How Often Do People With Bipolar Disorder Cycle?

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.

The frequency and duration of cycles are as varied as the individuals who have them. A study in 1992 found that 35 percent of people with bipolar disorder had only one cycle in a 5-year period, while 1 percent of the same group went through a complete cycle about every 3 months. 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. 

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.

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

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 suffer from bipolar disorder, only about 10 to 20 percent of those will develop rapid cycling. And some people are more likely to experience rapid cycling than others, namely women, children, and those with bipolar II. In fact, according to Dr. Demitri Papolos, co-author of  The Bipolar Child, the majority of children with bipolar disorder cycle very rapidly, some even alternating moods several times within one day.

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.

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