Literature on this Version of Ultra Rapid Cycling?
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Q:  Literature on this Version of Ultra Rapid Cycling?

I have been diagnosed Bipolar I and recently sought treatment after an(other) acute manic episode. I am also a clinician – the worst for seeking treatment always! I am now 41 y/o (f) and have been bipolar and ADHD since approximately age 15 but have always dealt with what I consider to be ‘normal’ (for me). I have functioned very well obtaining numerous degrees and successes in my endeavors. Unlike virtually all clinical presentations, my baseline is hypomania and I have never experienced depression. The question I have is in reference to rapid cycling. I experience ultra ultra rapid cycling during acute mania, but it is 2-3 times in a 5-10 minute period which will last until severely medicated. Is there any literature on this presentation? Thank you.

Dear N' -- 
"Ultradian" cycling is the term I've seen, coming from the NIMH, used to describe cycling greater than once in  24 hours.  But very little has been published on that phenomenon that I've seen.  Your version is just one more variation of the "ultra's" I've heard described to me by patients, although it's really ultra!  However, your baseline "hypomania", which you'll see referred to in the literature as "hyperthymic temperament", though there's not much on that either, might be part of the reason why your experience is as it is:  Dr. Hagop Akiskal, whose group has published on the phenomenon of temperament and how it predicts to some degree the kind of mania people experience, has associated hyperthymic temperament with euphoric mania (as opposed to dysphoric).  

Dr. Phelps

Published January, 2004


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