How Long Do Manic and Depressive Episodes Last?

In the context of bipolar disorder, a mental illness that involves extreme swings in mood, bipolar cycles are the period of time in which an individual goes through one episode of mania or hypomania and one episode of depression. How long do manic episodes last when someone is cycling? What about depression episode length?

Unfortunately, there is no definitive answer to the duration or frequency of bipolar cycles since they are as varied as the people who experience them. A change or "mood swing" can last for hours, days, weeks, or even months. Generally, a manic episode can last from seven days up to several months. Depressive episodes last from two weeks to several months and are usually longer in duration than manic episodes.

What Are Bipolar Cycles?

A bipolar cycle refers to the various stages a person with bipolar disorder experiences. In bipolar cycles, the manic or hypomanic stage is followed by a stage of depression.

How long these episodes last can vary. It really depends on the type of bipolar disorder you have, individual factors, and whether or not your condition is being treated. Without treatment, manic and depressive episodes will last much longer.

A person with bipolar cycles will typically experience an initial stage of mania, which includes behavior that is characterized by high levels of energy, excitement, and sometimes, agitation. However, someone with bipolar II disorder may experience hypomania instead of mania.

Hypomania is similar to mania but with milder symptoms. A person is still able to function with hypomania.

How often do people with bipolar disorder cycle? On average, people with bipolar will have one or two cycles yearly. In addition, there is a seasonal influence—manic episodes occur more often in the spring and fall.

Manic Episodes

Manic episodes are characterized by extremely high energy levels. A person may have a decreased need for sleep and a decreased appetite. They may also feel like they are able to multitask many things at a time.

A person experiencing a manic episode will usually have racing thoughts and even talk very quickly about a variety of different topics in a short amount of time.

While this high energy level can feel good and make a person feel "on top of the world," they are prone to making risky decisions such as drinking excessively, giving away money, or having unsafe sex. They may also feel more irritable or agitated.

Depressive Episodes

Depressive episodes, as the name suggests, are marked by periods of feeling deep sadness, a sense of hopelessness, or extreme worry. During a depressive episode, a person may have sleep disturbances (either sleeping too much or not enough).

Increased appetite and weight gain are common. People having depressive episodes tend to talk slowly, have trouble concentrating, and feel incapable of completing tasks or doing anything at all.

During a depressive episode, a person usually has no interest in activities that they normally like. They are usually disinterested in sex or anything that brings them pleasure. They may experience increased thoughts about death or suicidal ideation.

Mixed Episodes

A mixed episode can be considered a combination of both a manic episode and a depressive episode. A person will experience extremely high energy levels while feeling hopeless, sad, and depressed at the same time.

Triggers of Depressive and Manic Episodes

Certain conditions are known to trigger symptoms in people with bipolar disease. Understanding these triggers—and avoiding them—can minimize symptoms and limit the number of cycles a person experiences. These include:

• Alcohol and drug misuse
• Altercations with loved ones
• Certain antidepressants and other medications
• Change in seasons
• Events such as starting a creative project, falling in love, going on vacation, listening to loud music, and decreasing physical exercise
• Grief
• Insufficient sleep
• Menstruation, pregnancy, and other hormonal conditions
  

How Fast Can Bipolar Cycle?

In some people, bipolar cycles can occur in fairly quick succession. This is referred to as 'rapid cycling,' which is when someone with bipolar disorder has four or more cycles in a 12-month period.

While having four or more cycles in a one-year period meets the criteria for a diagnosis of rapid-cycling bipolar illness, rapid cycling is not necessarily a permanent pattern. Rather, rapid cycling can present at any point in the course of the disease. And it can be transient.

Rapid cycling may be more likely to affect those who were young when symptoms first appeared, those who have had bipolar disorder for a longer time, and those who misuse alcohol and other substances.

In addition, the term "ultra-rapid cycling" may be applied to those who cycle through episodes within a month or less. If this pattern occurs within a 24-hour period, the person's diagnosis could possibly be termed "ultra-ultra-rapid cycling" or "ultradian." It is often difficult to tell ultradian cycling from a mixed episode.

