- WEB MD talks about me
- December 8th, 2009
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 -- almost six million people. (I did, did)
About 10% to 20% of people with bipolar disorder have rapid cycling. People with bipolar II disorder are more likely to experience rapid cycling.
Most people are in their late teens(12) 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 one episode of mania in the patient's lifetime.(there is NO way I can count mine)
Episodes of depression [major depressive disorder], which are often recurrent. (mhm)
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. Rapid cycling bipolar disorder is diagnosed after four episodes of depression, mania, or hypomania occur within one year.
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.
Antidepressants such as Prozac, Paxil, and Zoloft can reduce depression in rapid cycling bipolar disorder. However, taking antidepressants alone can actually increase the degree of rapid cycling, and also trigger manic episodes.
For this reason, mood stabilizers must be taken with antidepressants. Mood stabilizers include antiseizure medicines (like Depakote or Tegretol (ICK), and antipsychotics, such as Zyprexa. Lithium is specifically not indicated in rapid cycling bipolar disorder.
Mood stabilizers are also the treatment for manic or hypomanic symptoms.
Treatment with mood stabilizers is usually continued even when a person is symptom-free. This helps prevent rapid cycling. Antidepressants are generally tapered as soon as depression is under control. Many people need to take two or more medicines daily to control rapid cycling bipolar disorder.
What Are the Risks of Rapid Cycling Bipolar Disorder?
The most serious risk of rapid cycling bipolar disorder is suicide. People with bipolar disorder are 10 to 20 times more likely to commit suicide than people without bipolar disorder. Tragically, 8% to 20% of people with bipolar disorder eventually lose their lives to suicide.
People with rapid cycling bipolar disorder are probably at even higher risk for suicide than those with "regular" bipolar disorder. They are hospitalized more often, and their symptoms are usually more difficult to control long term.
Treatment reduces the likelihood of serious depression and suicide. Lithium in particular, taken long term, reduces the risk.
People with bipolar disorder are also at higher risk for substance abuse. Nearly 60% of people with bipolar disorder abuse drugs or alcohol. Substance abuse is associated with more severe or poorly controlled bipolar disorder.