Rapid Cycling Bipolar Disorder: Information, Symptoms, Treatment and More

Rapid Cycling Bipolar Disorder is a mental health condition. The term ‘Rapid Cycling’ is used when an individual with Bipolar Disorder undergoes four or more manic/hypomanic or depressive episodes in a 12-month period.

Rapid Cycling can be aligned with either Bipolar I or Bipolar II. It is believed that up to 30% of individuals with Bipolar have rapid cycles [1].

This form of Bipolar Disorder features manic, hypomanic and depressed mood states. These mood states can last for several weeks, causing significant distress.

Rapid Cycling Bipolar Disorder is a very difficult condition to live with. However, with the right treatment and support, symptoms can be controlled more, which should lead to an improvement in quality of life.

Rapid Cycling Bipolar Disorder is often misdiagnosed, as depressive symptoms will last longer than hypomania – meaning it can often be diagnosed as another condition.

What are the symptoms of Rapid Cycling Bipolar Disorder?

Rapid Cycling Bipolar Disorder involves periods of mania, hypomania or depression. Moreover, there must be at least four of these episodes in a 12-month period.

It is possible for there to be time between each episode, where behaviour is relatively normal. The behaviour exhibited during the manic, hypomanic and depressive phases will differ from individual to individual.

As mentioned, it is possible for depressive, along with either hypomanic or manic episodes to be involved.

Mania:

• Excessively happy feeling, euphoria
• Uncontrollably excited
• Racing thoughts
• Very confident
• Not needing much sleep
• Feelings of grandiosity
• Acting impulsively
• Taking risks
• Irritable
• More promiscuous
• Symptoms of psychosis

Hypomania:

• Happy feeling, euphoria
• Excitable
• Racing thoughts
• Higher confidence than usual
• Not needing much sleep
• Acting impulsively
• Taking risks
• Irritable

Depression:

• Sadness
• Hopelessness
• Lack of energy
• Loss of interest in formerly enjoyable activities
• Feelings of guilt
• Changes in appetite
• Insomnia
• Low self-esteem
• Poor concentration
• Suicidal or Self-Harm Ideation

This isn’t an exhaustive list of symptoms. These symptoms will typically lead to an individual behaving in a markedly different way from their normal self.

What are the causes of Rapid Cycling Bipolar Disorder?

It isn’t known what causes Rapid Cycling Bipolar Disorder. As with any type of Bipolar Disorder, the causes aren’t clear. It is believed that multiple factors may be involved in its onset.

All types of Bipolar Disorder have the potential to run in families, with genetics therefore being a risk factor [2].

One study found that low thyroid function may also be a factor in the development of rapid cycling bipolar [3].

Other potential causes and risk factors put forward include trauma, a chemical imbalance in the brain, being the victim of abuse, or a major life event. Those who develop Bipolar Disorder in their teenage years are also believed to be at a higher risk of getting the rapid cycling sub-type.

Research shows that women are likelier to suffer from the rapid cycling version of Bipolar Disorder [1]. This is believed to be linked to hormonal fluctuations associated with the menstrual cycle.

Diagnosis of Rapid Cycling Bipolar Disorder

It is important to see a Doctor or mental health professional if an individual believes they may be suffering from any form of Bipolar Disorder. Bipolar Disorder is a serious illness, which left untreated, can cause significant distress.

Attending an appointment is a starting point. If the doctor believes that the individual has any form of Bipolar Disorder, the patient will be referred to a mental health specialist for a diagnosis.

When meeting a mental health specialist, a full assessment of the individual’s condition will be conducted. This will include more detailed questions regarding the symptoms – as well as any feelings that the person has in the build up to an episode.

For Rapid Cycling Bipolar Disorder to be diagnosed, an individual will need to have:

• Experienced at least four episodes of either depression, hypomania or mania in the period of 12 months

As such, it is common for Bipolar Disorder I or II to be diagnosed first, before the Rapid Cycling feature is added later on. Often, depressive episodes last longer.

Sometimes, a different form of Bipolar Disorder will be diagnosed, if the symptoms of the patient better fit a different type.

A diagnosis is seldom made over one appointment. A specialist may want to observe the behaviour of an individual over a period of time, due to risks of misdiagnosis. Bipolar Disorder can easily be confused with other conditions like Depression, Schizophrenia and various Personality Disorders. Sometimes, one of these conditions will be diagnosed instead.

