What Is Rapid Cycling Bipolar Disorder, And How Do I Manage It?

Rapid cycling in bipolar disorder occurs when a person experiences four or more manic, depressive, or combined episodes in a twelve-month period. Bipolar disorder itself is chronic, but rapid cycling is usually a relatively short-term phenomenon. 

Anyone with bipolar disorder can enter a period of rapid cycling, though some factors make it more likely, such as an early onset (before 17 years old) and type II diagnosis.

Characteristics of bipolar disorder

Bipolar disorder is a mood disorder characterized by highs, called mania, and lows, or periods of depression. There are two primary types of bipolar disorder, and rapid cycling can happen to those living with either one.

Bipolar I disorder

Bipolar I disorder is potentially the most recognizable form of bipolar disorder, largely because the episodes of mania and depression it causes are quite prominent and intrusive. Less than half of people with bipolar disorder are diagnosed with type 1 bipolar disorder.

Bipolar II disorder

In bipolar disorder type 2, the highs don’t reach the heights of mania that occur in bipolar type 1—instead, people experience what’s called hypomania. People with bipolar disorder type 2 are still susceptible to periods of highs and lows, but they often experience depressive symptoms more frequently and severely than hypomanic symptoms.

Characteristics of rapid cycling in bipolar disorder

The impact of rapid cycling in bipolar disorder looks a little different depending on which type of bipolar disorder a person has. Those with bipolar I disorder have shifts between episodes of mania, deep depression, and even combined episodes. People with bipolar II disorder, however, experience shifts between major depression and hypomania, a less severe form of mania. 

Regardless of the type of bipolar disorder, rapid cycling can be tough to manage. You may feel euphoric one week and weighed down by depression the next. The rollercoaster you might find yourself on during rapid cycling episodes can be emotionally and physically exhausting. It often makes navigating things like relationships, work, and school extremely difficult.

Who is likely to experience rapid cycling?

Researchers have conducted studies to identify what makes someone at risk of developing rapid cycling in bipolar disorder. Some studies have found that individuals are more likely to develop rapid cycling patterns when diagnosed with bipolar disorder at or around the age of 17 or younger. Other studies have also found that people with type 2 bipolar disorder and those assigned female at birth may be at higher risk of developing rapid cycling symptoms. 

Additionally, individuals who stop taking medications for bipolar disorder may be more likely to experience rapid cycling. There is also an established connection between alcohol and drug use and increased mood shifts. Finally, rapid cycling in bipolar disorder is thought to have a stronger association with disruptions to circadian rhythms than other forms of mental illness. 

Resolution of rapid cycling in bipolar disorder

Rapid cycling symptoms usually improve with treatment; in fact, many patients find that one to two years of consistent care can make a significant difference. While all the symptoms of bipolar disorder itself may not disappear entirely, the frequent and tumultuous changes that rapid cycling can cause may be subdued with the right treatment plan.

Learning to live with rapid cycling in bipolar disorder

There are many ways to manage the symptoms associated with rapid cycling in bipolar disorder. Perhaps the most obvious and potentially essential way to get started is by seeking medical advice from a mental health professional. Working with a team can help you address your needs and provide the support you need to begin to see change. 

There are also some things you can do to help yourself right from the comfort of your own home. It can be helpful, for instance, to have people around you that you trust to offer support when needed, such as reaching out on your behalf when your symptoms prevent you from doing so.

Medication 

The psychiatric community has long accepted that anticonvulsants are one of the best treatments for bipolar disorder, including rapid cycling bipolar disorder. Studies have found that a combination of different medications can also be helpful for reducing symptoms, though it may take several months for change to become obvious. 

Medications for rapid cycling in bipolar disorder include mood stabilizers and antipsychotics. Mood stabilizers can alleviate the effects of mood shifts and help prevent future episodes. Antipsychotics can address mood symptoms and also reduce symptoms of psychosis—such as delusions, hallucinations, and disorganized thinking—that can arise during severe episodes of mania and depression. It’s best to talk to your doctor about whether and which medication may be part of an effective treatment plan for you.

Psychotherapy

Talk therapy is a common component of treatment plans for rapid cycling bipolar disorder, regardless of what other steps you take to manage your symptoms. Cognitive behavioral therapy and mindfulness-based therapy, for instance, can help you recognize symptoms and adjust your thinking and behavior to compensate for mood changes. While you may not be able to control your rapid cycling bipolar disorder, with the help of a therapist, you may be able to exert some control over your reaction to them.

In many cases, convenient treatment options like online therapy can make it easier to find a professional who understands your experiences. Being able to meet with a therapist through the web means you won’t need to leave your home to receive the support you need, and may also allow you to more consistently participate in sessions.

Not only is online therapy convenient and affordable, but it’s also been shown to be a successful way to manage mental health symptoms, including those from bipolar disorder. A systematic review of studies focused on the effectiveness of online cognitive behavioral therapy found that it can lead to significant decreases in anxiety and depression symptoms. It was also found to be just as effective as in-person therapy for treating other mental health symptoms, including those related to panic disorder and PTSD.