Mood stabilers for cyclothymia

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Can mood stabilisers reduce the amount of hypomanic moods you might get?
They're the only time I really feel genuinely happy so I'm only on anti depressants to avoid losing that. But it looks like I'm going to be on meds long term now and anti downers seem to speed up my mood swings which is embarrassing when I'm around people.
I feel like I'm going to have a breakdown in public sometimes because it's too sudden and strong then I isolate myself again.

It feels weird accepting you're never going to be 'normal'. I always assumed once I was on anti downers that worked my moods would be like normal people's moods, but thats the same as seeing as a cure after all I guess...

Disclamier: My experiences are unusual and I was given unethical treatment.


Sure, If you don't mind the horrid side effects. I have cyclothymia. I am no longer on meds. I was on Geodon for years, I didn't have any hypo-manic moods on it. Of course it's hard to have a hypo-manic mood when you are practically comatose for 14 hours a day. I was a teen at the time and didn't have a say in my treatment, but after most of my teen years asleep and failing multiple classes, I finality convinced my Dr that I needed something else. I tried Abilfy, but it made me dizzy and made me feel numb emotionally. I was unable to feel any emotion, good or bad, it was like my mind was imprisoned. I couldn't even feel enjoyment from my special interest anymore.

After I became an adult, I reused to see that Dr, and I not taken a single psychiatric med since. I still feel the roller coaster, but it so much better than the alternative.

Yes, if a mood stabilizer works properly with your individual chemistry, it should eliminate both hypomania/mania and depression. Many bipolar individuals find it hard to eliminate their hypomania since it is often such a pleasurable experience. However, being on anti-depressants alone, without a mood stabilizer, is very risky. Anti-depressants are notorious for inducing hypomania/mania and rapid cycling. Since it seems like you're experiencing both of these, I advise that you talk with your doctor about mood stabilizers. Hopefully, he/she will be able to help you manage your moods. If you stay on just an anti-depressant, you may end up not having only hypomania. There is always a chance that anti-depressants could induce a full-blown manic episode in you, making you have a more severe form of bipolar disorder.

From what I've read, mood stabilisers tend to stop (hypo)manic moods more than they do depressive moods, but they should have an effect on both. Obviously that's different for each person and the many various meds out there.

Well I already get severely depressed and paranoid as it is. I don't want to lose the little bit that makes life worth some of that pain.

I haven't been hypomanic for over a year and a half by what I can tell. I get some slight hyper moods, but mostly it's going up and down on a much lower level.
Talking to my mom she said it is more often like I'm going from hypomanic to normal happy, up and down loads like that.
And when I'm on the other end it's going from severe depression to numb/normal sad.
My actual normal stages are not common at all.

But it's not like I go from depression to hypomania often. When ever I actually get hypomanic I can live normally. Despite my huge goals and excessive activity and lack of sleep and annoying people. All of which are fine by me.

My mood swings are more from going between motivated and slightly hyper and active, to severely depressed.

They're not too worried it'll go to bipolar yet, but I'm worried I will get more mixed episodes where I'm more likely to commit suicide within 5 minutes of onset (it's happened before, it's horrible).
If it means losing the hypomania then forget it. I'm going to die someday I'd rather it not happen at a time I completely eliminated the chance to be happy before. At least right now I can tell myself I might feel better.

Besides, it might be another 4 years before I see the rigth kind of professional as I'm having all sorts of trouble.
The GPs have lost my last 2 years of medical records.
My psychiatrist said I didn't have depression.
My psychologist finally got rid of me when I was feeling a bit happier.
The people who were supposed to give me an autism assessment mistook me for over 25 (I'm 20, not sure how they make that kind of mistake) and after 7 months waiting, cancelled my appointment wrongly and left no contact detail and didn't send the information to any other relevant professionals...
And I can't get through to the counselling service the GPs are telling me to try.

It gets tiring just thinking about it...

By definition, to be classified as cyclothymic, you have to continuously cycle between dysthymia and hypomania every 2-3 days. If there's a period of normal mood for longer than 2 months, the mood disorder doesn't fit the DSM-IV criteria for cyclothymia. It sounds more like you're bipolar II than cyclothymic. You're having full-blown depressive episodes along with hypomanic episodes, and the depression comes much more frequently than the hypomania.

