of the day-to-day stress is situational, and you can learn to deal with it by spending some time in therapy. I've found that the therapy is much more effective now that I'm on Lamictal, because I'm not worried that the next mood swing might undo all the good of the therapy. I can focus on dealing with the situational stuff, and I feel a lot healthier.
Yes, yes, yes!!! That is it exactly, Lilith! You explained how I feel about meds sooooooo much clearer, and beautifully, than I ever could.

My drug-of-choice is Depakote, which is actually (relatively) compatible with bfing (there are no known or reported side effects, although, as always, if possible, it's better to avoid introducing psychotropics to a developing brain - but getting you sane and keeping your kid bf'd is way more important!).

And yes, cyclothymia is on the Bipolar Disorder spectrum. It was my initial diagnosis as well (I was still so sick I couldn't let on how sick I was I've since been diagnosed with BP type II). It runs in families; someone with cyclothymia is more likely to have BPI or II relatives, including they can "pass it on" to their children (fortunately, we can also "pass on" how to live with it well ).

I also want to encourage you, Chickadee, to be careful adding an anti-depressant - in many people on the bp spectrum, it can make us go way over to the manic or psychotic end, even if we've never been there before. (Actually, that can happen to Unipolar Depressives, too, but it's more likely to happen if you already have a known tendency toward any kind of mania.) There are mood stabilizers, such as Depakote, that don't have that side effect, and are compatible with bfing, that maybe should be considered in addition to - or even instead of - a straight antidepressant.. (Not saying that that's right for you, just letting you know there are options.)

And hon, feeling like this:
Quote:
So I'm either making things up because I can't handle life or I can't handle life because I am ill to the point it frightens me. Either way I feel bad about myself and either way I feel terrible about being a bad mom to my kids.
is just ("just!" hah!) a symptom of the disease. I know I'm getting really bad when I start thinking that I am too weak, too stupid, too lame, too whatever, to live a sane, productive life, rather than that this disease that I have makes it difficult (but not impossible!!) to be happy and healthy.

And like Lilith said (have I mentioned recently how much I love what you said?), the meds just help the foundation of the life you're trying to build - eventually you're gonna have to work on the house itself. But first things first, let's get that foundation stabilized and solid, and then you can work on everything else - that's where the "right" supplements and modalities of treatment come in.

So to answer your second question, the things that have helped me (after the meds gave them a solid foundation on which to work) were, in no particular order;
  • getting regular amounts of sleep (I need 8-9/day, no more, no less, and I'm kind of dreading what's going to happen to that when I have a kid...), and getting up at the same time every day (that's even more important than when you go to bed).
  • Omega-3 fish oil supplements (I'm currently on 2g/day)
  • eating organic, and eating enough protein (I don't know why that matters, but it does, to me)
  • regular medical massage therapy - I've been getting a massage from an amazing body/energy worker every 2-3 weeks for the past two years, and it's not just a luxury (although it is luxurious ), it's really a medical/mental health necessity for me.
  • weekly psychotherapy, with a great guy who understands the "paradox" that bp is both a chemical disorder and a result of (or rather, is triggered/aggravated by) screwed up thinking, and who's helped me move into living in the "now," rather than obsessing about the past or the future, both of which were severe symptoms of my disease
  • regular sun exposure (I'm not so good at this one, but man does it help when I do)
  • exercise (ditto)
  • meditation (ditto again )
  • not talking about the disease with people who aren't going to be helpful about it, and talking about it openly with everyone else (until they prove they're going to fall in the first category) - this, actually, I think is one of the most important things I've done, so I'll say it again:
  • be completely open and honest about my disease, just as I would about, say, having cancer, or a broken bone, or any "socially acceptable" medical condition. BP disorder, in my experience, and particularly depression, is a darkness- and pain-loving creature. The more I bring it into the light, and the more I let it know that its mere existence cannot cause me pain, the less power over me it has (and the less pain and darkness it can bring into my life). I learned many years ago that the first symptom of an oncoming depression was a lack of desire to discuss, or even acknowledge, my disease - and conversely, the more often I was able to push pass that extreme hesitancy, the less severe and the shorter the impending depression would be.

Wow, I think I may have managed to outdo LilithParker for length. (Without near the beauty of her metaphors, alas.) I hope you may glean something of use out of all this.

post #7 of 11
Arwyn, thank you so much for your praise! Your list of suggestions is right on.

Quote:
getting regular amounts of sleep (I need 8-9/day, no more, no less, and I'm kind of dreading what's going to happen to that when I have a kid...), and getting up at the same time every day (that's even more important than when you go to bed)
This is part of building that good foundation... your body needs a regular schedule and the right amount of rest to function properly.

Quote:
eating organic, and eating enough protein (I don't know why that matters, but it does, to me)
Protein helps your brain function. When my doc started me on Lamictal, she ordered me to eat enough protein to equal the size of a deck of cards every day. That works out to a burger or a can of tuna, and it saves me from having to read labels and do math to figure out whether I'm getting enough of the good stuff.

