Rapid-cycling Bipolar Disorder (BP) is not as easy to diagnose as regular BP I or BP II because the person appears to just have normal mood swings. There is a belief that the predominant phase of the rapid-cycling person is depression. Rapid-cycling BP, also known as Ultradian Bipolar Disorder (daily cycling), Ultrarapid Bipolar Disorder (cycling every few days) or Mixed Episode Bipolar Disorder, may be affecting someone you know.
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Compare the person's mood in the morning with her mood at night. The majority of rapid-cyclers report feeling more depressed in the morning and either manic, hypomanic or euthymic ("normal" mood) in the evening.
Know if the person has made threats of suicide or if you believe she has had suicidal ideations. Studies show that rapid-cyclers are less likely to attempt violent suicide; this is more common in regular BP II.
Read the DSM criteria for rapid-cycling BP. See if your friend exhibits the criteria over the course of a month or so. The DSM defines "rapid" as four or more cycles per year, so for some people, the cycles are less obvious because they appear as if they are either in a funk or in a great mood for a few months at a time.
Learn the symptoms of Major Depressive Episode and Mania. Generally, depression includes a prolonged period of sadness, emptiness, lack of interest in normal activities, feelings of worthlessness, disrupted sleeping habits and chronic fatigue. Characterizations of mania include feelings of grandiosity, increased risk taking, decreased need for sleep, distractibility, talking a lot, racing thoughts and self-centeredness. The rapid-cycler goes through these symptoms at least a few times a year, if not more, as seen with Ultradian and Ultrarapid cycling. Sometimes the cycles are not to the extent of full-blown depression or mania, but do show some characteristics and interfere with social, family and work life.
Tips and warnings
- Some research has shown that use of antidepressant medications can increase the speed at which a person cycles, so treating rapid-cycling BP with these medicines isn't a good recommendation.