Bipolar disorder is a mental health condition that causes extreme changes in a person’s mood, energy and activity levels. These changes can shift between emotional highs, known as mania or hypomania, and periods of low mood or depression. These shifts are more than just everyday ups and downs. For people with bipolar disorder, these mood episodes can make it hard to function in their daily lives.
About 5.7 million adults live with bipolar disorder in the U.S. Of those, anywhere between 5% to 33% experience something called rapid cycling. An estimated 1 in 4 people with bipolar disorder will experience rapid cycling at some point in their lives.
Let’s explore what exactly rapid cycling bipolar disorder is and how it can be treated.
What is rapid cycling bipolar disorder?
While the term rapid cycling is widely used, it’s not a separate diagnosis in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Instead, it’s a pattern that describes how often a person’s mood episodes happen. Rapid cycling is when a person experiences four or more mood episodes in a 12-month period. These mood episodes can be:
- Manic
- Hypomanic
- Depressive
- Combination
These episodes must meet the criteria for a full mood episode, not just a short mood swing.
People with rapid cycling bipolar disorder may feel like their emotions are constantly changing. They may feel full of energy and ambition one month; the next, they may struggle to get out of bed. Some people may even experience mood shifts within the same week, or same day. This is ultra-rapid cycling. These faster mood shifts can be especially disruptive and are harder to track, diagnose and treat. They’re not formally recognized in the DSM-5, but mental health professionals are aware of these cycles and take them seriously.
These frequent shifts in mood can make living with bipolar disorder feel especially unpredictable and challenging to manage.
Treatment approaches for rapid cycling bipolar disorder
While rapid cycling can be intense and unsettling to experience, it can be treated. A well-rounded treatment plan can help manage your symptoms, reduce episode frequency and improve your quality of life. Treatment usually involves a combination of approaches:
Medication management
Medication is typically the foundation of treatment for rapid cycling bipolar disorder. The right combination of medications can help smooth out the extreme mood swings and prevent future episodes.
Mood stabilizers
These are usually the first line of defense. They work to reduce both manic and depressive episodes. The key is to find the right mood stabilizer or the right combination of mood stabilizers.
Atypical antipsychotics
These medications can be very effective in treating acute manic, depressive and mixed episodes, which can also help with mood stabilization.
Antidepressants
While these can help with depressive symptoms, they are used with caution in the treatment of rapid cycling. This is because antidepressants can trigger a manic or hypomanic episode or even increase the frequency of cycling. If they’re used, they’re almost always prescribed with a mood stabilizer.
Other medications
Sometimes, medications for anxiety or sleep may be used in the short term to help manage specific symptoms.
Finding the right medication combination can take time, and close monitoring by a psychiatrist or your primary care provider is essential.
Psychotherapy
While medication supports brain function and mood regulation, therapy helps you understand and manage your thoughts, feelings and behaviors. It’s an essential part to help your long-term stability and mental well-being. Effective types include:
Cognitive behavioral therapy (CBT)
CBT helps you identify and challenge negative thought patterns and behaviors that can make your mood episodes worse. You’ll learn healthy coping skills for managing stress, managing triggers and improving problem-solving skills.
Dialectal behavior therapy (DBT)
DBT focuses on helping people manage extreme mood changes, such as the ones that come from rapid cycling bipolar disorder. It helps them learn how to cope with their emotions to navigate difficult situations and strengthen their relationships.
Psychoeducation
This involves learning as much as you can about your condition. Understanding bipolar disorder, its symptoms and treatment options helps empower you to take an active role in your care.
Intensive treatment
If you’re having severe episodes, or if traditional weekly therapy isn’t enough to help stabilize your rapid cycling, a more intensive level of care can be highly beneficial.
Intensive Outpatient Program (IOP)
An IOP offers a structured treatment program that meets at least three days a week for three or more hours each day. This allows you to receive significant therapeutic support while still living at home and managing your daily responsibilities.
Partial Hospitalization Program (PHP)
A PHP provides you with even more intensive day treatment, where you participate in individual therapy, group therapy and other programming through most of the day, approximately five days a week, but return to your home each evening. This provides you with highly structured support while also allowing a connection to your home life.
Living with rapid cycling bipolar disorder can feel confusing, exhausting and isolating, but it doesn’t have to be. With proper care, support and the right treatment plan, stability is possible. You can feel better, think more clearly and regain control of your life.
Guidelight Health is here when rapid cycling bipolar disorder makes life feel unpredictable
At Guidelight, we understand how overwhelming rapid cycling can be. Our compassionate team of experts provides individualized care through therapy, medication support and a welcoming environment where you’ll never be judged or rushed. Whether you’re newly diagnosed or have been living with bipolar disorder for years, we’re here to walk alongside you every step of the way.
Everyone has a seat at Guidelight. Contact our team today for more information or to schedule an initial evaluation.