Quote:
regular sun exposure (I'm not so good at this one, but man does it help when I do)
If you've heard of Seasonal Affective Disorder, think of BP/Cyclothymia as having similar qualities. Exposure to sunlight wakes us up and improves our moods. It's cloudy here today, so I'm a bit "blah," but I can recognize that and compensate. I do some of my favorite things on cloudy days (take photographs, play with my dog, visit friends) to make up for the depressed feeling the clouds bring.

And with that, I'm off to therapy. Thanks again, Arwyn, for your kind words.
post #8 of 11
Thread Starter 
Thank you all so much for your honest responses!

I'm sorry to have started this and just disappeared. I somehow missed a notification in my email about this thread so I didn't realize there was a whole discussion happening. I alos was avoiding the whole topic. I started feeling so overwhelmed that I just couldn't handle any of it. And then I spent some time out in the sun and started sleeping and eating more and suddenly I'm relatively normal mom again. It is as though some door just closes and I can't imagine what I was having trouble with before. So now it all seems obvious, I was just down and now I am not. No need for drugs, just a temporary thing, right?

Except somewhere in my mind there is this sinking feeling that tells me it will come around again. Because it always does. And all the fresh starts I've made will end up on the list of things I can't accomplish.

I spent some more time with my psychiatrist. She says she hears a lot of different things in what I tell her, a lot of anxiety and depression, a nice dose of obsessive thought, an apparent cyclical quality to it all. She doesn't think that there is any full out mania and she still feels that an AD is the place to start. She is less interested in the precise labels and more in which tools help the condition. I now have a bottle of Zoloft sitting in my kitchen cabinet but I can't get it in my mouth. My fear is that starting those pills is leaving something behind, a sign that I will never change on my own. So I'll meet her in another two weeks to see if I've gotten any farther.

I want to say that I truly appreciate the things that you have all written. Lilith, I think I find your words threatening, but only because they are honest and ring true for me and part of me doesn't want that to be the case. You would think that after 20 years of mood disorder I would be willing to move forward in treatment but I seem to be struggling so much with it all. But I want you all to know that I have heard and am absorbing the tips and support and it has all been of help to me.
post #9 of 11
This is hard, huh? Just know that you're not alone - a lot of us have gone through this before, and unfortunately, a lot more will follow. At the same time, your particular situation, your own disease course, you, are unique.

Quote:
Originally Posted by Chickadee
I now have a bottle of Zoloft sitting in my kitchen cabinet but I can't get it in my mouth. My fear is that starting those pills is leaving something behind, a sign that I will never change on my own.
That's an understandable fear, and I don't know many (some, but not many) people who have gone on psychotropics who didn't feel that way, but it's not true. You leave nothing behind but the disease; it gives you a chance to change. And, going on the drugs now does not mean you'll be on them forever. Let me repeat: if you start the drugs now, you are taking them for now, not forever. At a later "now," you will always have a choice of going off them again (when it's appropriate, and in a way that's appropriate!).

I was on Zoloft (in addition to the Depakote) for about 9 months, because I needed it - at the time. But then I didn't anymore, and I got off of it (too quickly, but that's another story). Now I'm getting off the Depakote, which has helped me for the past 4.5 years, because it's no longer appropriate that I be on it (baby makin' is safer off it, don'tcha know. ). Maybe later I'll go back on it - but that's later, not now. "Now" is the only time you have any control over, so "now" is the only time you should be worrying about!

"Now" would be a good time to go start your meds and start getting better, don't you think?
post #10 of 11
Quote:
Originally Posted by Chickadee
Lilith, I think I find your words threatening, but only because they are honest and ring true for me and part of me doesn't want that to be the case. You would think that after 20 years of mood disorder I would be willing to move forward in treatment but I seem to be struggling so much with it all. But I want you all to know that I have heard and am absorbing the tips and support and it has all been of help to me.
It may take some time, but eventually this illness will seem a lot less scary. As Arwyn said, taking medication now doesn't mean you'll have to take it forever. Think of it as a trial period... if you don't like who you are when you're on the meds, you don't have to keep taking them (but remember to lower your Zoloft dose gradually if you want to stop taking it).
post #11 of 11
Thread Starter 
This is just a little update. I was doing well and then went waaaay back down again last week. Basically I can't handle any stress without just collapsing. I saw the psychiatrist at the beginning of the week and she offered me a short hospital stay in order to get me on meds. I declined and we worked out a deal where I have someone give me the AD once a day until I get a little more stable. My hope is that this works so that I don't get into drugs I would need to wean my daughter while on.

Thanks for being so encouraging. I'm really trying to get through life 24 hours at a time right now. I expect it will still be a week or so before knowing if I'm even tolerating the AD as I we are starting very low and working up.
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