How Often Do People With Bipolar Disorder Cycle?

Kimberly Read

Medically reviewed by

Updated on January 08, 2020

In the context of bipolar disorder, a mental illness that involves extreme swings in mood, a cycle is the period of time in which an individual goes through one episode of mania and one episode of depression (or hypomania and depression). As for how often these cycles occur, there is, unfortunately, no definitive answer.

Frequency of Bipolar Cycles

The frequency and duration of cycles are as varied as the individuals who have them. This change or “mood swing” can last for hours, days, weeks, or even months.

Typically, someone with bipolar disorder experiences one or two cycles a year, with manic episodes generally occurring in the spring or fall.

A 2010 study of people with bipolar 1 disorder found that mood episodes lasted an average of 13 weeks. On average, people with bipolar will have one or two cycles yearly. In addition, there is a seasonal influence—manic episodes occur more often in the spring and fall.

Triggers in Bipolar Disease

Certain conditions are known to trigger symptoms in people with bipolar disease. Understanding these triggers—and avoiding them—can minimize symptoms and limit the number of cycles a person experiences. These include:

Insufficient amounts of sleep
Altercations with loved ones
Alcohol and drug misuse
Certain antidepressants and other medications
A change in seasons
Pregnancy and other hormonal conditions
Grief over the death of a friend or family member
Events such as starting a creative project, falling in love, going on vacation, listening to loud music, menstruation, and decreased physical exercise

Rapid Cycling in Bipolar Disease

The phrase rapid cycling is tagged to the diagnosis of those who have four or more cycles in a 12-month period. However, while four or more cycles in a one-year period meet the criteria for a diagnosis of rapid-cycling bipolar illness, rapid cycling is not necessarily a permanent pattern for a person who experiences it. Rather, rapid cycling can present at any point in the course of the disease and can be transient.

While about 2.5 percent of Americans have bipolar disorder, only about 10 to 20 percent of those will develop rapid cycling.

Rapid cycling may be more likely to affect those who were young when symptoms first appeared, those who have had bipolar disorder for a longer time, and those who misuse alcohol and other substances.

In addition, some people with The term "ultra-rapid cycling" may be applied to those who cycle through episodes within a month or less. If this pattern occurs within a 24-hour period, the person's diagnosis could possibly be termed "ultra-ultra-rapid cycling" or "ultradian." It is often difficult to tell ultradian cycling from a mixed episode.

Treating Bipolar Disorder

Whether a person with bipolar disease experiences a cycle once every five years or many times each day, there are treatments that can help. These include:

Using medications, including mood stabilizers, antipsychotic medications, and antidepressants
Cognitive-behavioral therapy and other forms of psychotherapy
Electroconvulsive therapy commonly referred to as "shock therapy"
Disease education and self-management techniques
Alternative and complementary health practices such as meditation