Before we talk about rapid cycling bipolar disorder, let’s define bipolar cycling in general...

Bipolar disorder is a mood disorder that is characterized by mood cycling between depression and an elevated state known as mania or hypomania, depending on the severity. Bipolar used to be referred to as “manic depression.” In reality, you only need one manic episode to be diagnosed with the condition, even if you don’t have the corresponding depression.

Depressive episodes can be characterized by:

• Low mood for most of the day

• Taking little pleasure in normal activities

• Increase or decrease in appetite

• Sleeping too much or insomnia

• Feelings of worthlessness of guilt

• Difficulty thinking or concentrating

• Suicidal thoughts

Mania, by contrast, is an elevated mood that can be characterized by:

• Grandiosity

• Little need for sleep

• Rapid speech

• Racing thoughts

• Risky behavior

• Psychosis

Like mania, hypomania is an elevated mood state but it’s less severe. Someone with mania might engage in promiscuous sex or fly across the globe on a whim. Someone with hypomania might stay up all night cleaning their kitchen until it sparkles.

Like many mental illnesses, bipolar cycling is a spectrum, so the line between hypomania and mania can be a bit blurry. People with mania or mania and depression have Bipolar I. People with hypomania and depression have Bipolar II.

(There’s also a type of bipolar cycling called a mixed episode or mixed mania.)

Back to Rapid Cycling Bipolar—What Is It Exactly?

Most people with bipolar disorder alternate between long stretches of depression and (hypo)mania. For example, they may have depression for months or years at a time.

With rapid cycling bipolar, a person experiences four episodes of mood cycling in one year. This could include any combination of mania, mixed mania, hypomania, or depression. Usually these shifts take place over the course of weeks or months, but some psychiatrists report having patients who can experience shifts lasting just a few days.

It is estimated that 12 to 24% of patients at mood disorder clinics have rapid cycling bipolar, so mood cycling of this sort is a fairly common thing. It also explains the pop reference to someone whose mood goes up and down or back and forth as “bipolar,” even if they don’t technically have the diagnosis.

Rapid Cycling Bipolar Disorder Can Be More Difficult to Treat

Bipolar cycling in general is a difficult condition to treat. In many people with mood cycling, antidepressants can actually cause mania, so bringing them out of a depressive state is not as simple as prescribing Prozac.

With rapid cycling bipolar, just when you think you’ve gotten one mood under control, you find yourself dealing with the opposite, and your whole strategy has to change. It can be very exhausting for bipolar sufferers and their loved ones to constantly be in a back or forth with their moods.

Rapid Cycling Bipolar Usually Requires Medication and Therapy

Some people are able to address their depressive symptoms through therapy and lifestyle changes alone. If you think you have rapid cycling bipolar, however, there’s a good chance you will need medications to manage your mood cycling long term, in addition to making healthy changes like sleeping at consistent times and exercising.

People with rapid cycling bipolar disorder need to become “mood cycling ninjas.” They need to recognize early signs of depression or (hypo)mania and be able to adjust their lifestyle accordingly.

Therapy can help you identify warning signs and come up with a game plan that involves your closest loved ones. While this may not completely prevent a mood episode, responding quickly and with care can make your depression or (hypo)mania less severe while preventing some of the long-term consequences.

For example, a client with bipolar II may have a pattern of overspending when hypomanic. In therapy, this client would learn to recognize the early signs of his or her hypomania, like talking quickly and intently researching potential purchases online.

This client and his or her therapist would come up with a game plan. This might include the client giving any bank cards to his or her spouse, being more careful to go to bed and wake up at set times, and avoiding high-pressure situations that might further elevate the client’s mood.

The therapist can provide feedback if the client seems to be headed into a mood episode. The therapist can also keep the client accountable to the game plan. Most of the time, if we see a client struggling with depression or (hypo)mania we will also have them contact their psychiatrist just to keep that professional in the loop as well.

Get in Touch to Get a Game Plan in Place Today

If you’re struggling with untreated bipolar disorder, the best thing you can do is contact a therapist. We’ll help you develop tools to deal with your mood disorder, and we can refer you to additional resources if needed. Contact us today at (760) 283-7000 to get started.