Rapid cycling bipolar disorder is essentially the same as traditional bipolar disorder. However, it’s marked by the fact that you’ll struggle with four or more distinct mood episodes, which alternate between manic and depressive episodes, within a single year. ¹

In contrast, those who struggle with traditional bipolar disorder will only experience one or two episodes per year. ² Still, rapid cycling bipolar disorder can appear in the traditional four types of bipolar disorder, which include:

• Bipolar 1
• Bipolar 2
• Cyclothymic disorder
• Other bipolar (and related disorders)

Unlike other types of bipolar, rapid cycling cannot be diagnosed by a medical professional. Instead, it’s a reference for how frequently someone struggles with alternating mood swings.

While rapid cycling may appear temporarily in some people, it can also be an ongoing battle for others.

Symptoms

As mentioned, rapid cycling bipolar is NOT marked by the symptoms themselves, but rather by the frequency of these symptoms. With that said, symptoms are identical to other forms of bipolar disorder. These include:

• Bipolar 1 – Manic episodes that last seven days followed by depressive episodes.
• Bipolar 2 – Depressive episodes followed by hypomania episodes.
• Cyclothymic Disorder – Less severe emotional highs and lows. ³

However, to get a better idea of how these symptoms work, we need to take a look at each episode:

Manic

During a manic episode, you’ll experience:

• Aggressiveness
• Anger and irritability
• Grand thoughts
• Impulsivity (uncontrollable outbursts)
• Intense physical and mental energy
• Lack of sleep
• Overemphasized optimism and self-confidence
• Racing thoughts and speech

In severe cases, you may also experience psychosis (hallucinations and delusions). ⁴

If you experience hypomania, you’ll experience similar symptoms, but to a less severe degree.

Depressive

During a depressive episode, you’ll experience:

• Abnormal aches and pains
• Chronic sadness and potential crying
• Difficulty concentrating (forgetfulness)
• Feelings of worthlessness, hopelessness, and guilt
• Irritability, anxiety, anger
• Lack of energy (fatigue)
• Loss of interest in activities you once enjoyed
• Pessimism, indifference
• Sleeping too much (or unable to sleep)
• Substance abuse
• Withdrawal from socialization

In severe cases, depressive episodes can lead to thoughts of death, self-harm, and suicide.

If you or a loved one has shown signs of suicide, you need to seek help. In crisis cases, go to your nearest emergency room or call 911. In all other cases, you can contact the 988 Suicide & Crisis Lifeline.

Most people who struggle with bipolar will experience five or more symptoms during two weeks. But these may vary, depending on how severe or mild your bipolar is.

Causes

Current research indicates that between 12% and 24% of those with bipolar have rapid cycling. ⁵ However, it remains unclear what causes some people to struggle with traditional bipolar and some with rapid cycling.

If you already struggle with bipolar disorder, then you’re at risk of developing rapid cycling. Women may be more at risk than men, but this also cannot be confirmed. ⁶

Some medical researchers believe that rapid cycling bipolar disorder is caused by:

• Antidepressants
• History of substance abuse
• Severe bipolar 1
• Thyroid complications

Other researchers believe a person is more vulnerable to rapid cycling when bipolar appears at an earlier age and goes for a long period before treatment.

Diagnosis

As mentioned, rapid cycling bipolar disorder is not a diagnosable condition. Instead, you’ll be diagnosed with a standard form of bipolar disorder, and from there, a medical professional will determine whether or not you struggle with rapid cycling.

For this, you must struggle with symptoms for at least one year. Rapid cycling bipolar reveals itself by whether or not you experience four episodes within that year.

Admittedly, rapid cycling can be difficult to detect. Especially if someone has longer periods of a depressive episode. For this reason, you may struggle with rapid-cycling bipolar that goes unnoticed by your doctor.

Treatment

Rapid cycling is treated in the same fashion as traditional bipolar disorder; through medication and psychotherapy.

Since everyone’s reactions to both treatments vary, it may take some trial and error before your doctor determines the right combination for you. Naturally, you may also experience little to no relief during these periods.

When it comes to bipolar medication, rapid cycling is usually treated with one of the following:

• Antidepressants ⁷
• Atypical antipsychotics ⁸
• Mood stabilizers ⁹

Cognitive behavioral therapy (CBT) is the most common psychotherapy for bipolar. This will allow you to identify negative thought patterns and develop coping mechanisms to overcome them. ¹⁰

Final Word

If you struggle with four or more episodes of mania and depression annually, then you may struggle with rapid cycling. While this condition is treatable, it may prove to be more difficult than other forms of bipolar disorder.

Due to this, extra precautions are preferred to help curb symptoms. These include lifestyle changes (such as a bipolar diet) alongside other forms of natural treatment.

References

¹ Anonymous. On madness: a personal account of rapid cycling bipolar disorder. Br J Gen Pract. 2006 Sep;56(530):726-8. PMID: 16954013; PMCID: PMC1876649.

² Jain A, Mitra P. Bipolar Disorder. 2023 Feb 20. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32644424.

³ Van Meter AR, Youngstrom EA, Findling RL. Cyclothymic disorder: a critical review. Clin Psychol Rev. 2012 Jun;32(4):229-43. doi: 10.1016/j.cpr.2012.02.001. Epub 2012 Feb 10. PMID: 22459786.

⁴ Burton CZ, Ryan KA, Kamali M, Marshall DF, Harrington G, McInnis MG, Tso IF. Psychosis in bipolar disorder: Does it represent a more “severe” illness? Bipolar Disord. 2018 Feb;20(1):18-26. doi: 10.1111/bdi.12527. Epub 2017 Aug 23. PMID: 28833984; PMCID: PMC5807194.

⁵ Lee S, Tsang A, Kessler RC, Jin R, Sampson N, Andrade L, Karam EG, Mora ME, Merikangas K, Nakane Y, Popovici DG, Posada-Villa J, Sagar R, Wells JE, Zarkov Z, Petukhova M. Rapid-cycling bipolar disorder: cross-national community study. Br J Psychiatry. 2010 Mar;196(3):217-25. doi: 10.1192/bjp.bp.109.067843. PMID: 20194545; PMCID: PMC2830056.

⁶ Arnold LM. Gender differences in bipolar disorder. Psychiatr Clin North Am. 2003 Sep;26(3):595-620. doi: 10.1016/s0193-953x(03)00036-4. PMID: 14563100.

⁷ Cascade EF, Reites J, Kalali AH, Ghaemi N. Antidepressants in bipolar disorder. Psychiatry (Edgmont). 2007 Mar;4(3):56-8. PMID: 20805912; PMCID: PMC2922360.

⁸ Combination Atypical Antipsychotics in Adolescents or Adults with Bipolar Disorder with Psychotic Features: A Review of Clinical and Cost-Effectiveness and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2016 Sep 6. Available from: https://www.ncbi.nlm.nih.gov/books/NBK395828/

⁹ Nath M, Gupta V. Mood Stabilizers. 2023 Apr 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32310601.

¹⁰ Chiang KJ, Tsai JC, Liu D, Lin CH, Chiu HL, Chou KR. Efficacy of cognitive-behavioral therapy in patients with bipolar disorder: A meta-analysis of randomized controlled trials. PLoS One. 2017 May 4;12(5):e0176849. doi: 10.1371/journal.pone.0176849. PMID: 28472082; PMCID: PMC5417606.