What Is Rapid-Cycling Bipolar Disorder?

Bipolar disorder is a condition in which the patient's mood can range from an extreme, energy-filled manic state to a low, depressive state. Although these moods can last for months at a time before going from one to the next, the rapid cycling subtype operates on a different, faster cycle.

Bipolar Moods

• Many people can have mild mood swings that occur because of life events. It isn't abnormal to feel more energized on some days than others. For those diagnosed with bipolar disorder, an energized mood can last for several weeks at a level that can interfere with important life functions. A patient in a manic mood can immerse himself in highly physical or sexual activity, take part in several projects at once, and can be especially susceptible to stimulant substances like caffeine or cocaine.

  The depressive state can be just as powerful. Patients can find themselves with especially low energy, reluctant to finish those several projects or even participate in daily functions. Sleep can also become a problem. In the depressive state, patients can sleep for lengthy periods of time during the day and have problems sleeping through the night. This mood can affect a patient to a point of suicidal contemplations. Nearly 10 to 15 percent of patients actually complete suicide.

Rapid Cycling

• The rapid cycling bipolar subtype is described by the DSM-IV as a patient who has at least four mood episodes within 12 months. The episode swings can happen within weeks, days, or in rare cases, a 24-hour period. Manic episodes do not last as long as the depressive episodes with rapid cycle patients. Rapid cycling does not necessarily occur in a patterned fashion; the rapid mood changes can happen at differing intervals.

Risk Factors

• 10 to 20 percent of bipolar patients are of this subtype. Those diagnosed may have more rapid cycling periods earlier in their illnesses. Women tend to be diagnosed more with rapid cycling bipolar disorder than men. Diagnosis usually happens in the late teen years.

Kindling Theory

• As with bipolar disorder, there are a variety of theories, but there is no singular cause for rapid cycling. The "kindling" theory suggests that certain triggers are more sensitive to rapid cycling bipolar disorder than others. Significant life events like a death in the family--or smaller events like a work schedule change--can set off a rapid cycling episode. The theory also suggests that as time goes on, rapid cycle sufferers become even more sensitive to these triggers.

Biorhythms

• Biological rhythms are also a suspected cause of rapid cycling bipolar disorder. The natural circadian rhythm of people dictates that we tend to be sleepier at night and more wide awake during the day. Patients with rapid cycling tend to have rhythms that are "off," possibly causing disturbances. Another aspect of this theory suggests that--if the biorhythms don't cause rapid cycling--they may contribute to the length of the episodes.