What Are Bipolar Disorder Cycles?

What Are Bipolar Cycles?

Bipolar cycles refer to someone with bipolar disorder cycling through the stages of mania and depression. Depending on which type of bipolar disorder the person has, these stages may be cycled through within days or weeks, or last for years. With the right treatment plan, a person may be able to limit their bipolar cycles to experiencing symptoms instead of full-blown stages.

Manic Episodes

All three types of bipolar disorder include periods of mania or hypomania. With Bipolar 1 these episodes last at least seven days, with bipolar 2 these symptoms are not as full blown, and with cyclothymia these symptoms last at least two years.

People experiencing a manic episode may exhibit the following:

• Feelings of being very “high” or elated
• Decreased need for sleep
• Loss of appetite
• Increased rate of speech
• Racing thoughts
• Engaging in risky behaviors such as high risk sex or excess spending
• Feeling invincible and that they can do anything
• Bipolar memory loss

A person in the throws of a manic episode may exhibit behavior that is unusual or unrecognizable to their peers and family. The person is also unable to recognize the shift and may simply insist that they are just feeling great or are exuding the best version of themselves.¹

Depressive Episodes

A person with bipolar disorder will experience a depressive episode, generally directly following a manic episode. This shift will often look like a crash.

Someone with bipolar disorder experiencing a depressive episode may exhibit the following:

• Feelings of sadness, emptiness, or hopelessness
• Restlessness or a slowed down feeling
• Trouble falling asleep or sleeping too much
• Increased appetite and weight gain
• Slow speech and forgetting what they have to say
• Inability to carry out even simple tasks
• Little interest in activities and anhedonia (the inability to experience pleasure)
• Increased thoughts of death or suicide

A person experiencing a depressive episode may retreat within themselves and temporarily cut off contact with the people in their life. In some cases this isolation can play a role in job loss, bipolar relationships failing, and, in extreme cases, suicide.¹

Mixed Episodes

Some people experience symptoms of mania and depression simultaneously, which is called an episode with mixed features. This presentation will look like a combination of the symptoms listed above (e.g., feeling empty and hopeless but extremely energized).

How Often Do People With Bipolar Disorder Cycle?

The duration of these cycles present differently in each individual, and the length of each cycle varies depending on the diagnosis. A large influence on how long the cycles may last depends on how engaged an individual is in treatment. People who follow a steady regimen are more likely to experience symptoms and less likely to experience a full episode of either depression or mania. However, because treatment is so nuanced with this particular disorder, managing these cycles is a lifelong struggle.

How Long Do Manic Episodes Last?

The duration of manic episodes can vary based on the type of bipolar cycle. Manic episodes can last from hours or days to weeks for some types of bipolar cycles, while others can last from months to years. Alcohol and drugs can induce manic episodes. The episodes can be so extreme that some people need to be hospitalized due to drastic changes in behavior.

Rapid-Cycling in Bipolar Disorder

Bipolar 1, or rapid-cycling bipolar disorder, involves dramatic mood swings and is very recognizable to family and loved ones. The disorder is characterized by a person having a manic episode and then shifting to hypomania (less severe symptoms), followed by a major depressive episode lasting at least two weeks.

Bipolar 1 is diagnosed at the onset of the manic episode, and the person needs to be experiencing at least three manic symptoms (e.g., grandiosity, lack of sleep, fast speech, increased risky behavior, or racing thoughts). The diagnosis is further supported when a person experiences a major depressive episode.

A major depressive episode is characterized by having at least five of these symptoms (and always including the first two):

• Intense despair or hopelessness
• Loss of interest in activities
• Increased sleep
• Restlessness
• Slowed speech
• Loss of energy and extreme fatigue
• Frequent thoughts of death or suicide

People with rapid cycling bipolar disorder also generally experience other mental disorders such as attention deficit hyperactivity disorder (ADHD), bipolar anxiety or a substance misuse disorder.²

What It Feels Like to Cycle With Bipolar Disorder

Cycling can feel like you are out of control of your mind and body, and at the same time, feel like you do have control. That is the danger of bipolar disorder cycles. It can feel like you are both unstoppable and as a result, you may make a lot of risky and impulsive decisions. You may feel happy or energetic however you don’t recognize how short-lived this feeling could be.

The cycles could lead you to staying awake for days and becoming fixated on specific things. This keeps people detached from the day to day life they live and removes them from reality. You might begin several tasks at once and then not be able to focus on any of them.

Bipolar Triggers

Many times a major stressful event, either experienced in late adolescence or early adulthood, can be the start of someone’s bipolar cycle. Drugs and alcohol can also trigger an initial manic episode, and those who have a genetic disposition to the disorder are encouraged to be cautious when using substances.

In addition, one of the main things that triggers a new cycle is the individual’s noncompliance with treatment, specifically medication. Many people with bipolar disorder feel that medication will “dull” them too much and this leads to decreasing dosage or stopping altogether. Additionally, some individuals will stop medication because they feel “better” and think that they can continue to control their symptoms on their own. More often than not, stopping medication will lead to a manic episode—and sometimes hospitalization.²

Manic Episode Triggers

It can be difficult to decipher what exactly is causing your manic episodes, as they appear with no real warning. However, there are some triggers and causes to be aware of, such as:

• Overly stimulating environment
• Substance use
• Poor quality of sleep
• Crowds or loud noises
• Major changes in life
• Stress

Treating Bipolar Disorder

Treating bipolar disorder involves either medication alone or a combination of talk therapy and medication. Each person’s treatment is individualized and tailored to their specific symptoms. A person may likely need to try multiple medications before finding the one that works best for them.

Mood stabilizers and antipsychotics are generally used to treat bipolar disorder. Providers will generally prescribe an antidepressant as well as a mood stabilizer to prevent the antidepressant from triggering a manic episode. It is important that people taking medication are consistent and do not suddenly stop; suddenly stopping can lead to a worsening of symptoms.

Talk therapy along with medication can be very helpful and often entails a lot of psychoeducation around the disorder and ways in which to manage day to day. Cognitive behavioral therapy (CBT) specifically has proven to be very helpful.³

How to Support a Loved One Who Is Cycling

When someone you love is having a bipolar disorder cycle, and you see how out of control they are, it can be really hard to know how to support them, but it is possible.

Here are a few tips that can help your loved one in the midst of a bipolar cycle:

Advocate for Them

It can be difficult for someone in a bipolar cycle to try to get help. If they give permission and you are able to, advocating for them with their doctor and therapist and any other specialist they’re working with can help them get the care they need much sooner.

Encourage Healthy Habits

Encouragement is key. It is hard for your loved one who is experiencing a bipolar cycle to act in healthy ways if you are not exemplifying healthy habits yourself. Trying to come up with routines for healthy habits and sticking to them is important.

Listen to Them

There is always room to listen and validate. The experience of a cycle feels very real for the person in the cycle, so arguing with their reality can make things worse. Instead, listen and validate their emotions, recognize their struggle and help them see where they are capable of coming down from the cycle. Staying neutral in affect and demeanor can help them equilibrate.

Take Care of Yourself

While you are trying to support your loved one, don’t forget to help yourself. It can be very emotionally taxing to support a loved one through a cycle so making sure you are setting limits and boundaries for yourself is important. Thinking about getting into a support group can be helpful and can give you and your loved one both an outlet to get support during cycles.

Final Thoughts on Bipolar Cycles

If you or a loved one are dealing with bipolar disorder, your issues are specific to you, but you’re not alone. Connecting with a skilled therapist can make a big difference in how you feel. Having a space in which to process through some of the challenges that you may face living with bipolar disorder can provide you with a sense of relief.