rapid mood cycling, depression and extreme emotions...

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so i'm having rapid mood cycling, and someone here suggested it may be Bipolar 1, but i'm pretty sure the mood cycles are (by and large) too short. i maybe get a few one that last weeks, but usually they're only for a few hours or couple minutes or even seconds. someone else has suggested it may be BPD, which really scares me - but most of the symptoms fit: the extremes of mood, the feeling of uselessness (lack of self worth, never had a job etc) and victimization (it happens a lot - the bank, the DWP, SAAS, my college, the boy racer who ran me over, everyone i've complained to about the former) - i don't want to go into it but basically everything BUT the "manipulation"/harm to others bit of BPD seems to fit...

the sensible option would be go to a shrink/GP - except i only have the energy to go if i'm not experiencing the symptoms, in which case i couldn't convey how badly they affect me or downplay how it does. Also, in the heat of the moment, i can't seem to vocalize the full extent of what i'm feeling (i wish i could).

I went to my GP a few years ago about my moods and my GP just said "it sounds like you're probably just a bit sad, everyone gets this from time to time". let me assure you, this is not being sad. I know the difference between being sad and curling up not being able to think of anything except... well, very negative thoughts.

most times, on a scale of +3 thru 0 to -3, it only dips to -1 and that i can deal with. -3 is curling up under the duvet crying and not being able to think of anything other than nearby tall buildings to jump off.

I had a relationship breakup 2 years ago (my first and currently last) and i'm still not over said person, not completely anyway. also i drink more than i should- but not all the time. not sure if it could be PTSD. who knows.


just wondered if anyone else could relate. or maybe light some shed.


EDIT: i want to point out that whenever i'm on a job (assuming i've got to the gig - the one area of work that, i least i think, i'm good with), i rarely even dip to -1 if at all. i'm usually between +2 and 0. possibly because i feel valid as a person, or because i get overload and so have no "memory/brain cycles" left for that sort of stuff....

if i ever "dip" during a gig, it's because of aspie sensory overload (assuming something hasn't gone badly wrong which makes me feel stupid or etc) - not a mood cycle

also, i recently (about a few weeks ago) i had a bash to the head after tripping over some building equipment a stupid council employee left in the middle of a public walkway (it was dark) and my head collided with something metal and solid. and i keep getting recurring raging headaches since then. I've always had mood swings but they've become more frequent since then. i also had a bash to the head 3 years ago this november (got hit by a boy racer and my head totaled his windshield and roof.)

i wish i could offer you more than the cold comfort of "it could always be much much worse." but that is about as much as this old world has to offer those of us who are hurting. the only thing that i can hold onto for my sanity [as a drowning man grasps at flotsam] are the words abraham lincoln said in a speech to the wisconsin state agricultural society in 1859-

"It is said an Eastern monarch once charged his wise men to invent him a sentence, to be ever in view, and which should be true and appropriate in all times and situations. They presented him the words: "And this, too, shall pass away." How much it expresses! How chastening in the hour of pride! -- how consoling in the depths of affliction! "And this, too, shall pass away."

That's a bit a difficult topic and I have the feeling psychiatry is not that far to answer this correctly.

I also searched for information to answer questions like this and those are the informations I found:

Bipolar:
Some researchers suggest a connection between Bipolar and Autism, but until today it is controversal. Others believe that Bipolar is not more common in autistics and this combination is overdx because of mood fluctuations in autistic.
But nevertheless, both disorders seem to be genetically related upto a certain degree.
So, until today there is no clear answer to that.


Borderline:
Marsha Linehan, a BPD researcher, who invented DBT, a therapy for ppl with BPD, believes that BDP is nothing more than an emotion disregulation disorder and nearly all diagnostic criteria would just be part of the emotion disregulation.

I also don't think that "manipulation" is a "have to" criteria and is just a maladaptive way to deal with extreme emotions for some patients.

It is still not clear what BPD actually is. Some say it's a form of PTSD, others that it's related to the bipolar spectrum.
With the right therapy, like DBT, BPD is very well treatable and usuall, once treated and the symptoms went away, there are also no relapses.
Putting all this information together, it seems to be an emotion disregulations disorder like Marsha Linhan suggests, who can be learned upto a certain degree to deal with it correctly.

