What is Ultradian Bipolar?

June 24, 2025

Authored by: Taylor Shaw, B.S.

Edited by: Angeleena Francis, LMHC

An individual living with bipolar disorder experiences manic or hypomanic episodes, and often also experiences depressive episodes in between. Rapid cycling refers to a higher frequency of mood shifts to four manic or hypomanic episodes per year; ultra-rapid cycling refers to episodes occurring within the course of weeks to several days; ultradian cycling (or ultra-ultra rapid cycling) refers to distinct, abrupt mood shifts of less than 24 hours duration.¹

Ultradian Bipolar is classified under “rapid cycling bipolar disorder,” at the highest frequency of mood shifts. The conventionally recognised limit in episode duration for Ultradian Bipolar is usually considered 24 hours (i.e. a cycle duration of 48 hours).² Due to the nature of these rapid fluctuations and oscillations in patients’ moods, Ultradian Bipolar is often misdiagnosed as borderline personality disorder (BPD) or attention deficit hyperactivity disorder (ADHD).

An individual struggling with rapid cycling or ultradian bipolar disorder will likely have an increase in the other physical symptoms that come along with manic episodes and mixed episodes. The rapid mood cycling may increase one’s risk of suicide, psychosis, convulsions, intensify the depressive symptoms, or more. If you or a loved one are struggling with ultra-rapid cycling bipolar disorder, don’t hesitate to reach out for help today. At AMFM Mental Health Treatment, we provide our clients with a safe and secure location to begin your recovery journey.

More on Rapid Cycling

Recent studies have shown that the comorbidity of other disorders with rapid cycling bipolar disorder can lead to increased physical symptoms of the mood swings. In one cohort of patients with rapid-cycling bipolar disorder, more than 41% had at least 1 suicide attempt; any comorbidity of psychosis during depression, early life physical abuse, female sex, and the bipolar I subtype were associated with increased risk and/or the number of previous suicide attempts.³ Another study of mood episodes found that year prevalence of rapid cycling among all bipolar patients ranges between 5%-33.3%, while lifetime prevalence ranges between 25.8%-43%.

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Psychiatric Care for Rapid Cycling Bipolar Disorder

AMFM Mental Health Treatment provides comprehensive psychiatric care, along with traditional therapeutic modalities for ultradian cycling and ultra-rapid cycling bipolar disorder. Our on-staff clinicians are equipped to design personalized treatment plans for your continued success. In combination with psychotherapy, psychiatry is handled safely, to help you or your loved one overcome mental health challenges.

Lithium

For over half a century, Lithium has been used as a mood stabilizer to treat bipolar disorder, treating both the manic episodes as well as the bipolar depression.⁴ However, Lithium treatment can have side effects and complications in long-term use on the kidney and thyroid, and it’s important that an individual keep his or her clinical team in the loop on any side effects as they come up.

Antidepressants and Antipsychotics

Antidepressants and antipsychotics are both commonly used (alone and in tandem) in the treatment of Bipolar Disorder as mood stabilizers. However, rapid cycling is sometimes a side effect that is associated with antidepressant treatment in bipolar disorder.⁵ Conventional antipsychotics have been proven to be effective for short-term treatment of Bipolar Disorder, but there has been little research on the long-term efficacy of antipsychotics and antidepressants for BD.

Ketamine

In recent years, researchers have studied whether or not ketamine may be a useful pharmacological tool for treating rapid cycling bipolar disorder, specifically, due to the nature of the disorder. There was some success with levothyroxine, which could be explained by thyroid dysfunction and antithyroid antibodies that have been reported to be associated with mood disorders, and specifically with rapid cycling bipolar disorder. However, for now, the evidence is too sparse to recommend the use of ketamine for rapid cycling bipolar disorder.⁶

General Symptoms of Bipolar Disorder

Bipolar I Disorder is considered the most severe form of Bipolar Disorder, and is diagnosed when an individual enters a manic state, characterized by an intense mood swing “up”, consisting of high-energy, uncomfortable irritability, racing thoughts and impulsivity. While Bipolar II Disorder is also characterized by manic episodes, they may be shorter or less severe, referred to as hypomania. A person struggling with Bipolar II will experience depressive episodes, while an individual struggling with Bipolar I may or may not experience depression.

