Rapid Cycling Bipolar Disorder: Symptoms, Risks, and Treatments

In Diagnosis & Treatment, Online Doctor by Dr. Clinton Osborn

When a person is described as extremely active for one week and then unexpectedly depressed the next, it’s possible that person is bipolar. Bipolar involves the opposite extreme spectrum of a person’s mood. There’s nothing in the middle when it comes to bipolar; it’s either all in or all out. However, rapid cycling involves quick mood changes with at least four mood episodes for at least one year.

Having bipolar disorder is a lifelong journey and it often manifests during a person’s mid-20s to late 30s. Symptoms can still occur during the adolescent years, but it’s difficult to diagnose because mood changes are very common during this stage of development. In order to be diagnosed with bipolar disorder, an individual will have to experience one manic episode and depression.

Rapid cycling bipolar disorder can lead to suicide if it’s not managed properly. If you or a loved one has experienced any bipolar symptoms, we at GuruMD are here to provide all the information that you need to make an informed decision.

What is Rapid Cycling Bipolar?

Rapid cycling disorder is a frequent pattern of distinct episodes that are linked to bipolar disorder. During the rapid cycling process, the individual with bipolar will experience four or more episodes of either depression or mania for at least a year. It can occur anytime during the bipolar process and can occur for over many years. It may not be permanent, but it depends on the individual and how they manage it. Patients who aren’t compliant with medication or have been diagnosed with a severe form of bipolar will most likely develop rapid cycling disorder.

Who is at Risk for Rapid Cycling Bipolar?

According to verywellmind.com, people with bipolar disorder have 5 to 10% of developing rapid cycling disorder. There is still a lot of research that needs to be done to further understand this development. However, doctors have found some common risk factors that contribute to rapid cycling disorder.

Women are at higher risk than men to developing rapid cycling bipolar due to hormone fluctuations. People who develop bipolar during their adolescent or teen years are more likely to have rapid cycling disorder. People with hypothyroidism, or low thyroid hormone, can lead to hormonal fluctuation, which makes them vulnerable to the rapid cycling of moods. Another issue is that patients with major depressive disorder can become bipolar and eventually escalate into rapid cycling disorder. This is mainly because long-term use of antidepressants may trigger the rapid cycling process.

What are the Symptoms of Rapid Cycling Bipolar?

If you feel on top of the world and filled with a surge of positive energy for a few days, and then unexpectedly start feeling depressed, tired, and miserable the next few days, you may have rapid cycling bipolar disorder.

Here are some episodes and symptoms to help identify if you or a loved one may have rapid cycling bipolar:

Rapid Cycling Mixed Episodes

Rapid cycling mixed episodes include a combination of manic, hypomanic, and depressive episodes combined together. The basic symptoms are rapid speech, impulsiveness, self-destructive behavior, aggressiveness, suicidal thoughts or behavior, easily irritable, feelings of hopelessness, and uncontrollable mood swings.

Rapid Cycling Manic Episodes

During the rapid cycling manic episode, patients often experience high physical and mental activity, high mood, intense aggression, a boost in self-confidence, decreased sleep, sensitive to stimuli, racing thoughts and speech, high sexual desires, delusions, hallucinations, and poor judgment.

Rapid Cycling Hypomanic Episodes

During the hypomanic stage of rapid cycling disorder, individuals tend to have less severe symptoms compared to the manic episode. The symptoms are similar but do not include hallucinations or delusions that are often present in a manic episode.

Rapid Cycling Depressive Episodes

In order to be diagnosed with rapid cycling disorder with depressive episodes, the symptoms must last for two or more weeks. The usual symptoms include changes in appetite, sleep behavior, and loss of interest in things that they used to be interested in. People experience a decrease in concentration and libido, and encounter intense feelings of sadness, anger, pessimism, fatigue, guilt, and hopelessness. Those with rapid cycling depressive episodes also tend to constantly use drugs and alcohol.

How to Diagnose Rapid Cycling Bipolar

The problem with rapid cycling bipolar is that there aren’t any blood tests that can be done to determine the disorder. Healthcare providers diagnose the disorder based on the symptoms and/or episodes.

In order to be diagnosed with bipolar disorder, you would need at least one episode of hypomania or mania in your lifetime. Mania would entail abnormal behavior of high energy and elevated mood with irregular behaviors. Hypomania, on the other hand, is an elevated mood, but not as bad as mania, and only lasts for about four days. Depression is often a recurring symptom that can occur during the process of the disorder.

Usually, people with rapid cycling behavior will alternate between depression and hypomania, as well as repeated episodes of manic disorder. In order to properly diagnose rapid cycling bipolar disorder, healthcare providers will have to look at a detailed medical history of the patient with an accurate timeline to pinpoint bipolar or rapid cycling bipolar disorder. Either way, a trip to the doctor’s office is a must when it comes to these mental health concerns.

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How is Rapid Cycling Bipolar Treated?

Successful treatment of rapid cycling bipolar disorder involves prescription medication and cognitive behavior therapy or dialect therapy. The medication that your doctor will prescribe is often a mood stabilizer such as lithium or valproic, or an antipsychotic such as Zyprexa or Seroquel.

