Rapid cycling may be a temporary experience for someone with bipolar disorder. Talk therapy and medication can help with management.

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Rapid cycling is a feature of bipolar disorder in which episodes of mania, hypomania, or depression are more frequent. These episodes may appear unexpectedly and are mostly temporary.

About 5.7 million people in the United States live with bipolar disorder. It’s estimated that in a single year 5% to 33% of people with bipolar disorder are experiencing rapid cycling, and 26% to 43% experience it at some point in their lives.

Although researchers are just beginning to learn what might cause this condition, there are promising treatments on the horizon.

Rapid cycling can happen with any kind of bipolar disorder. Someone has rapid cycling bipolar disorder when they experience at least four distinct mood episodes over a 12-month period.

Rapid cycling is a feature of bipolar disorder and not a stand-alone diagnosis. According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) a clinician should specify if the person has experienced rapid cycling at the time of diagnosis.

A large 2020 study, citing older research from 2010 and 2015, explained that about one-third of people with bipolar disorder experience rapid cycling. Additionally:

  • Rapid cycling was found more frequently in younger females with an early onset of bipolar disorder.
  • The same study cited 2006 research that showed about 20% of those with bipolar disorder experienced euthymic (no episodes) states that last around 60 weeks.
  • Year-long euthymic (no episodes) states were found more frequently in older working males with a lower occurrence of alcohol use disorder.

A different study from 2020 found that, among individuals diagnosed with bipolar disorder, females are more likely than males to experience rapid cycling.

Here are some answers to specific questions about rapid cycling in:

  • cyclothymia (sigh-clo-thigh-me-uh), a mood disorder that causes ups and downs in emotions and energy levels
  • bipolar I, which is diagnosed after at least one manic episode
  • bipolar II, which is diagnosed after at least one depressive episode and one hypomanic episode

Are rapid cycling mood shifts a temporary or permanent characteristic of bipolar disorder?

According to the Depression and Bipolar Support Alliance (DBSA), most people only temporarily experience rapid cycling. The experience might not follow a regular cycle, so mood episodes may occur over days, hours, or months.

Can rapid cycling happen in a day?

Some people do experience significant changes in mood, such as from a state of mania to one of depression, in a single day. When mood changes happen this frequently in someone with bipolar disorder, it’s called ultra-rapid cycling.

Ultra-rapid cycling is when four mood episodes occur within a month, according to the DBSA.

Is rapid cycling bipolar disorder a sign the condition is worsening?

It’s hard to predict the course of bipolar disorder in any person. If a person experiences rapid cycling, a 2020 study explains they may, during that episode, be more likely to relapse with substance misuse.

Rapid cycling often coexists with and can compound symptoms of other conditions.

Research from 2020, citing earlier studies, reported that, on average, people with rapid cycling may have more mood episodes and may have more attempts at suicide.

If you’re considering acting on suicidal thoughts, please seek professional support immediately.

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The same research also notes that people with rapid cycling often have obesity and diabetes, and are more susceptible to hypothyroidism and insulin resistance.

Rapid cycling can also contribute to work impairment.

It may also happen in people who have lived longer with bipolar disorder and can lead to longer-term problems.

What are the characteristics and triggers?

The “kindling” theory says that actual or anticipated stressful life events can lead to rapid cycling. These life events can be different for everyone but might include the loss of a loved one, loss of employment, or another significant stressor.

If you’re experiencing rapid cycling, you may want to discuss potential therapies with a mental health professional.

Since rapid cycling is not a stand-alone diagnosis, but a feature of bipolar disorder, there may not be a treatment specifically for rapid cycling.

Evidence-based treatments for rapid cycling bipolar disorder

Medication is prescribed to treat bipolar disorder. Types of medication include:

Doctors may also recommend medications to treat other experiences in those with bipolar disorder, such as medications that target anxiety or help with sleep.

Electroconvulsive therapy (ECT) may be an option for people with severe symptoms of bipolar disorder. It’s a kind of brain stimulation that happens under anesthesia.

In a 2017 study, nearly 69% of patients whose bipolar disorder symptoms were resistant to medication, responded effectively to ECT.

Newer treatments for rapid cycling bipolar disorder are also under study. For example, a 2015 case study found that the medication ketamine was effective in helping a person with rapid cycling to recover from a depressive episode.

Best talk therapies for rapid cycling bipolar disorder

Psychotherapy, also called “talk therapy,” is often a part of bipolar disorder treatment.

In a 2017 literature review, cognitive behavioral therapy (CBT) was shown to reduce relapse rate in people with bipolar I disorder and bipolar II disorder.

Other talk therapies that may also benefit people with rapid cycling include:

  • Interpersonal and social rhythm therapy (IPSRT). IPSRT targets a person’s circadian rhythms, or biological clock, in order to reduce symptoms of bipolar disorder.
  • Family-focused therapy (FFT). This involves a person’s family members and caregivers in an approach to managing bipolar disorder.

Talking with a therapist in a one-to-one setting may help you to better understand your experiences with rapid cycling.

A therapist may recommend keeping a mood journal to reveal patterns in life events, stress, diet, and other factors that lead to mood changes.

People with bipolar disorder may experience rapid cycling, defined as four or more mood episodes in a single 12-month period.

Rapid cycling is a feature of bipolar disorder and not a stand-alone diagnosis.

Bipolar disorders are treatable conditions. A treatment plan for rapid cycling bipolar disorder can include medication and talk therapy. Newer treatments, like interpersonal and social rhythm therapy, may be particularly effective at managing rapid cycling.

If you’re looking for a therapist but not sure where to start, Psych Central’s How to Find Mental Health Support resource can help.