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Bipolar disorder -

Bipolar disorder is a lifelong condition that typically first appears in young adulthood. While symptoms can emerge during adolescence, they may be hard to identify since mood fluctuations are common at this stage of development. 

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"Cycles" -

In addition to mood changes, bipolar disorder also leads to shifts in energy levels and behaviors, known as cycles.

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The two main types of bipolar disorder -

There are two main types of bipolar disorder: Bipolar I and Bipolar II. Both types involve significant mood swings, but the severity and nature of the manic episodes differentiate them.

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Bipolar I disorder -

This type is characterized by manic episodes that last at least seven days or by manic symptoms that are so severe they require immediate hospital care. 

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Bipolar I disorder -

Depressive episodes typically occur as well, lasting at least two weeks. People with bipolar I disorder may also experience hypomanic episodes, but these are not necessary for a diagnosis.

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Bipolar II disorder -

Bipolar II disorder: This type involves a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes typical of bipolar I disorder. While hypomania is less severe than mania, it can still significantly impact a person's life.

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Rapid cycling -

Anyone with bipolar disorder can develop rapid cycling. According to the National Library of Public Medicine, it may occur more in women than men, but this still isn’t completely clear. It is estimated that 12 to 24 percent of individuals with bipolar disorder will experience rapid cycling at some point.

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Diagnosing rapid cycling -

Diagnosing rapid cycling can take time, as it requires at least four episodes within a year. Additionally, the diagnostic criteria specify that there must be a gap of at least two months between episodes.

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An elusive condition -

The exact causes or triggers for rapid cycling remain unclear, leaving its causes somewhat elusive. However, bipolar mood shifts are associated with imbalances in brain chemicals. Additionally, the following factors have been identified as potential common triggers.

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Common triggers: circadian rhythm disruption -

Some studies suggest that circadian rhythm regulation may play a role, as disruptions in sleep often accompany mood shifts. Although it is unclear whether disruptions to circadian rhythms directly cause rapid cycling, maintaining good sleep hygiene is known to help alleviate symptoms.

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Common triggers: kindling -

Another potential cause of rapid cycling is known as kindling or sensitization. According to this theory, early episodes are triggered by real or anticipated stressful life events. Over time, the individual becomes more sensitive to these triggers, making mood cycles increasingly likely to occur and follow a recurring pattern.

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Common triggers: anti-depressants -

It has been found that anti-depressants can increase the frequency of cycling. Some experts have advised against the use of anti-depressants in individuals living with bipolar, especially for the long term.

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Other common triggers -

A history of substance use disorder and thyroid issues has also been linked to rapid cycling. Additionally, it may be associated with an earlier age of onset and a longer duration of illness.

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Treatments -

The primary treatment options for bipolar disorder include medication and psychotherapy, often requiring a combination of both. Alongside these treatments, maintaining a healthy lifestyle can be highly beneficial in managing symptoms.

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Medications -

To bring symptoms under control, medication is typically the first line of treatment. The medications most commonly used to manage bipolar disorder are mood stabilizers, antipsychotics, and antidepressants.

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Mood-stabilizing drugs -

However, many experts advise against the use of antidepressants (especially long-term) in bipolar patients with rapid cycling. Mood-stabilizing drugs such as carbamazepine (Tegretol), lamotrigine (Lamictal), lithium (Lithobid), and valproate (Depakote) are the core treatments of rapid cycling.

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Mania and hypomania -

Mania is characterized by a period of abnormally high mood and increased energy, typically accompanied by impulsive or erratic behavior, lasting at least seven days. In contrast, hypomania is a milder form of elevated mood, which doesn't reach the intensity of full-blown mania and lasts for at least four days.

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Fluctuations -

In individuals with rapid cycling bipolar disorder, some alternate between periods of hypomania and major depressive episodes. However, it is more common for repeated episodes of depression to dominate, with infrequent, shorter intervals of elevated or normal mood in between. 

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Manic symptoms -

Manic symptoms may include extremely high energy, feelings of productivity, strong levels of happiness, speaking quickly, difficulty concentrating, delusions or hallucinations, increased irritability, and reckless behavior. These signs can vary in intensity but are generally associated with manic episodes in bipolar disorder.

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Depressive symptoms -

Depressive symptoms are often the opposite of manic symptoms and can include strong feelings of sadness or hopelessness, low energy levels, experiencing delusions or hallucinations, thoughts of self-harm, a lack of interest in daily activities, and feelings of self-doubt, pessimism, or guilt.

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Is it hereditary? -

Bipolar disorder can be hereditary, with a higher likelihood of developing the condition if a first-degree relative, such as a parent or sibling, has it. 

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Genetics -

While genetics plays a significant role in its development, the exact cause remains unclear. Researchers are exploring specific genes that may contribute to bipolar disorder, though environmental factors are also known to influence its onset.

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Jean-Claude Van Damme -

After years of being undiagnosed, actor and martial arts legend Jean-Claude Van Damme was eventually diagnosed with rapid-cycling bipolar disorder. He has publicly stated that following his diagnosis, he made significant changes to his lifestyle habits, which he believes are essential for managing the symptoms of the disorder.

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Identifying rapid cycling bipolar disorder -

Rapid cycling bipolar disorder can be difficult to identify because mood episodes sometimes fluctuate without fully resolving, making them appear as ongoing shifts rather than distinct episodes.

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Misdiagnosis -

Although rapid cycling makes mood changes more noticeable, the majority of people with this condition experience longer periods of depression than manic or hypomanic episodes. This can often lead to misdiagnosis as unipolar depression instead.

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Keeping a log of your symptoms -

If you suspect you’re experiencing rapid cycling, try keeping track of your daily moods, medications, symptoms, life events and stressors, and sleep patterns. This can provide valuable insights into how your condition is progressing and help identify potential triggers for mood shifts.

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Seeking professional help -

Keeping a record of these factors may assist healthcare professionals in diagnosing your condition more accurately and developing an effective treatment plan tailored to your needs. For those experiencing symptoms, seeking professional support and being proactive in treatment is crucial.

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Ongoing research -

Ongoing research and awareness are essential to improving the lives of those affected by this complex form of bipolar disorder. If you or someone you know is experiencing symptoms, seeking professional medical help is crucial for proper diagnosis and treatment.

Sources: (Healthline) (Camh) (Better Help) (Medical News Today) (National Library of Medicine) (Webmd)

See also: The stars living with bipolar disorder

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