Manic Episodes

In order to be diagnosed with Bipolar I Disorder, according to the diagnostic and statistical manual of mental disorders (DSM-5) an individual must experience at least one manic episode. Episodes of mania are generally characterized by mood changes, increased energy levels, rapid talking, increased grandiosity, (an overinflated sense of self), distractibility (which may be misattributed or related to attention deficit hyperactivity disorder), engaging in impulsive or risky behavior, occasionally psychosis, and more.

Hypomanic Episodes

Hypomania refers to a shorter duration of manic symptoms, with generally milder symptoms. In order to be diagnosed with Bipolar II, an individual must experience at least one episode of hypomania, in addition to an episode of depression.

Depressive Episodes

In order to be diagnosed with Bipolar II, an individual must experience both a hypomanic and a depressive episode. Depressive episodes are characterized by low moods, low energy, suicidal thoughts, or other common symptoms of depression like loss of interest, low self-esteem, fatigue, or changes in appetite.

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Popular Forms of Therapeutic Treatment for Bipolar Disorder

Therapeutic Treatment for rapid cycling bipolar disorder is always recommended, whether in combination with psychiatric care, or separately from psychiatry. While small lifestyle changes like daily physical activity, regular exercise, and stepping outside into the sunlight when possible are helpful tactics, psychotherapy is highly regarded as the most effective method of mental health care for those struggling with mental disorders.

Cognitive-Behavioral Therapy (CBT)

Cognitive-Behavioral Therapy (CBT) is a form of therapy that’s focused on restructuring and reprogramming maladaptive and negative thought processes. Psychologists are trained to help you change your cognitive and emotional processes in order to outgrow coping mechanisms that may no longer be serving you.⁷

Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy (DBT) is most commonly referred to as “talk therapy,” and is designed to help process emotions and strive for emotional regulation, as well as mood regulation. Qualified professionals offer psychological therapy to move forward with healthy ways of engaging in interpersonal relationships and alleviating physical and emotional distress.

Eye Movement Desensitization and Reprocessing Therapy (EMDR)

EMDR Therapy is a renowned method of reprocessing most often used in trauma therapy. By activating the prefrontal cortex through a series of bilateral stimulation, qualified professionals can lead you through traumatic experiences, helping you to alleviate the distress symptomized by trauma.⁸

Electroconvulsive Therapy (ECT)

ECT is a form of “Shock Therapy,” designed for brain stimulation, and only utilized in cases of severe depression. While ECT has historically gotten a bad reputation, when properly administered it can be a useful tool for those who cannot accept psychiatric assistance.

Transcranial Magnetic Stimulation (TMS)

TMS is a type of therapy that uses magnetic pulses to treat depression by stimulating certain areas of the brain. This is a noninvasive method of treatment that some mental health programs offer.

AMFM Treatment Center for Rapid-Cycling Bipolar Disorder

AMFM Mental Health Treatment center offers specialized treatment for bipolar disorder, mood disorders, and hypomania episode care across multiple locations. Our California, Virginia, and Washington locations offer you or your loved one mental health programming and mental health crisis services at the highest level of care. We provide comprehensive case management, a variety of therapies, behavioral health services, and a safe and supportive environment for wellness. We are strategically placed to provide accessible, high-quality care tailored to your needs. To find out more about our facilities, contact us today. Explore our locations below to find the one nearest to you.

California

Mental Health Treatment Program in California

AMFM’s California treatment centers are located up and down the coast of Southern California, from the greater Los Angeles area, to Orange County, down to San Diego. Our inpatient mental mental health treatment program locations are: Fallbrook, Carlsbad, Lake Forest, Dana Point, San Juan Capistrano, Laguna Hills, and Laguna Nigel. For personalized support and for insurance verification, contact us today.

