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Lloyd I. Sederer, MD Headshot

Rapid Cycling Bipolar Disorder: In The Office And On 'The Street'

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RAPID CYCLING BIPOLAR DISORDER
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Rapid cycling bipolar disorder is a turbulent and psychologically painful condition characterized by four or more major mood shifts in the course of a year (sometimes even in a week). Moods go up or down in this condition and are demarcated by a rapid switch to a state of the opposite polarity. Rapid cycling states can come at any time, and are known to appear and disappear.

Rapid cycling bipolar disorder is perilously vulnerable to outside influences, notably both those that are troubling and deleterious or, alternatively, uplifting and beneficial. Stressful events are famous for precipitating shifts into low or high states of mind. The condition begs for a stable environment and a predictable and reliable future.

This disorder is notoriously difficult to treat. Among the remedies used are mood stabilizers, anti-convulsants and anti-psychotics(!). When one intervention fails, as often happens, another is piled on; then another. In some tragic cases, all this effort is to no avail. In other cases, where the cycling abates, the myriad of interventions leaves little clue as to which one may have made a difference.

Lives are put in shambles, families rendered asunder, workplaces disrupted and resources dangerously stretched when rapid cycle bipolar disorder sets in and affects individuals and their communities.

Rapid cycling is typically associated with a poorer longer-term prognosis. One cycle, up or down, seems to trigger another, and another. The more cycles there are, the more likely another cycle will explode upon the scene leaving those affected thunderstruck and anxious as to whether they will ever escape the condition's grip. Over time, hope can fade. Over time, resources dwindle. With little to live on and scarce opportunity for a better future individuals may have little choice but to rely upon government entitlement programs.

You might think I am talking about my business, psychiatry, where we recognize a condition with these features and call it "rapid cycling bipolar disorder." But, instead, as I tuned into relentless media reports coming from Wall Street to Tokyo all this past week, I started wondering about the equity markets -- and our societies. What we are witnessing seems to meet all the diagnostic criteria for rapid cycling bipolar disorder. Without effective interventions, reductions in stress and a good dose of hope (see "Raising the Hope Ceiling") the prognosis is not good. We need a game changer for this condition wherever it may appear.

www.askdrlloyd.com
The opinions expressed here are solely my own as a psychiatrist and public health advocate. I receive no support from any pharmaceutical or device company.

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