Once a diagnosis has been made, treatment can proceed. By getting a full picture of how Bipolar Disorder affects an individual, the specialist can tailor a treatment plan to fit the specific symptoms.

How is Rapid Cycling Bipolar Disorder treated?

Treatment is available for Rapid Cycling Bipolar Disorder. In many instances, with the right treatment plan, symptoms can be controlled much more. Treatment normally consists of:

Talking Therapy

Talking therapy is often used in the early stages of Bipolar Disorder. After an individual has lived with their condition for a while, they are unlikely to need more therapy. However, it can be very helpful to begin with.

There are many different types of therapy that can be used. Talking therapy can be particularly useful for helping an individual to recognise episode triggers, and to come up with healthy coping mechanisms.

Psychoanalytical Psychotherapy: Psychoanalytical Psychotherapy is a talking therapy that aims to help uncover and resolve unconscious beliefs that cause psychiatric conditions. Traumatic experiences that may or may not be buried in the unconscious mind can be highlighted and processed. Psychoanalytical psychotherapy involves talking to a trained therapist. The therapist can show the individual how early memories and past traumas have affected their thinking, behaviour and attitude in the modern day. Psychoanalytical psychotherapy is especially useful for any condition that involves past trauma. Renowned neurologist Sigmund Freud developed this therapy, which is typically completed over a long-term basis.

There are a range of different types of talking therapies available. For further information, you can see our Therapy section.

Medication

Medication forms the main part of treatment for Rapid Cycling Bipolar Disorder. Mood stabilisers like Lithium are often used. Additionally, anticonvulsant medicines like Lamotrigine, Valproate and Carbamazepine can be prescribed. However, these aren’t always suitable for everyone.

Antidepressants can sometimes be used in cases of Rapid Cycling Bipolar Disorder. However, they are not routinely used, as antidepressants can sometimes worsen episodes of mania [4].

Additionally, antipsychotic medicines can occasionally be used. This is particularly the case when agitation during episodes is common.

Mood Stabilisers: Mood stabilisers can help level out moods, meaning fewer lows, and fewer euphoric highs are felt. Lithium Carbonate is the best-known mood stabiliser. Others include Lamotrigine and Sodium Valproate, which are anticonvulsant medicines that have mood stabilising properties. These medicines are generally taken on a long-term basis.

Antidepressants: Antidepressants can help to improve and regulate mood. They should improve motivation and restore energy. SSRI Antidepressants are the most commonly prescribed. They act on the brain chemical serotonin – which is thought to help in regulating mood and emotion. They may include side-effects such as a dry mouth, sexual problems and nausea, though these should hopefully be short-term. Other classes of antidepressants are available in the event of an inadequate reaction.

Antipsychotics: Antipsychotics (also known as neuroleptics) block the effect of dopamine – a chemical in the brain that is heavily linked to psychotic symptoms like hallucinations. They can also be useful for stabilising mood, and treating anxiety. They are not suitable for everyone however, and are often associated with many side effects like weight gain, dizziness and dry mouth.

Other

In severe cases, Electroconvulsive Therapy can be used. This should only ever be used in Bipolar Disorder when an individual has failed to respond adequately to a range of treatments, is experiencing a long and severe period of depression or mania, and is in a life-threatening situation.

Electroconvulsive Therapy (ECT): Electroconvulsive Therapy (commonly referred to as shock treatment) is a treatment that sees an electric current sent through the brain of an individual. The aim is to trigger an epileptic seizure, with the ultimate objective to relieve symptoms of a mental health problem. The human body is fully restrained during the procedure, which also involves a general anaesthetic. Electroconvulsive therapy is normally a last resort. Despite this, ECT actually has an impressive efficacy rate, with many people finding it helps immeasurably.

Summary

Rapid Cycling Bipolar Disorder is a very difficult condition to live with. Cycling rapidly between episodes can be a horrible experience.

Fortunately, treatment is available for the condition. For further information, our website can assist you.

See Also

• Bipolar Disorder Section
• What Is The Prognosis for Bipolar Disorder?
• Therapy Homepage
• Medicine Homepage