What Is Rapid Cycling Bipolar Disorder?
Bipolar disorder is characterized by alternating episodes of mania and depression. There are several types of bipolar disorder, including bipolar I, bipolar II, and cyclothymia. Rapid cycling can be experienced by any type of bipolar disorder, although it is most often part of bipolar II disorder. When a person with bipolar disorder experiences rapid cycling, this is defined as four or more distinct episodes of mania or depression in one year, typically without a period of stability or normalcy in between. In some cases, a person may experience ultra-rapid cycling, in which they have four or more episodes of mania or depression in one month.
Episodes of bipolar disorder can be very disruptive to a person’s life. When a person struggles with rapid cycling of their condition, they can struggle with intense changes to their mental state that are difficult to control.
In order to understand what rapid cycling bipolar disorder does, it is useful to understand what an episode of bipolar disorder looks like. An estimated 10 percent of people who have been diagnosed with bipolar disorder experience rapid cycling. Although this experience is disruptive, it is temporary, especially when the person is able to receive appropriate therapeutic treatment.
What Are the Phases of Rapid Cycling Bipolar Disorder
The stages of an episode are outlined below
Many people who struggle with any type of bipolar disorder are often initially misdiagnosed as suffering from depression. This is because the very beginning of the cycle typically starts with an episode of depression. Depressed episodes have symptoms like:
- Feeling sad, empty, lonely, or hopeless for most of the day or several days per week
- Experiencing no pleasure or very little pleasure for most of the day, including activities that were normally enjoyed
- Changes in appetite or weight
- Insomnia or excessive sleep
- Restlessness or slowed behavior
- Lack of energy throughout the day
- Feeling worthless or guilty for no reason
- Decreased cognitive ability or concentration
- Suicidal ideation
When a person experiences five or more of these symptoms over a two-week period without relief, it could be a sign of major depression or bipolar disorder’s onset. If the person has no history of bipolar disorder or manic episodes in the past, then it can be difficult to diagnose the condition properly.
2. Bipolar Prodrome/Mania
Prior to a full manic episode, the person may experience prodrome, which features indistinct and transitory manic symptoms. These are not terribly disruptive to the person’s life and may feel like a relief from depressive symptoms. Typical prodrome symptoms include:
- Heightened mood and energy (could be euphoric, happy, irritable, or angry)
- Slightly more rapid speech
- Faster thoughts
- Decreased need for sleep
- Physical hyperactivity, twitchiness, or restlessness
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In some instances, prodrome can be followed by hypomania, which appears less serious than a more intense manic episode. The symptoms are milder, less disruptive, and typically make the individual appear happier and more social. Symptoms of hypomania include:
- Excessive cheerfulness or giddiness
- Selfishness or pompousness
- Increased jokes, jabs, insinuations, or social talking
- Sense of grandiosity
- Easily distracted
It is difficult for people experiencing hypomania to feel like anything is wrong with them because the symptoms improve how others see them in some cases, and they are likely to feel better than they have during episodes of depression. However, unrecognized and untreated, hypomania can lead into full manic episodes, which can be extremely disruptive.
4. Acute Mania and Delirious Mania
Hypomanic symptoms become more intense in acute mania, and delusions, especially delusions of grandeur, appear. Speech patterns and thoughts become much more rapid and intense. The person may get louder or more emphatic in their speech. Physical energy increases dramatically, and the person may run around, do jumping jacks, pace, leap on and off furniture, or roll on the ground.
Acute mania may transition into delirious mania, which involves hallucinations, confusion, and changes in delusions. They may become paranoid of their surroundings or begin to dissociate from reality and believe they are in a fantasy world. Irritability, anger, and fear become much more pronounced, transitioning away from the giddiness and intense euphoria in the hypomanic and acute mania stages. The person is unable to complete any projects or work, cannot focus, and may not even be able to complete a sentence or thought. Cognition is incredibly difficult.
It is rare for a person with bipolar disorder to experience all stages of mania. For example, a person may begin with an acute manic phase, skipping hypomania and receiving no warning from a prodrome stage. However, the longer a person experiences rapid cycling bipolar disorder, and it goes untreated or self-medicated, the worse manic and depressive stages will become.
5. Depressive Episode
Particularly in rapid cycling bipolar disorder, the person is likely to experience another major depressive episode immediately after a manic episode. When a person experiences rapid cycling of their bipolar condition, they are less likely to experience relief from their symptoms between episodes. This can lead to self-medicating as brain chemistry changes, and it is very disruptive.
Alcohol, narcotics, cigarettes, marijuana, and cocaine are common drugs of abuse among people who struggle with bipolar disorder, especially during episodes of rapid cycling. Although these substances may feel like they provide relief at first, the person is more likely to experience more intense symptoms and more likely to continue rapid cycling of their symptoms if substances are abused.
Help Is Available
It is extremely important for people who suffer any symptoms of mental illness, including depression, mania, or other issues, to get professional help. People who struggle with bipolar disorder experience unpredictable swings in their mood, between both manic and depressive episodes, especially during periods of rapid cycling. This means that many of these individuals may turn to drugs or alcohol as a way of moderating their mood, and this can lead to dependence, addiction, or substance abuse problems.
Fortunately, as more researchers study the correlation between mental health and substance abuse, more rehabilitation programs are prepared to treat people struggling with these co-occurring disorders. A rehabilitation program can help a person safely detox from the substances they have abused, get appropriate psychiatric medications as necessary, and work with therapists to learn to manage their disorders.