Bipolar disorder with rapid cycling is diagnosed when a person experiences four or more episodes of mania, hypomania, or depressive episodes in any 12-month period. Rapid cycling can occur with any type of bipolar disorder, and maybe a temporary condition for some people.
What is rapid cycling?
People who live with bipolar experience the “highs” that come with mania or hypomania, they also experience “lows” that come with depression. When Rapid Cycling occurs, it means that four or more manic, hypomanic, or depressive episodes have taken place within a twelve-month period. Changes in mood here can happen quickly and occur over a few days or even over a few hours. If there are four mood changes within a month, it is called ultra-rapid cycling. While the phrase “rapid cycling” may make it seem that there is a regular cycle to these shifts in mood, most cycles do not follow a pattern.
Who develops rapid cycling?
As many as half of all individuals who live with bipolar may develop rapid cycling at some time. For most, rapid cycling is a temporary occurrence. For a small number of individuals, the pattern of cycling can continue indefinitely. While there are no hard rules for who will develop rapid cycling, it may be more likely to develop in women. Bipolar is equally common in both genders.
What causes rapid cycling?
The cause of rapid cycling is unknown however, there are several theories that have been posed:
The kindling theory proposes that early episodes are triggered by actual or anticipated life events. Stressful circumstances such as loss of a job or of a loved one may become ‘triggers’ for that individual. Again, this can be actual or anticipated. Perceived or actual stress associated with these circumstances may result in the cycling of mood seen in rapid cycling. As the triggers continue to present themselves an individual can experience the increase of cycling.
Circadian or Biological Rhythms
This theory proposes that individuals who experience rapid cycling are “out of sync” with their typical biological rhythms. Circadian rhythms represent the 24-hour cycle that people experience each day. This rhythm keeps people in sync with dusk and dawn, sleep, and activity. While it is uncertain if inconsistency with circadian rhythms can cause rapid cycling, it is understood that good sleep hygiene can mitigate symptoms associated with bipolar.
Hypothyroidism means that the thyroid is underactive in the system and is not producing enough of the thyroid hormone for the brain. Some with rapid cycling have responded to treatment with the thyroid hormone.
It has been found that anti-depressants can increase the frequency of cycling. Some experts have advised against the use of anti-depressants in individuals living with bipolar, especially for the long term. More commonly individuals living with bipolar are prescribed mood-stabilizing drugs which can be a treatment for rapid cycling. Before changing medication, talk to your physician. Do not stop medication without first consulting with your physician.
Treatment for Rapid Cycling
Rapid cycling is not its own diagnosis, rather a specifier that defines how the course of a bipolar diagnosis is experienced. It can be difficult to treat rapid cycling, however, people may find benefit in talk therapy and tracking their mood.
Keeping track of your mood may help you understand patterns that cause stress. By keeping records of mood changes, as well as lifestyle factors such as sleep, diet, exercise you can better understand what may trigger mood shifts.
Talk therapy can help people to identify and stick to a specific treatment plan. Collaborating with a therapist can help people who are experiencing rapid cycling. Feelings such as irritability, sadness, and racing thoughts can interfere with day to day life. By talking to a therapist those feelings can be explored in a “judgment free zone.” Establishing a treatment plan with a therapist can help you keep track of what improves or worsens symptoms.