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Understanding Rapid Cycling Bipolar Disorder

written by: Rene Wolf • edited by: Paul Arnold • updated: 5/30/2011

Rapid cycling bipolar disorder is diagnosed when an individual with bipolar disorder experiences a minimum of four episodes of mania, depression, hypomania or a combination within a period of one year.

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    Bipolar disorder, sometimes referred to as manic-depressive illness, is a disorder of the brain that results in an unusual shift in energy, mood, ability to complete daily tasks and levels of activity. The shifts experienced with bipolar disorder are much more extreme than a normal change in mood, can become overwhelming, and often result in damaged relationships, loss of employment and in some cases suicide. Some people with bipolar disorder may be diagnosed with rapid-cycling bipolar disorder. Understanding rapid-cycling bipolar disorder requires the sufferer as well as family and friends to learn the symptoms of rapid cycling, the risks and the treatment in order to fully grasp how overwhelming the disorder can be.

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    Depression, Mania & Hypomania

    Rapid cycling is when someone with bipolar disorder experiences four or more episodes of depression, hypomania, mania or mixed symptoms within a years time. Mania is when the person experiences an abnormally elevated mood. During a manic episode the person may have erratic behavior. The manic phase typically has a duration of four to seven days. Episodes of depression (major depressive disorder) is often more recurring than a manic phase. Hypomania is when the mood is elevated, but not quite a full manic phase. The person may not experience the symptoms of either depression or mania for several months, whereas someone with rapid-cycle has symptoms that switch rapidly from depression to mania or vice versa without a lengthy delay between symptoms.

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    The Risks

    Suicide is the most serious risk for someone with bipolar disorder and those with rapid-cycling bipolar disorder are at an even higher risk. These individuals are hospitalized more frequently due to the symptoms being more frequent and more difficult to control. Substance abuse is common among people with uncontrolled bipolar disorder and those with rapid-cycling bipolar disorder are at a higher risk especially during a manic phase when the behavior is extremely erratic. Someone with rapid-cycling has difficulties maintaining employment due to the frequent fluctuation in mood swings and erratic behaviors. These individuals also experience a higher risk to damage in relationships as the continuous change in mood is often difficult for a spouse, family member and/or friend to cope with.

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    Treatment

    Treatment for rapid cycling bipolar disorder is possible, however, it can often be difficult to pin-point which treatment will be the most beneficial. The symptoms of depression are most often the dominant phases experienced so the primary treatment is often for relieve of the depression. Antidepressant medications such as Zoloft, Prozac or Paxil are often beneficial in reducing the depression in rapid-cycling bipolar disorder. However, in some situations, taking only the antidepressants may increase the rapid cycling and may trigger episodes of mania. For this reason, mood stabilizers which include anti-seizure medications such as Tegretol or Depakote and antipsychotics such as Zyprexa are typically prescribed with the antidepressants. Mood stabilizers are also beneficial as treatment for the hypomania or manic symptoms. When the symptoms begin to taper off, the mood stabilizers are continued, however, the antidepressants are typically reduced in strength or discontinued. Psychotherapy is typically used along with medications for the treatment program. Psychotherapy is an important part of the treatment because the person is guided through understanding rapid cycling bipolar disorder and its symptoms as well as given the opportunity to discuss their thoughts, behaviors and fears regarding their disorder.

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    References

    National Institute of Mental Health: Bipolar Disorder http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml

    Depression Guide: What Is Rapid Cycling Bipolar Disorder http://www.depression-guide.com/rapid-cycling-bipolar-disorder.htm

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