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). Unfortunately, there is no definitive answer to how often these cycles occur.

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

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 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 refers to four or more cycles in a 12-month period. However, while having four or more cycles in a one-year period means meeting the criteria for a diagnosis of rapid-cycling bipolar illness, rapid cycling is not necessarily a permanent pattern. Rather, rapid cycling can present at any point in the course of the disease. And it can be transient.

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, 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:

• Medications, including mood stabilizers, antipsychotics, and antidepressants
• Cognitive-behavioral therapy and other forms of psychotherapy
• Electroconvulsive therapy (commonly referred to as "shock therapy")
• Education and self-management techniques
• Alternative and complementary health practices, such as meditation