I also want to point out, that PDs are made up cathegories of psychiatry to describe human behavior.


Autism and mood disregulation:
Severe mood problems are more common in ppl with ASD and seem to be up to a certain degree part of ASD. Some researchers suggest that they are comorbidities of other mood disorders such as Bipolar and/or BPD, others suggest that they are part of ASD.
Until today there is no clear answer to that.


My personal opinion on this subject is, that if they are not too extreme, that they are indeed part of ASD, because they are very common in autistics, also selfharm, emotional outbursts and so on.
Medications can help, but they can just supress the symptoms. You have to learn to handle you mood.
If this is not possible, you could check for Bipolar, but indeed, moodchanges in Bipolar are usually much longer.
There also exists ultra rapid cycling, but usually if the mood changes are very fast, it's something else and so the mood changes should be treatable through behavioral therapy.

I don't mean this in any way that belittles your problem, but instead of thinking about disorders, perhaps you should look at the stress in your life. You don't need to be mentally ill to go through emotionally unstable phases due to life events. If your struggling, which it sounds like you are, perhaps that's the cause.

I bring this up because I was depressed and suicidal for YEARS. Until I struck out and had some crazy adventures away from everything. I moved to a new state, left everything behind. Unfortunately my health got bad and I needed to go back.

When I went back, the stress in my life skyrocketed and I started getting terrifying mood swings. I seriously thought I might be BPD or Bipolar. But now I just think I'm stressed. (I've also sort of settled on depression.)

However, I've read that in Autism + BPD, there are a few things more that are commonly different. We aren't as likely to have substance abuse, and we don't understand people well enough to be truly manipulative.

When my bipolar started 6 years ago, I managed for a while until it got much much worse, but I didn't want to admit to having a mental illness. When I eventually went to the GP, and explained my concerns, I asked for a psychiatrist referral because I thought it could be more complicated than what the GP said, which was depression. He practically forced some SSRIs (antidepressants) onto me, which I later found out the hard way are not good for bipolar disorder because they can cause mood switching. So I was admitted shortly after to hospital with a massive mixed-mood psychotic episode, and still not diagnosed, but put on anti-psychotics and given early intervention for psychosis. I was starting to get back on my feet again when I abruptly stopped my medication, and was admitted to hospital with pure mania this time, and was diagnosed as bipolar I. Slowly but surely I have been getting back on track with lithium, family support, therapies and mindfulness meditation. Two years out of hospital and I have even travelled overseas for six months.

I guess moral of the story is firstly, take your mood very very seriously and get a fully professional diagnosis. Consider the value of medications seriously even though they may have nasty side effects. And don't rely solely on medications, you need a full blown management strategy. Lastly, don't try to do it alone. Work on your relationship with friends and family and ditch the useless ones.

Also, I'm sorry you hit your head - I hope you complained. I don't know whether a mild head injury without concussion will affect your mood directly, but certainly if you are worried or anxious about it and have constant headaches your moods will be affected. Best to check it out anyway (and always get a blood test before forking out for a CT scan).

Best of luck!

Borderline is more or less a mood disregulation disorder.
You have to fullfill 5 out of 9 diagnostic criteria and the general criteria for personality disorders.
There is no need to be manipulative, that's not even part of the diagnostic criteria and not even necesserally substance abuse, what's just part of one diagnostic criteria and a lot of autistics on the higher end of the spectrum use alcohol to calm down.

My opinion is, that certain borderlinebehaviour is extremly common under autistics, but that autistic ppl don't fit in the "textbook borderline description". In my opinion Borderline is nothing more than a emotional disregulation disorder. I also believe that NTs just deal different with it and that the current describtions about Borderline and what it exactly is will change.
So because of that, most of the time autistics wouldn't get the borderline lable, but just because they deal differently with emotional times in their life, but autistics are a lot more vulnerable towards emotional instable periods in their life.

To be honest, that sounds a lot like what I experience and I've been diagnosed with Bipolar 1 ultradian/ultra rapid cycling. But like others said, I would definitely recommend seeing a specialist professional (not a GP, a psychiatrist).

