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Rapid Cycling Bipolar Disorder

What Is Rapid Cycling Bipolar Disorder?

Rapid cycling is a pattern of symptoms in bipolar disorder. In rapid cycling, a person with bipolar disorder experiences four or more episodes of mania or depression in one year.

Understanding Bipolar Disorder

Who Gets Rapid Cycling Bipolar Disorder?

Virtually anyone can develop rapid cycling bipolar disorder. About 2.5% of the U.S. population suffers from some form of bipolar disorder – nearly 6 million people.

About 10% to 20% of people with bipolar disorder have rapid cycling. Women, and people with bipolar II disorder, are more likely to experience rapid cycling.

Most people are in their late teens or early 20s when symptoms first start. Nearly everyone with bipolar II disorder develops it before age 50. People with an immediate family member with bipolar disorder are at higher risk.

What Are the Markers of Bipolar Disorder?

The major markers of bipolar disorder include:

  • At least 1 episode of mania in the patient's lifetime
  • Episodes of depression (major depressive disorder), which are often recurrent

Mania is a period of abnormally elevated mood, usually accompanied by erratic behavior lasting at least seven days at a time. Hypomania is an elevated mood not reaching full-on mania. The usual duration is four to seven days.

A few people with rapid cycling bipolar disorder alternate between periods of hypomania and major depressive disorder. Far more commonly, though, depression dominates the picture. Repeated periods of depression are punctuated by infrequent, shorter periods of elevated mood.

How Is Rapid Cycling Bipolar Disorder Diagnosed?

Bipolar disorder is diagnosed after someone experiences a hypomanic or manic episode along with multiple additional episodes of either mania, hypomania, mixed episodes, or depression. Rapid cycling bipolar disorder is diagnosed after four episodes of depression, mania, or hypomania occur within one year.  "Rapid cycling" is not in itself a diagnosis, but rather, a course specifier for bipolar disorder that describes the pattern and frequency of episodes during a one year period.  Rapid cycling can occur at any time in the course of bipolar disorder and may come and go at varying points over a lifetime course of illness.

Rapid cycling bipolar disorder can be difficult to diagnose. Rapid cycling may seem to make bipolar disorder more obvious, but because most people with rapid cycling bipolar disorder spend far more time depressed than manic or hypomanic, they are often misdiagnosed with "just" depression. 

For example, in one study of people with bipolar II disorder, the amount of time spent depressed was more than 35 times the amount of time spent hypomanic. Also, people often don't take note of their own hypomanic symptoms, mistaking them for a period of unusually good mood.

How Is Rapid Cycling Bipolar Disorder Treated?

Because symptoms of depression dominate in most people with rapid cycling bipolar disorder, treatment is usually aimed toward relieving depression while preventing the comings-and-goings of new episodes.

WebMD Medical Reference

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