Frequently Asked Questions About Rapid Cycling In Bipolar Disorder

Rapid cycling refers to a pattern of unusually frequent mood swings between mania and depression in people suffering from bipolar disorder.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), to meet the clinical definition of rapid cycling you need to have experienced four or more distinct episodes of mania, hypomania, or depression over the course of twelve months, with either a switch to an episode of the opposite polarity or at least two months of full remission between episodes.

How prevalent is rapid cycling in bipolar disorder?

As many as half of all individuals suffering from bipolar disorder are likely to develop rapid cycling at some time (Depression and Bipolar Support Alliance). Women appear to be at higher risk and are more likely to be affected by it than men.

What causes rapid cycling?

The exact cause of rapid cycling is unknown, but the following factors are thought to play a role:

• An actual or anticipated stress-causing life event.
• Being out of sync with one’s circadian rhythms.
• An underactive thyroid.
• Use of antidepressants without a mood stabilizer.
• Developing bipolar disorder at a younger age.

What are the symptoms of rapid cycling episodes?

Rapid cycling episodes can be manic, hypomanic, or depressive. Symptoms are the same as those exhibited in regular manic and depressive cycles of bipolar disorder. The only difference is the rate at which the episodes alternate.

• Manic episode symptoms may include high energy, unpredictable conduct, elevated mood, euphoria, delusions, grandiosity, overspending, poor judgment, rapid speech, racing thoughts, impulsiveness, risky behavior, and/or a reduced need for sleep.
• Hypomanic episodes symptoms are similar to manic ones, except they are less severe.
• Depressive episodes are characterized by symptoms such as melancholy, pessimism, loss of energy, inability to concentrate, loss of interest in things you used to enjoy, hopelessness, social isolation, lethargy, oversleeping, and/or thoughts of death or suicide

What does rapid cycling feel like?

Rapid cycling changes can be mentally and physically exhausting. According to licensed therapist Harold Jonas, rapid cycling “makes a person literally live life at its extreme ranges of emotion and pushes their mental and physical endurance to the brink. It’s a literal rollercoaster where the emotional ‘highs’ are very high, and the ‘lows’ are dangerously low.”

Are there any risk factors associated with rapid cycling?

Rapid cycling tends to disrupt a person’s quality of life. It can lead to failed relationships, loss of employment, and a higher rate of substance abuse. The greatest risks, however, are psychosis and suicide.

What treatment options are there for rapid cycling in bipolar disorder?

The best treatment option for rapid cycling is a combination of medications to stabilize mood and prevent psychosis, paired with counseling.

A trained mental health professional can help you learn how to identify the warning signs of an oncoming episode and develop strategies for adjusting your lifestyle accordingly. One tool for doing this is keeping a mood journal to identify patterns and triggers. This will enable you to plan and prepare for an episode in advance.

If you are struggling with rapid cycling and have questions or would like to set up an appointment to meet with one of the faith-based counselors in our online directory, please don’t hesitate to give us a call. You don’t have to walk this path alone. We would be honored to come alongside you and help you along the way.