Cyclothymia also called cyclothymic disorder, is a mood disorder. Cyclothymia causes emotional ups and downs, but they're not as extreme as in bipolar disorder type I or II.
With cyclothymia, you experience periods when your mood noticeably shifts up and down from your baseline. You may feel on top of the world for a time, followed by a low period when you feel somewhat blue. Between these cyclothymic highs and lows, you may feel stable and fine.
Compared with bipolar disorder I or II, the highs and lows of cyclothymia are less extreme. Still, it's critical to seek help managing these symptoms because they increase your risk of bipolar disorder I or II. Treatment options for cyclothymia include talk therapy (psychotherapy), medications and close, ongoing follow-up with your doctor.
SYMPTOMS
Cyclothymia symptoms alternate between emotional highs and lows. The highs of cyclothymia are characterized by symptoms of an elevated mood (hypomanic symptoms), which resemble those of mania but are less severe. The lows consist of mild or moderate depressive symptoms.
Cyclothymia symptoms are similar to those of bipolar disorder I or II, but they're less severe. When you have cyclothymia, you can typically function in your daily life, though not always well. The unpredictable nature of your mood shifts may significantly disrupt your life because you never know how you're going to feel.
Hypomanic phase of cyclothymia
The highs (hypomania) of cyclothymia meet the same diagnostic definition of hypomania for type II bipolar disorder. Signs and symptoms may include:
An exaggerated feeling of happiness or well-being (euphoria)Extreme optimismInflated self-esteemPoor judgmentRapid speechRacing thoughtsAggressive or hostile behaviorBeing inconsiderate of othersAgitationExcessive physical activityRisky behaviorSpending spreesIncreased drive to perform or achieve goalsIncreased sexual driveDecreased need for sleepTendency to be easily distractedInability to concentrate
Depressive phase of cyclothymia
Depressive episodes of cyclothymia may include a combination of these signs and symptoms:
SadnessHopelessnessSuicidal thoughts or behaviorAnxietyGuiltSleep problemsAppetite problemsFatigueLoss of interest in activities once considered enjoyableDecreased sex driveProblems concentratingIrritabilityChronic pain without a known cause
For the first two years after symptoms begin, the highs and lows of cyclothymia are less extreme. After that time, your highs and lows may become more pronounced. You may have depressive episodes that meet the criteria for full-blown major depressive episodes. Or you could experience full manic episodes.
CAUSES
It's not known specifically what causes cyclothymia. As with many mental health disorders, research shows that it may result from a combination of:
Heredity — cyclothymia tends to run in familiesYour body's biochemical processes, such as changes in brain chemistryEnvironment
COMPLICATIONS
Left untreated, cyclothymia can result in significant emotional problems that affect every area of your life — and it might develop into bipolar disorder I or II, based on worsening or more-extreme signs and symptoms.
DIAGNOSIS
Your doctor or other health care provider must determine if you have cyclothymia, bipolar disorder I or II, depression or another condition that may be causing your symptoms. To help pinpoint a diagnosis for your symptoms, you'll likely have several exams and tests, which generally include:
General medical exam. During this exam, your doctor measures your blood pressure and listens to your heart and lungs, among other things — or reviews results of recent physical exams — to determine if there could be any medical reasons for your symptoms.Lab tests. These may include a complete blood count as well as thyroid tests and other blood tests. You may also have a urinalysis or tests for drug and alcohol use.Psychological evaluation. A doctor or mental health provider will talk to you about your thoughts, feelings and behavior patterns. You may also fill out psychological self-assessments and questionnaires. You may be asked about substance or alcohol abuse. And with your permission, family members or close friends may be asked to provide information about your symptoms and possible episodes of mania or depression.
Diagnostic criteria for cyclothymia
To be diagnosed with cyclothymia, you must meet the criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
Diagnostic criteria for cyclothymia include those below.
You've had numerous periods of elevated mood (hypomania) and many periods of depressive symptoms for at least two years.Your periods of stable moods usually last less than two months.Your symptoms significantly affect you socially, at work, at school or in other important functions.You don't have manic episodes, major depression or schizoaffective disorder — a combination of schizophrenia symptoms, such as hallucinations or delusions, and mood disorder symptoms, such as mania or depression.Your symptoms aren't caused by substance abuse or a medical condition.
TREATMENT
Cyclothymia requires lifelong treatment — even during periods when you feel better — usually guided by a mental health provider skilled in treating the condition.
To treat cyclothymia, your doctor or mental health provider aims to:
Decrease your risk of bipolar disorder I or II, since cyclothymia carries a high risk of developing into more severe bipolar disorderReduce the frequency and severity of your symptoms, allowing you to live a more balanced and enjoyable lifePrevent a relapse of symptoms, through continued treatment during periods of remission (maintenance treatment)Treat alcohol or other substance abuse problems, since they can worsen cyclothymia symptoms
The main treatments for cyclothymia are medications and psychotherapy.
