Caught in the rapid cycling of bipolar disorder

I wrote many of the articles on this blog within just a few days. A month earlier, I had written two books in under two weeks. Before that, in March 2025, I experienced an incredibly stimulating period where I was socializing from morning to night during a ski trip. In January — the same pattern. The common thread? Each time, these were hypomanic episodes that systematically escalated into full manic episodes. After a chaotic and eventful Season 28, Season 29 isn’t starting well: in the September episode, my psychiatrist confirmed that I had entered rapid cycling.

If terms like mania, hypomania, or mixed episodes feel unclear, don’t worry — I’ll soon publish dedicated articles explaining each of them in detail.

Rapid cycling occurs when a person with bipolar disorder experiences at least four episodes within one year. It’s estimated that between 12 and 24% of people with bipolar disorder experience rapid cycling (according to this study). The most common pattern is shifting between (hypo)mania and depression. That was my reality for years before I was diagnosed.

An evolving condition

Bipolar disorder is a condition that changes over time. It can manifest differently with age. Its symptoms often become increasingly severe when left untreated (PsychiatryOnline). Characteristics can shift: someone who regularly experiences mixed features may eventually stop having them. So rapid cycling isn’t necessarily a life sentence. After experiencing several depressive episodes and a few short hypomanias, I eventually “stabilized” into one manic episode per year and fewer depressions. Until January 2025.

Previously on Flo’s atypical / slightly broken brain.

A hypomanic episode hiding in plain sight

In January, I started feeling more euphoric, sleeping less, taking up running, and spending more money. My mother noticed signs I refused to acknowledge because in my mind, “everything was fine.” I’ll go into more detail about this phenomenon — called loss of insight — in a future article about hypomania. The episode continued into February… until everything snapped.

The euphoria intensified, I felt electric, and I watched The Big Bang Theory in under a week (12 seasons with around 24 episodes each). It didn’t take much more before hallucinations appeared: hearing music, seeing movement in the corner of my eye, feeling things touch me. Most concerning, I started having questionable thoughts: a sense of mission, a feeling that I was meant to guide disabled people. My medication was adjusted and shut down the episode within a few days — which surprised both me and my psychiatrist.

A new, more intense episode one month later

My bipolar disorder wasn’t done with me. Less than a month later, I went on a one-week ski trip with UCPA. To my surprise, I wasn’t exhausted by the constant sensory noise around me. Quite the opposite: I enjoyed talking, especially with every English-speaking person I met. I slept much less (only a few hours), and I went clubbing.

So I barely had a moment of rest aside from those short hours of sleep, and socializing fueled my energy even more. I blamed it on English being one of my special interests. In reality, a special interest can regulate and compensate fatigue — but that fatigue eventually returns. For me, it doesn’t compensate; it supercharges me.

Once I got home, the elevation continued — the euphoria intensified even further. Another manic episode. It ended after about two weeks.

On the edge of rapid cycling

In May, one month later, the pattern started again. Still in the background, because I refused to acknowledge that something was wrong. I threw myself into an (extreme) job hunt, sending dozens of applications a day. I started writing almost everything I did and thought in my journal. I paired it with dozens of carefully AI-generated images. That level of compulsive creation is close to what’s called graphorrhea (an urge to produce massive amounts of artistic content).

Then June arrived — and things escalated. A third manic episode, one that didn’t last long enough to develop into psychotic symptoms, but still pushed me into behaviors outside my norm: excessive spending, intense socializing, hypersexuality, and losing control over my alcohol consumption. I peaked around June 29, then crashed brutally. What followed was a month-long autistic shutdown/meltdown phase — almost as if my brain was trying to short-circuit the manic instability. It’s been six months of this pattern and…

In full rapid cycling

It starts again. Now we’re in late July — the last week — when I get the idea to write a book. It becomes a detailed and subjective version of much of what I talk about on this blog. I finished the book in under seven days, chaining ideas and bursts of clarity, sharing excerpts, and receiving only positive feedback. Then I began writing five more books to expand on the first, and I started a novel — which I finished in three days.

