We spent some time this morning trying to summarize the things that we would like to know about someone with mood cycles before coming up with a plan for moodsurfing.
We would like to know the answers to these questions about their moods –
Are there any seasonal patterns? Many people have characteristic shifts in mood at different times of year. A young man we have been working with for a year always got manic in September. Knowing his we were able to come up with a plan for dealing with Fall that was very successful. Often people have dips into depression in October or November, again that information allows you to manage what might otherwise be overwhelming mood cycles.
What is the sequence of mood changes? Often there is a pattern of mood shifts that allows you to predict what is likely to happen next, and also allows you to make suggestions for interventions. For instance, some people have a characteristic pattern of getting gradually depressed, and then suddenly powering out of that depression into an energized state (we call that DMI pattern). Others will get gradually energized and then, as if they “flew too close to the sun” will crash into depression (MDI pattern).
How frequently do moods change? And is that frequency changing? Early on mood cycles tend to happen less frequently, perhaps only once a year. The frequency may gradually increase (one of the reasons some people end up taking medication to prevent big episodes). And then some people go into periods of “rapid cycling” where ups and downs can become very rapid. Thyroid medication and lots of attention to regular sleep and light exposure can help.
What are the effects of interventions? What does bright light do? Does it depend on what time of year it is? How about exercise? Changing sleep – wake cycles (going from going to bed late, to getting up early)? What about medications? Diet? There is nothing that is really a pure “mood stabilizer” in the sense that that is all that it does. Knowing the detailed effects of interventions allows you to use the most effective strategy for managing your moods. For example, we were talking to a musician with bipolar moods. He noted that lithium made him slow to follow music, but it allowed him to have better long term focus. It might then be helpful if thoughts are jumping around too quickly to allow him to compose music, but might be problematic during a time when he is playing improvisational jazz with other musicians.