Virginia

Mental Health Treatment Program in Virginia

If you’re searching for mental health treatment options in Virginia, AMFM’s mental health treatment programs are available in Fairfax Station, Vienna, and Great Falls, VA.These locations in Virginia are qualified to assist with anxiety treatment and to meet your needs.

Washington

Mental Health Treatment Program in Washington

AMFM Mental Health Treatment Center offers outpatient mental health treatment programs in Washington, conveniently located at 6900 East Green Lake Way N, Suite G, Seattle, WA 98115. A Mission For Michael Mental Health Treatment has one location in the state, providing dedicated and comprehensive mental health care for lasting well-being.

Additional Mental Health Conditions for Treatment

AMFM Mental Health Treatment has extensive experience treating a variety of mental health disorders–through evidence-based therapies, support groups, mental health resources and more–including but not limited to the following:

Anxiety Disorders
Depression
Eating Disorders
Cyclothymic Disorder & Mood Disorders
Obsessive Compulsive Disorder (OCD)
Post-Traumatic Stress Disorder (PTSD)
Crisis & Traumatic Events
Attention-Deficit/Hyperactivity Disorder (ADHD)
Psychosis
Phobias
Schizophrenia
Panic Attacks

Recovery can feel isolating; mental health programming can provide treatment options and cohesive plans to help you or your loved one as you move forward.

Health Insurance Coverage for Ultradian Bipolar Treatment

Most health insurance companies provide some form of coverage for bipolar disorder treatment.

AMFM Mental Health Treatment accepts most major insurance providers and can find out what your coverage levels would look like for one of our mental health facilities. Coverage may vary by carrier, but AMFM Mental Health Treatment Centers is in-network with many major insurance providers.

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Citations

Kramlinger KG, Post RM. Ultra-rapid and ultradian cycling in bipolar affective illness. Br J Psychiatry. 1996 Mar;168(3):314-23. doi: 10.1192/bjp.168.3.314. PMID: 8833685.

Gillette, H. (2023, October 24). Ultra-rapid cycling in bipolar disorder: Signs, prevalence. Healthline. https://www.healthline.com/health/bipolar-disorder/ultra-rapid-cycling-bipolar#ultra-rapid-cycling

Gao K, Tolliver BK, Kemp DE, Ganocy SJ, Bilali S, Brady KL, Findling RL, Calabrese JR. Correlates of historical suicide attempt in rapid-cycling bipolar disorder: a cross-sectional assessment. J Clin Psychiatry. 2009 Jul;70(7):1032-40. doi: 10.4088/jcp.08m04231. PMID: 19653978; PMCID: PMC3457055.

Burdick KE, Millett CE, Russo M, Et. al, The association between lithium use and neurocognitive performance in patients with bipolar disorder. Neuropsychopharmacology. 2020 Sep;45(10):1743-1749. doi: 10.1038/s41386-020-0683-2. Epub 2020 Apr 29. PMID: 32349118; PMCID: PMC7419515.

Kusumakar V. Antidepressants and antipsychotics in the long-term treatment of bipolar disorder. J Clin Psychiatry. 2002;63 Suppl 10:23-8. PMID: 12392350.

Bourla A, Ferreri F, Baudry T, Panizzi V, Adrien V, Mouchabac S. Rapid cycling bipolar disorder: Literature review on pharmacological treatment illustrated by a case report on ketamine. Brain Behav. 2022 Feb;12(2):e2483. doi: 10.1002/brb3.2483. Epub 2022 Jan 18. PMID: 35041295; PMCID: PMC8865164.

“APA Dictionary of Psychology.” APA Dictionary of Psychology, https://dictionary.apa.org/cognitive-behavior-therapy. Accessed 20 February 2025.

“What is EMDR?” EMDR Institute, https://www.emdr.com/what-is-emdr/. Accessed 20 February 2025.