I am not bipolar (my mood swings are all AS-related), so I can only imagine how hard it must be to yearn for a spurt of hypomania to feel truly happy. However, I understand what you're going through as far as losing hope in the doctors, as I have been down that road with my OCD many a time. Psychiatric medications being all trial and error at this point in science is very discouraging when you feel awful and are suffering. I still would encourage you to try and see a psychiatrist about mood stabilizers and/or to monitor your condition while on an anti-depressant alone. Lamictal is a good mood stabilizer for bipolar-II depression, and it tends to have low side effects. There is always the risk of the Stevens-Johnson rash, but Lamictal doesn't tend to cause weight gain or some other horrible side effects of psych medications. I took Lamictal myself for a while (my psychiatrist thought I might be cyclothymic before we found out about AS, even though I knew I wasn't), and I personally had a low side effect profile. Everyone's different, but it doesn't get as bad a reputation as some other meds out there. Whatever you decide to do, I wish you the best and hope you feel better soon.

I've never had a normal mood for months if I'm honest. But it's not like I'm near insane all the time.
It's interesting that people who meet me in one stage think the other stage is really strange and can't get used to it, which implies they're different enough for people to notice. Although I'm used to most of it... I just gets a bit much when it's swapping too frequently and the chances of a mixed episode is closer.
I' have thought my depression makes it seem more like bipolar but only the GPs have Dx me, and they've just put cyclothymia and depression. Which could pretty much be the same as bipolar II but I think GPs feel more comfortable with such a diagnosis than Bipolar, and I'm thankful for that as no one is pushing mood stabilisers to me yet. It has only been mentioned once.

Because my hypomanic moods are so functional they agree with me that they don't seem to be anything of a problem.
The Psych Drs are rightly more interested in treating me than diagnosing me. So again, for once I can't complain about this side of the Drs actions, if I'm honest.

I've been trying to get in touch with a counselling team for a few months now, when they interview me I am fairly certain they'll say counselling isn't enough for me, if they don't then, they will after a few sessions, as is usually the case. I just have to work from the bottom up again. So it could take over a year to finally see a psychiatrist again, and I don't want to be with a psychiatrist only, I want some kind of actual therapy as well. As my first and only psychiatrist I saw 3 times, he kept having me see his GP trainees, and when he saw me he just had a mood and acted childishly before saying if my meds didn't work I shouldn't come back. Then wrote that I wasn't depressed.
You'd think a psychiatrist would know a possible cyclothymiac might react less well to his series of antidepressants as unipolar depressives. But apparently not.

Thanks for the encouragement.
Thankfully I'm underweight, so the 'problem' of weight gain never bothered me, although I've never had it with any of my meds so far, so I might just be generally immune to weight gain!
I'll try to remember the name of that should things get worse and I need a starting point for sure.

Um, sounds very much like Bipolar Type 2 because:

You have severe mood swings. If other random people are noticing and thinking (what the hell?) then you have a mood disorder.
Also, you are are describing severe depressions where you even have some paranoia.
You describe hypomanic moods where you are just very productive but are not disabling.
Sometimes people with mood disorders don't really have a good idea what "normal" moods are. (I know I sure don't)
Anti-depressants can be great for treating depression, however they will worsen mood cycling if you are prone to it.

Lamotrigine (Lamictal) seems to be a first choice med for this stuff, if you haven't tried others.

I really hope you find a decent psychiatrist--that often seems to be the hardest part.

I have mood cycles with bad months in February, May, August and November. This pattern has been the same for over 30 years. Currently the best shot medical guess is that it's atypical cluster migraine, because in the bad months I get many migraine symptoms without a particularly painful headache. It's manageable but pretty weird. I've always put it down to neuroatypicality.

Last edited by rosewood on 21 May 2012, 2:38 am, edited 1 time in total.

Well my dr said she doesn't think its anything like that because she hasn't seen any fluctuation. Although any mood swings have been swift and mild. The most of a high mood I get are racing thoughts and paranoia in addition to my depression. Yay..

Then again, said Dr said she needed 'evidence' of my 'wanting to get better' by showing more motivation, before she'd be inclined to fully help with ESA. Even though the worse symptom of depression for me is lack of motivation. So maybe she's just being like a normal Dr now. Normally they're not too helpful but as she was new she wasn't fairly different.

And Rosewood, I have near constant dull headaches, but they get sort of 'colder' for lack of better words, at certain times. I attribute it to barometric pressure changes. It's a pain in the ass but I don't think it's migraine worthy so my Drs won't care. The most I get is vertigo and if I move from sitting down or turn around, or rarely if I look to the side, I get temporarily blinded with white and my head hurts more.
Don't know if it links with my mood much, can't say I've noticed a correlation, but it's not often I'm without a headache of some sort so I guess I usually ignore it.

That is interesting though.

The body is odd. =/

That's what my bad months are like. I have a headache of some sort nearly all the time and find it very hard to concentrate. On some days I wake up in the morning with the symptoms of a hangover, though I rarely drink alcohol and even then it's typically a small glass of wine with a meal.