I've been thinking about the connection between those two conditions. Autism and BPD are often considered opposite conditions. However, this may not be completely true. Autism is my primary diagnosis, but I still fit most of the BPD criteria. BPD is often a condition that comes and goes, and is often triggered by events in your life. In this aspect it may remind of PTSD, but I don't think BPD is caused by trauma although it may be a triggering factor for the development of the condition. I'd say BPD is a mood disorder that causes disturbance in behavior and self-identity. All the other factors like substance abuse, self-harm etc are consequences of these primary symptoms.

Raziel, I agree with your view to a high degree on this issue.

BPD is considered the opposite due to the theory that BPD has a hyperfunctional theory of mind while autism is characterizes by an impaired theory of mind. This doesn't necessarily mean that BPD causes manipulative behavior. I'd say a impaired theory of mind gives a higher risk for this because when you don't understand people it's easy to consider them as objects and thus they may be manipulated if you learn to use the programming language in an efficient way. Hyperfunctional theory of mind could possible lead to insecurity and a tendency to try understanding people on a deeper level, which could lead to less manipulative behavior. (Just my thoughts about the subject.)

About rapid cycling. Last time I checked rapid cycling was defined as 4 or more episodes per year. So, I don't really see how this would be called "rapid" in any way. And then what is the even more extreme form, "ultrarapid"? I don't really like these conditions, they are poorly defined.

StevieC, your mood changes quite fast it seems. Are your episodes simply mood changes or true bipolar episodes that also lead to behavioral changes? I wouldn't say a mood change is really bipolar. Hypomania/mania should usually lead to distinct changes in behavior, plans, life-style etc.
But your condition is more directed to depression, not mania?

I may have similar mood fluctuations as you have. I may go from hypomania to rage and depression to emptiness to normal during the same day. I wouldn't say this is bipolar disorder, it's too fast for that.

So, it seems that the argument Raziel proposed concerning the similarities in mood fluctuations between BPD and autism may be accurate. These two conditions may be more similar than it has been believed so far.

There are no biological reasons that would indicate that BPD and autism could not be co-morbid.

Most of the time, i think they're just mood changes, but sometimes when i'm in an elevated mood i tend to get loads more done and have tons of ideas coursing thru my head (like when I'm working on my website) ... i dunno... its weird to explain.... I've been awake 5 hours (on GMT) and feeling a "0" right now, but it feels like a +0.5


as for the bash on the head, i did have a blackout that lasted about a minute (i couldn't see properly), and i made a very hysterical phonecall to the council - so because i complained literally less than an hour after it happened they probably didn't take it seriously (maybe they did, maybe they didn't - i don't know).


maybe it is just stress - but there's not really enough happening for it to be stress

Well, it is calles "rapid" cycling with 4 or more episodes per year, because most of the time it is less and with rapid cycling it get's more and more difficult to treat. Interestingly, usually ppl who are dx with Bipolar II experience rapidid cycling and less those who are dx with Bipolar I, but you can't say that in generall.
Some researchers suggest that there is an overlapp from Bipolar II ultra rapid cycling to BPD. I don't know if this is correct, but it's possible. 20% of ppl dx with BPD also meet the criteria for Bipolar. This rate is much higher than for any other PD. Also ppl dx with ADHD meet to a much higher degree the diagnistic criteria for BPD and Bipolar.
Espessially ADHD, BPD and Bipolar are all 3 closely connected and all 3 often go along with mood instability, impulsivity and so on.
Also, how it seems, autism, ADHD and Bipolar are connected and ppl with autism experience very often symptoms like self-harm, problems with emotion disregulation and so on.