What Bipolar Cycles Feel Like

A common feeling of people with bipolar disorder experiencing a cycle is that they are on a roller coaster. It can be exhausting and even frightening to experience such a wide range of different emotions—especially if it's within a short period of time.

Many people with bipolar disorder feel as though cycling makes them feel out of control. For instance, they may make decisions during a manic episode that they feel unequipped to deal with when they shift to a depressive episode.

During a manic episode, you may feel like you are truly special and powerful. Then, during a depressive episode, you may feel completely empty and like your life isn't worth anything at all. It can be daunting to undergo such extreme emotional shifts.

Treating Bipolar Cycles

Whether a person with bipolar disorder experiences a cycle once every five years or many times each day, there are treatments that can help. These include:

• Alternative and complementary health practices, such as meditation
• Cognitive behavioral therapy (CBT) and other forms of psychotherapy
• Education and self-management techniques
• Electroconvulsive therapy
  
• Medications, including mood stabilizers, antipsychotics, and antidepressants
  

How to Support a Loved One With Bipolar Cycles

You may be wondering how to best support a loved one with bipolar disorder, especially when they are cycling through depressive and manic episodes. Here are some tips.

Advocate for Them

If you are the caregiver to someone with bipolar disorder, you have the right to advocate for them. Speak with their medical team about their cycling. Maybe you notice that their cycling symptoms are getting worse, or that there has been a change in how rapidly they cycle from one stage to another.

Make sure doctors have access to all prior medical treatments your loved one received for their bipolar disorder. Ask them what they can do differently to help your loved one.

Reach Out

If you have a friend or family member with bipolar disorder, but they don't live with you, try reaching out to them on a regular basis to see how they're doing. They may not always be up for doing something together but try suggesting an activity.

Your loved one might be hesitant to say how they're really feeling, especially if they are depressed. Let them know that they don't have to pretend around you.

Of course, respect their space if they don't feel like talking. Don't bombard them with texts and calls if they need time alone.

Encourage Healthy Habits

You can help encourage your loved one to lead a balanced lifestyle—one that promotes a nutritious diet, adequate sleep, and limiting alcohol and substance use. For instance, suggest you both go on a walk or see a movie instead of going to a bar or a party where people might be drinking excessively.

If your loved one is misusing substances or skipping their medication, try not to chastise them for their behavior. Show them that you understand why they may be acting this way, but encourage them to make an appointment with their doctor as soon as they can.

Have Compassion

Compassion can go a long way in supporting a friend or family member who has bipolar disorder. Understand that they are coping with a disorder and that they may have little control, at times, over things they say or do.

If they say something that upsets you, you can walk away from the situation. Try to take a few deep breaths instead of reacting negatively or arguing with them.

But staying calm during conflict doesn't mean you need to pretend you're OK if they hurt your feelings or cross a line. When it's appropriate, let them know what your expectations are and what is not acceptable around you. Establish healthy boundaries with them.

Listen to Them

Sometimes, we all need someone who can lend a listening ear. You can't stop your loved one from cycling in bipolar disorder, but you can listen to them when they need someone to talk to about their frustrations, anxieties, or worries.

Remind them that they can talk to you about anything. If they speak of self-harm or suicide and you fear that the risk of suicide is imminent, get them help right away.

Take Care of Yourself

It's crucial that you take time for yourself, away from your loved one, to engage in self-care. Coping with mental illness is never easy for anyone—even for friends and family.

The following are some ways you can prioritize your own physical and mental health:

• Eat a nutritious diet
• Get enough physical exercise
  
• Get enough sleep
• Join a community organization for caregivers
• Receive emotional support from a therapist
  
• Share how you're feeling with trusted friends or family
  

Oftentimes, caregivers or loved ones experience guilt because they can't do more to help their loved one who has bipolar disorder. Talk about this with friends, family, or a mental health professional. You can't control your loved one's bipolar disorder, so try not to take any blame upon yourself.

By putting yourself and your health first, you'll be better able to handle the ups and downs that come with your loved one's cycling, which is also better for them.

Takeaways

How long a depressive or manic episode lasts can vary from one person to the next. It is important to remember that without treatment, a manic or depressive episode can last for several months. Seeking help, adhering to treatment recommendations, and avoiding mood triggers can help minimize these mood episodes and improve your ability to function in your daily life.