Psychiatric specifier

With rapid cycling

Multiple distinct mood episodes occur within a year, separated by remission or a switch in polarity.

Course and onset

Bipolar I disorderBipolar II disorder

At a glance

Applies to: Bipolar I disorder · Bipolar II disorder
Deciding signal: Count syndromal episodes across time; do not substitute moment-to-moment emotional lability.
Ask this: Does the longitudinal timeline show repeated distinct episodes rather than rapid shifts within one episode?
Wording outcome: Bipolar I disorder, current episode depressed, with rapid cycling

Mood shifts occur within hours in response to events without distinct syndromal episodes.
A single prolonged mixed, unstable, or substance-related episode is being counted as several episodes.

Fit and exclusions

Start with the deciding signal, then test chronology, competing explanations, and the effect on diagnostic wording.

Distinct depressive, manic, or hypomanic episodes can be identified on a timeline.
Episodes are separated by remission or a clear switch in mood polarity.
Medication, thyroid, substance, sleep, and reproductive factors have been reviewed.

Use the episode timeline to guide maintenance strategy and reduce destabilising contributors.

Bipolar I disorder, current episode depressed, with rapid cycling

At a glance

Applies to

Bipolar I disorder · Bipolar II disorder

Deciding signal

Count syndromal episodes across time; do not substitute moment-to-moment emotional lability.

Ask this

Does the longitudinal timeline show repeated distinct episodes rather than rapid shifts within one episode?

Wording outcome

Bipolar I disorder, current episode depressed, with rapid cycling