I also want to point out:
"Fitzgerald (2005) notes that borderline personality disorder (BPD) and Asperger's can be difficult to differentiate in adulthood,
since both impair interpersonal functioning and share several features: problems with identity, impulsivity, suicidal behavior,
mood lability, feelings of emptiness, uncontrollable rage, and "transient, stress-related paranoid ideation" (p. 452)."
(Quote: Jeffrey Dahmer: His Complicated, Comorbid Psychopathologies and Treatment Implications Abigail Strubel, M.A.1, The New School Psychology Bulletin Volume 5, No. 1, 2007)

ASD also get's very often missdx with BPD. I also was once missdx with it, after I had to my ASD also a trauma, stayed on the place of my trauma, couldn't articulate myself really about it and had hudge mood fluctuations at that time.
I believe it was something different than the classical concept of BPD we have today, who seems to be still something different. But after the years I was missdx with it, I think about BPD a lot different than most ppl propably do.
This is because I was once "missdx" with it and I also met other ppl over the years who got dx with it.
Most of the time I didn't experienced them as manipulative, so I think that in every clichée there is some truth, but in this case it is way too much clichée.
I also know this feeling of too much preshure that I need certain things to be done in my way. Marsha Linehan, the BPD-researcher points out something very simmilar in ppl with BPD and believes that this added to the clichée that ppl with BPD would be manipulative all the time. Because in such situations the other person feels like it.
My old shrink felt like it most of the time, but I never lyed to her, never manipulated her, nothing, but she always thought I would and missinterpreted a lot of situations and added to the "chaos" and my suffering I had at that time.

It is actually very common that ppl who get neglected, misstreated, bullied or something simmilar show BPD-symptoms, like I did in this traumatic situation, and when you put them in a different environment they don't anymore. So it has been suggested that those ppl don't have "real Borderline", but maybe they had, but just in those situations and others just have it a lot more heavyer, so that they also develop sometimes malaptabtive coping mechanisms like substance abuse, manipulation and so on...!

I have to say, that this traumatic situation where I behaved very simmilar for nearly two years was the horror for me and sometimes I still have flash backs because of this situation back than. I can't imagine how it is to feel like this in every situation, but it must be the horror. Of course you could also call it different in my case, it is possible. But my opinion to this is that all those disorders are connected in a certain way and most researcher will tell you that they are something "complitely different", but I don't think so.
It is also not that important how you call something, as long as you know how to treat it.

Last edited by Raziel on 18 Oct 2012, 12:02 pm, edited 5 times in total.

If I were you, I would ask for behavioural therapy if this is possible.

If you blacked out even for a second or two and are having headaches please go to the doctor,you could have some swelling of the brain.I have Bi-polar 2 and it can take awhile to get a diagnosis,you need to see a therapist regularly so they can observe your symptoms ,they don't usually give you one right off.

Do you think it's possible that your head injury would cause the mood swings? That may happen after serious head trauma, but in your case it wasn't that serious, I presume? But you did blackout, so it could be something related to that? (But that is not really my area of expertise, so I don't know.)

StevieC, may I ask why you think the autistic sensory overload is not the same thing as mood fluctuations? I would say they are the same. The underlying cause may not be the same as bipolar disorder or BPD, but it's still affecting your mood.

"but sometimes when i'm in an elevated mood i tend to get loads more done and have tons of ideas coursing thru my head (like when I'm working on my website)"
Looks like you are able to enjoy the benefits of hypomania to some degree, but I don't know if regular "happy mood" causes the same effect.

Yes, "just" to be autistic could be "too much stress" so that a specialist for ASD would be the right choise to go to.

Often the medical health care doesn't know how to treat it. That is the problem. You may have many different diagnosis but the treatment is still the same for every one of those.

Raziel, I would think BPD and ultrarapid cycling would overlap but doesn't mean they are linked together. Actually, most of the psychiatric disorders overlap in some way. Most of the diagnosis are poorly defined and they are just terms that has been made up in order to describe different conditions. They are rarely based on scientific studies, only on "how it looks like".

I'm not sure about it.
It's not like I would have one opinion about it I'm 100% shure of.
I just read studies about it and know ppl. dx with those disorders and out of my own experience, that's all.

I found here a study about it: Differential diagnosis of bipolar affective disorder type II and borderline personality disorder: analysis of the affective dimension.

and here: Bipolar and Borderline Personality Disorder
Are Bipolar and Borderline Personality Disorder Related?

I think that that those disorders are mostly different, but still even to a higher degreee overlapping than research thought in the past.