Keep in mind that antidepressants can be very dangerous in this case. This is mainly because when you prescribe a bipolar patient with an antidepressant, it triggers or exacerbates the manic phase. This is a very common problem with people who are misdiagnosed with depression when, in fact, they have an underlying issue of bipolar.

Here are some popular medications to look at when it comes to managing bipolar or rapid cycling disorder:


Lithium is the most popular mood stabilizer that doctors often prescribe for patients with bipolar. Studies have shown that lithium has done wonders to keep the mood well-regulated so those with bipolar don’t experience a massive fluctuation of manic and depression.

Unfortunately, this drug does come with side effects such as low thyroid hormone, kidney issues, and can cause heart problems for an unborn fetus during pregnancy. That is why you want to make sure that you are not pregnant before considering taking lithium. Your doctor may have to check on your thyroid and kidney functions to make sure that the drug won’t do any damage.

Valproic Acid

Valproic acid is an excellent alternative to lithium. Usually, the patient can switch to using valproic if they’ve suffered from low thyroid hormone or kidney problems due to lithium. This is an excellent mood stabilizer that does a great job of keeping mood fluctuations under control.

However, the side effects of valproic are liver damage and it can be problematic for pregnant women. Valproic acid can reduce folate absorption for the fetus in the mother’s womb. If you need to take valproic during pregnancy, your doctor will have to increase the dosage of folic therapy to prevent neural tube defects for the infant(s).


Olanzapine is a popular antipsychotic that is used alongside with a mood stabilizer. It helps decrease the manic episode and the hallucinations or delusions that come with the episode.

Olanzapine has safer and lower side effects than other antipsychotics; that is why it’s often used for the bipolar patient. The only side effect that we should be concerned about is that olanzapine can increase blood sugar levels and fat deposits in the body. A lot of patients often complain of weight gain and elevated blood sugar levels after using the drug. In that case, your doctor may have to lower the dosage or give you another form of antipsychotic.

How to Reduce Bipolar Attacks

Bipolar attacks are unpredictable; it comes out of nowhere. However, there are ways to reduce the attacks so that you can live a happier life.

Properly Manage Bipolar

It’s essential to be compliant with your medications. If you experience side effects from the mood stabilizer or antipsychotic, then it’s important to let your doctor know so they can adjust the dosage or provide you with an alternative medication.

Another thing is you may want to consider seeing a therapist every week to help keep your bipolar under control. For bipolar to be managed properly, it requires both medication and counseling. Once your bipolar is kept under control, it reduces the risk of it escalating into rapid cycling bipolar disorder.

Decrease Stress

Stress is a significant culprit for stimulating mental disorders. Stress usually occurs when there is family conflict, drama, deadlines, and exams. All of this triggers various hormones to come to play. This results in major hormone fluctuations that can instigate the bipolar disorder.

To reduce your stress levels, try doing yoga, meditation, or relaxation exercises to keep yourself calm, cool, and collected. That way, it reduces the development of bipolar and the escalation of rapid cycling disorder.

Excellent Support System

It’s best to have friends and family that understand what you are going through. If you are surrounded by positive people who love, care, and support you, then that can definitely help reduce the bipolar or rapid cycling attacks. Your friends and family could be there to talk to you and help you through any episodes. Surrounding yourself with love can be an excellent treatment and support system that can get you through the disorder.

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How Does Rapid Cycling Affect the Quality of Life

Rapid cycling disorder can negatively impact your life. It puts you at a higher risk for substance and alcohol abuse, and it can increase the probability of self-harm and suicide. According to the University of Barcelona in 2009, various research was conducted that indicated that rapid cycling disorder is associated with an increase in the number of suicide attempts compared to non-rapid cycling disorder.

Even if rapid cycling disorder doesn’t result in suicide, this disorder can decrease a person’s quality-of-life. The rapid mood swings make it impossible for them to maintain a committed schedule, and it can hinder their job performance, social life, and communication with other people.

When to See a Doctor

If you are experiencing unusual, irregular, and rapid mood swings, it’s best to see your doctor right away. It is understandable that getting out to the office or clinic can be very troublesome, exhausting, or stressful, so there’s another strategy you could do. You can contact GuruMD and speak to an online doctor in the comfort of your home.

Your doctor can conduct a thorough interview to see if you have the disorder or not. After all, finding out if you have a mental health disorder can be very stressful and can lower your self-esteem, which makes it that much harder to go to a physical clinic for a check-up.

Fortunately, when you talk to a doctor online, you are more comfortable to disclose any details of your symptoms with the confidence that everything is confidential between you and your doctor. With all this in mind, definitely consider this option and get details on how to get access to a healthcare provider.


If you are diagnosed with bipolar, it’s essential to keep it under control with the proper mood stabilizer and therapy. Keep in mind that if your bipolar is not properly managed, you can develop rapid cycling disorder, which involves four different episodes of mood irregularity for at least a year. In addition, be sure to try and decrease stress levels, reduce conflict, and practice a healthy lifestyle to help further manage your mental health.

If you experience any changes in your symptoms or issues with the medication, definitely see your doctor right away. There are online healthcare providers such as GuruMD that can provide you with further information and details on how to combat this disorder.

Don’t let bipolar or rapid cycling disorder ruin your life; it’s time to take control and get the help you need. Contact us today.

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