I agree ... the body is *very* odd.

Taking anti-depressants without a mood stabiliser made me seriously ill, continuous rapid cycling for about a year with mixed episodes from hell. Since I've been on mood stabilisers I don't get mixed episodes, I don't get hypomania either but I don't really miss it because I tended to get dysphoric manias with aggression and irritability more than euphoric hypomania where you actually feel good, and if it started that way it'd go horrible after a couple of days anyway. I have more problems with depression than mania but I'm on 2 mood stabilisers which are particularly good for depression (lamotrigine and quetiapine, which is an antipsychotic but also a good mood stabiliser and helps with my sleep). When I added quetiapine (Seroquel) last year it was like a light being switched on, I now actually have good times without the problems of hypomania where I actually feel "normally" happy. A couple of years ago I never thought that would happen. Being on the wrong meds can really mess you up, it took me about 5 years and trying 7 different meds in various combinations to get it really under control to the point where I can actually contemplate having a life now but it was worth it.

That's encouraging.
My ex is taking Seroquel and prozac or something, for depression and anxiety.
My drs only have me on 40mg of citalopram and are saying they haven't seen any recent fluctuations in mood so mood stabilisers aren't an option. (This is the new dr who hasn't seen anything to suggest I have the mood swings other drs have seen.)
I like my highs anyway. I just don't like the mixed episodes. But it does feel like I'm only 'happy' when I'm hypomanic, which in a way means I'm only happy when I'm unwell... it makes me wonder how much of my mood swings are me and how much are me being unwell. it's hard to tell what are normal moods for yourself when you're comparing them to normal moods of people nothing like you.
Maybe instead of seeing this as a disorder I can just see it as me, and some thing I might want to change to make life easier, but it doesn't have to mean all symptoms of the disorder are wrong. If I like them I guess it's fine to consider them a part of me.
It just makes it more difficult to treat. Maybe.

Dr's here seem reluctant to mix drugs. They just keep trying to swap me between ciltalopram and fluoxetine.
If I want anything else I need a psychiatrist and they suck and take ages to get in contact with.
I'm going to ask my GP to refer me to one soon though.

I feel kinda ok on these, but I felt kinda ok without them if I'm honest. I just noticed I wasn't doing basic things to take care of myself. And I've started using the judge of whether I do it at least half the week, and if not, how hard it is to do so, or how bad it is.
And so far, I'm getting out of bed and washing just under half of the week, consistently.
It takes great effort to eat one thing a day. And I spend most my time in my room.
I try to go out 2 times a week so that I at least do the basic things those days but with my money running out that will stop soon and it's questionable whether these meds are helping enough for me to actually be able to carry on without that commitment to going out when the money runs out.

I don't feel particularly sad, I'm just suspicious, and volatile lately. And constantly worried and guilty. And I always have nightmares. But I don't normally make a big fuss about those things, although considering the above, I don't think the drugs are working a huge amount. *shrugs*

Yeah, I'm just rambling..

I love it when people mention "normal mood". I mean, how do you judge that? Based on past experience? I have no idea what normal mood is supposed to feel like, so I don't even know what I'm aiming for with my meds. I'll settle for them stopping me thinking about suicide when I get stressed. I am not cyclothemic (ad far as I know) but rather have emotional dysregulation (according to psych) and am on the mood staniliser lamotrigine.

It's so true. Part of dealing with mental health requires trying to find yourself outside of the 'health and illness' categories, and that mainly relies on perception. It's important to pay attention to the terms we use and forget to consider the actual meaning of.
=.= It's a process I'm constantly working on.

Not a great source, but, Wikipedia says this;

I did think emotional dysregulation sounded very broad. It's probably a better kind of label though, if it allows treatment to be more flexible or you don't fit into some categories.
I don't think my Drs know such a term, because they keep changing my treatment (I doubt they ever have thought of making a treatment plan, they just swap and change then give up, blame me and wonder why I go for a while). They often say I don't seem to neatly fit any of their categories; maybe that kind of word would be of use to them.

I've gone past the point of wanting a label from them, because it wouldn't feel like an answer.

Yeah, I don't know what "normal mood" is but I think what is being described is "appropriate emotional response to stimuli". Of course, I don't know how the heck you are supposed to judge that. My moods just sort of happen. I have tried to have therapy where they try to tell you to look for triggers before a mood episode. The best I can seem to do is take my meds regularly and count how much sleep I am getting. I am also sensitive to feedback where different people (not the same one) suggest I have "problems". Unfortunately, this can make my mood disorder difficult to treat.