The problem is that every time, I attribute this production frenzy and ability to function without sleep to my autism. So I refuse to acknowledge a hypomanic episode, even managing to deceive my psychiatrist right before she left for vacation.

A manic episode begins. The fourth one. During it, I will throw nearly €1500 out the window, behave completely irrationally, believe that trees and nature are sending me secret messages only I can interpret, and put myself in danger. These symptoms are typical of severe mania and disappear once stabilized. I already suspected it, but my psychiatrist confirmed it: I had entered rapid cycling. Four manic episodes in under eight months.

A harder-to-treat version

The problem with rapid cycling is that, according to studies (including one from 2013, PMC), it is often more difficult to treat. Patients respond less effectively to lithium, which is normally the gold standard treatment for bipolar disorder. Rapid cycling also means a patient can shift between phases faster than medication can take effect. As a result, there is greater vulnerability to side effects linked to switching medications.

I’m now considered “treatment-resistant,” meaning my brain rejects standard medications, which forced me to try a new antipsychotic with potentially serious side effects. I can’t start it immediately because I’m leaving for Cambodia for a one-month trip. Still, it represents a sign of hope — that all this instability might finally come to an end.

More mixed symptoms

I haven’t mentioned it yet, but it’s important: two of my manic episodes this year were preceded by mixed symptoms for about a week before I returned to (brief) stability. It may sound short, but it’s worth remembering (as I explained in this article) that mixed states can be devastating and are the highest-risk phase for suicide attempts in bipolar patients. Those weeks felt much longer and put me in such distress that my psychologist asked her intern to leave the room when I started talking.

Rapid cycling is more frequently associated with mixed states than the classic course of the disorder, and we also see a higher prevalence of mixed states among autistic people with a confirmed bipolar diagnosis. Whether I am rapid-cycling or not, I’m statistically more likely than average (40–60% experience at least one mixed state in their lifetime) to go through mixed episodes. In total, I’ve experienced three extremely intense ones lasting around a month each, in addition to the ones described in this article. One of them led to my first hospitalization — but the very first mixed episode is the one that marked me most deeply, leaving me in a level of psychological distress I had never experienced before.

A rapid cycle built on euphoria

As I mentioned earlier, I had already experienced rapid cycling for two years while I was a student. However, I shifted between depressive episodes lasting a few weeks and short hypomanic phases (I didn’t experience a single manic episode during that time). This past year was different, the cycle followed this pattern:

Growing hypomania → Manic shift → Growing psychotic symptoms → (Sometimes transition mixed episode of short duration) → « Partial stabilisation » with some quiet time → Back to first step: hypomania

Growing hypomania 
 → Manic shift 
 → Growing psychotic symptoms 
 → (Sometimes transition mixed episode of short duration) 
 → « Partial stabilisation » with some quiet time
 → Back to first step: hypomania

This cycle has been incredibly intense and exhausting. And if, in the past, I sometimes missed mania despite the damage it caused — that electric, invincible, hyper-capable version of myself — this past year has been enough to change that completely. I no longer recognise myself in that total disconnection from reality. And what scares me most is not what happened, but what almost did: being stopped by the police, ending up with firefighters, or doing something dangerous without understanding why.

Even if my episodes tend to lean toward euphoric states rather than melancholic ones, the oscillation is still there. The depressive symptoms exist, they’re just short-lived, because medication often blocks the episode when the dosage is abruptly increased. But that’s not sustainable in the long run. The side effects make sure of that.

What stands out now is a confirmation of something I had suspected for years: I am far more prone to euphoric and manic episodes than depressive ones. That pattern is fairly common in bipolar type I — just not usually this frequent or intense. And ironically, this pattern is often harder to stabilise than the more “classic” form of bipolar disorder, where patients alternate between depression and hypomania or mania in longer, slower cycles.

