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the Cycle of Mania and Depression

Understanding the Cycle of Mania and Depression in Bipolar Disorder

Living with Bipolar Disorder (BPD) can be understood as trying to achieve balance without falling into either extreme of mania or depression. However, for someone who is predisposed to this mood disorder, there are some key features to be aware of to understand and avoid the cyclical nature of uncontrolled mania and depression.

Rapid Cycling

One should be aware that there is a degree of severity of BPD called rapid cycling. Mayo Clinic defines it as when, “you have had four mood episodes in the past year where you switch between mania and hypomania and major depression.” If you identify this in yourself, talk to your doctor about manic depression and about taking correct medications to first stabilize before attempting to escape the vicious cycle and regaining balance.

Know Your Triggers

Previous posts have discussed such triggers of mania and depression as stress, insomnia, poor diet, trauma, substance abuse, alcohol, lack of exercise, isolation, hot weather, cold weather, lack of sun exposure, etc. Each one of these variables can trigger the cycle of mania and depression, so knowing yours will help you recall what set things out of control and to better deal with them in the future if not completely avoid.

There is No Straight Path

Everyone with BPD has a different experience in terms of the sequence, duration, and severity of manic and depressive symptoms. While one may start in hypomania another person may start with depression. Here are two sample pathways: 

John experiences stress and insomnia, which leads to a hypomanic state for 1-month. This then elevates to mania for 4-months. Finally, in an act of self preservation to stop the unsustainable lifestyle, John’s body dramatically shifts him to major depression for 13-months. In this 13-month period of depressive symptoms, John is tipped into mixed states where he experiences hypomania and depression at the same time. 

Jane has a poor diet. Bad calories lead to low energy, lack of motivation, bloating, moodiness, which then send Jane to depression. She cries motionless in her room and is unable to sleep due to the sinking feeling in her chest. This happens for 1-month until her spiraling thoughts and lack of sleep result in frantic activity. Jane thinks her depression has lifted and goes on a shopping spree, socializes excessively, and takes on many projects to make up for lost time. She does not realize she is hypomanic and falls into the manic state of bipolar disorder after 6-months of hyperactivity. 

The cycle of bipolar disorder is unpredictable, confusing, and unique for every person. Each cycle can also have a unique pattern, so it takes incredible will and focus to regain balance. 

How to Escape the Cycle of Mania and Depression

  1. Take your medication according to the prescribed dosage and frequency. 
  2. Prioritize sleep by being in bed for 8 hours every night. Go to sleep at the same time and wake up at the same time. 
  3. Eat healthy meals throughout the day and eat your last meal at least 4 hours before going to sleep. You can find the BPH nutritional guidance and sample meal plans in the book The Five Pillars of Bipolar Recovery which can help in shortening the bipolar disorder recovery time.
  4. Identify and remove the causes of stress in life. This is easier said than done as often the cause of stress is work or family. Consider temporarily finding work that is less stressful even if it pays less and to distance yourself from loved ones out of a desire to be better to them in the future. 
  5. Move your body everyday. This can be walking, Yoga, weight training, etc. Combined with proper sleep and healthy eating, this is a great way to recalibrate.
  6. Seek therapy to process painful experiences so they no longer trigger mania or depression after mania. Psychology Today is a great resource for finding therapists online and in your locality.

The two scenarios John and Jane portray how a person can be stuck in this cycle for months or even years. However, follow the advice above and you are likely to find brief periods of stability, and with consistency and time those periods of stability will expand so much that stability becomes the norm. Talk to your doctor to see if you are rapid-cycling, know your trigger to avoid them, observe the nuanced differences of each cycle, and follow the tips above to find and maintain stability one day. Recovery is possible, so keep up the hard work!

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