How short a cycle can you have and still be "bipolar"?

Q: although i have been diagnosed as being bipolar, i am unsure. i've been reading a lot about it and and as far as i can tell, a few of its symptoms do not pertain to me; for example, my mood shifts can last from 10 minutes up to two or three days, but no longer than that. i am CONSTANTLY unstable and affected by my volatile moods. to my knowledge bipolar mood shifts last for longer periods of time. cyclothymia sounds to me to be the closest disorder characterized to mine. am i wrong? do i have bipolar or could it be something else?

Dear Mary --
Very good question.  No one has ever defined how short a "cycle" can be, and still be "bipolar".  At some point less than a few hours, it all just dissolves into extreme mood lability (jargon term meaning "labile" or changeable mood) without much pattern to it.  Remember Dr. Jamison's quote (you might have seen this on my site; I think it's just a crucial mind-broadening quote about the nature of bipolar disorder):

"The clinical reality of manic-depressive illness is far more lethal and infinitely more complex than the current psychiatric nomenclature, bipolar disorder, would suggest. Cycles of fluctuating moods and energy levels serve as a background to constantly changing thoughts, behaviors, and feelings. The illness encompasses the extremes of human experience. Thinking can range from florid psychosis, or "madness," to patterns of unusually clear, fast and creative associations, to retardation so profound that no meaningful mental activity can occur. Behavior can be frenzied, expansive, bizarre, and seductive, or it can be seclusive, sluggish, and dangerously suicidal. Moods may swing erratically between euphoria and despair or irritability and desperation. The rapid oscillations and combinations of such extremes result in an intricately textured clinical picture." (Kay Jamison, Ph.D.)

She all but says that any pattern of "oscillation" could count, and that's basically how it looks to me: any pattern can be bipolar.  The diagnosis is made on the basis of the symptoms, not the timing of the pattern (I'm sure that's not new news to you!).   And remember, whether you call it bipolar II or cyclothymia or mixed state with rapid cycling -- it all ends up being basically the same as far as prognosis and treatment (which means which label you pick doesn't make to much difference...).

Dr. Phelps


Published January, 2001