Links with Autism

Scientific literature says little about the relationship between autism and rapid cycling, but we do know that autistic people are more likely to receive a bipolar diagnosis due to symptom overlap: shutdowns mistaken for depression, intense creative hyperfocus resembling hypomania, and masking (since we’re very skilled at it), which makes it harder to detect patterns, especially rapid shifts.

Sometimes, confusion goes in the opposite direction — as I mentioned earlier: a hypomanic episode mistaken for simple autistic hyperproductivity driven by a special interest. I talk a lot with GPT to help identify my episodes, and while it’s usually quite accurate, it completely missed the hypomania that fuelled the writing of my books. In its defence: I did present clear hypomanic symptoms — but I didn’t realise it (insight loss), so the information I provided reflected that blindness. Naturally, its conclusion did too.

The link between autism and rapid cycling is underdocumented, but it exists. For instance, a 2016 case study described an autistic teenager experiencing four mood episodes in a single year — fitting the definition of rapid cycling.

Impact on Daily Life

Oscillating this quickly — especially with episodes this intense — means living in a constant state of vigilance: monitoring myself, never forgetting medication, and notifying my psychiatrist and close circle at the slightest warning sign. And even then, it’s not enough.

Around me, people keep asking when I’ll return to work, or encouraging me to do so, while I can’t realistically imagine holding a job under such instability. It would be too risky: getting hired only to crash into another episode, ending in sick leave — or a terminated trial period. For now, my priority is containing the damage and hoping treatment eventually stabilises things.

In daily life, it also means continuously watching my spending, which exploded this year, to the point of impacting not only me but my family, who now have to help financially after the chaos triggered during manic phases. I’ve lost count of how much money I burned. The total is… substantial.

My parents also monitor my bank account daily to catch the slightest slip before it spirals. That’s why they’ve told me several times this year that I should have gone to the hospital — something I avoid like the plague. My mother often does my groceries to spare me unnecessary exhaustion at a time when these phases drain my energy constantly. My friends, too, are usually the first to notice a shift in my mood and point it out. I am very supported. Some have been there repeatedly — letting me visit them late on weeknights just so I wouldn’t stay alone with my “madness.”

Clinical Deep Dive

I’ve talked here about rapid cycling, but scientific literature also describes ultra-rapid cycles, where mood shifts can happen within a month, a week — or even a single day. Some psychiatrists believe that this last form may actually be closer to a mixed episode rather than a true fluctuation. Ultra-rapid cycling isn’t formally recognised in the DSM-5, but it is studied — and undeniably real.

The aggravating factors are numerous: antidepressants can trigger a manic episode (which makes them difficult to introduce, especially during rapid cycling), insomnia (the main cause of a manic switch), substance use, and chronic stress. Among autistic people, many report intense mood shifts triggered by sudden disruptions of routines. I’ve experienced that several times following moves that uprooted my habits and led to hypomanic or manic episodes.

Hope keeps us alive

As the saying goes. Research has been investigating for years why some patients are so resistant to treatment, and we may see new medications emerge in the coming years. Bipolar disorder is one of the most studied psychiatric conditions, which means research is moving fast.

In the meantime, I have to rely on preventive coping strategies, especially to keep my psychiatrist informed as soon as relapse signs appear. I use a mood-tracking app where I log a lot of data daily, and with each episode I’m learning to spot patterns: frantic writing, unusually high social drive, increasing spending, and loss of sleep.

I’m at least aware now when I’m standing on the edge of mania — and that I need to prevent the escalation by strictly following my treatment. I also constantly need to differentiate: is this a meltdown or the beginning of depression? Is this creative surge mania, or just an autistic special interest kicking in?

The difference is simple: when it’s autism, the fatigue remains and eventually hits me hard.
When it’s mania, I feel invincible — overflowing with energy.

Rapid cycling means exactly this: a weaker response to treatment, a greater need to monitor and protect your health, and a succession of episodes that can feel like an emotional roller coaster.

Originally published in French on: 15 Sep 2025 — translated to English on: 18 Nov 2025.