Medications
Medications may help control cyclothymia symptoms and prevent episodes of hypomania and depression. Medications used to treat cyclothymia include:
Mood stabilizers. Mood stabilizers help regulate and stabilize mood so that you don't swing between depression and hypomania. Lithium (Lithobid) has been widely used as a mood stabilizer. Anti-seizure medications, also known as anticonvulsants, are also used to prevent mood swings. Examples include valproic acid (Depakene), divalproex sodium (Depakote), carbamazepine (Tegretol, Equetro, others) and lamotrigine (Lamictal). Your doctor may recommend that you take mood stabilizers for the rest of your life to prevent and treat hypomanic episodes.Antipsychotics. Certain antipsychotic medications — such as olanzapine (Zyprexa), quetiapine (Seroquel) and risperidone (Risperdal) — may help people who don't benefit from the mood-stabilizing effects of anti-seizure medications.Anti-anxiety medications. Anti-anxiety medications, such as benzodiazepines, may help improve sleep.Antidepressants. Use of antidepressants for cyclothymia is typically not recommended, unless they're combined with a mood stabilizer or antipsychotic. As with bipolar disorder I or II, taking antidepressants alone can trigger potentially dangerous manic episodes. Before taking antidepressants, carefully weigh the pros and cons with your doctor.
If one medication doesn't work well for you, there are many others to consider. Keep trying until you find one that works well for you. Your doctor may advise combining certain medications for maximum effect. It can take several weeks after first starting a medication to notice an improvement in your cyclothymia symptoms.
All medications have side effects and possible health risks. Talk to your doctor about the benefits and risks.
Medications such as mood stabilizers may harm a developing fetus or nursing infant. Women with cyclothymic disorder who want to become pregnant or do become pregnant must fully explore with their health care providers the benefits and risks of medications.
Psychotherapy
Psychotherapy, also called counseling or talk therapy, can help you understand what cyclothymia is and how it's treated.
Types of therapy that may help cyclothymia include:
Cognitive behavioral therapy. Cognitive behavioral therapy helps you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones. In addition, you can explore what triggers your hypomanic or depressive episodes and learn how to manage stress and cope with upsetting situations.Family therapy. Family therapy helps you and your family members learn how to communicate, solve problems and resolve conflicts with each other. Family therapy helps identify stressors within the family that may contribute to unhealthy behavior patterns. Your family may also gain a better understanding of your condition and why you think and behave the way you do.Group therapy. Group therapy provides a forum to communicate with and learn from others in a similar situation. It may also help build better relationship skills.Interpersonal social rhythm therapy. This type of therapy helps you manage your daily routines (including your sleep schedule), improve your relationships and develop better communication skills so that interpersonal problems don't disrupt your routines.
With cyclothymia, you experience periods when your mood noticeably shifts up and down from your baseline. You may feel on top of the world for a time, followed by a low period when you feel somewhat blue. Between these cyclothymic highs and lows, you may feel stable and fine.
Compared with bipolar disorder I or II, the highs and lows of cyclothymia are less extreme. Still, it's critical to seek help managing these symptoms because they increase your risk of bipolar disorder I or II. Treatment options for cyclothymia include talk therapy (psychotherapy), medications and close, ongoing follow-up with your doctor.
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| Mood changes due to Cyclothymia |
SYMPTOMS
Cyclothymia symptoms alternate between emotional highs and lows. The highs of cyclothymia are characterized by symptoms of an elevated mood (hypomanic symptoms), which resemble those of mania but are less severe. The lows consist of mild or moderate depressive symptoms.
Cyclothymia symptoms are similar to those of bipolar disorder I or II, but they're less severe. When you have cyclothymia, you can typically function in your daily life, though not always well. The unpredictable nature of your mood shifts may significantly disrupt your life because you never know how you're going to feel.
Hypomanic phase of cyclothymia
The highs (hypomania) of cyclothymia meet the same diagnostic definition of hypomania for type II bipolar disorder. Signs and symptoms may include:
An exaggerated feeling of happiness or well-being (euphoria)Extreme optimismInflated self-esteemPoor judgmentRapid speechRacing thoughtsAggressive or hostile behaviorBeing inconsiderate of othersAgitationExcessive physical activityRisky behaviorSpending spreesIncreased drive to perform or achieve goalsIncreased sexual driveDecreased need for sleepTendency to be easily distractedInability to concentrate
Depressive phase of cyclothymia
Depressive episodes of cyclothymia may include a combination of these signs and symptoms:
SadnessHopelessnessSuicidal thoughts or behaviorAnxietyGuiltSleep problemsAppetite problemsFatigueLoss of interest in activities once considered enjoyableDecreased sex driveProblems concentratingIrritabilityChronic pain without a known cause
For the first two years after symptoms begin, the highs and lows of cyclothymia are less extreme. After that time, your highs and lows may become more pronounced. You may have depressive episodes that meet the criteria for full-blown major depressive episodes. Or you could experience full manic episodes.
CAUSES
It's not known specifically what causes cyclothymia. As with many mental health disorders, research shows that it may result from a combination of:
Heredity — cyclothymia tends to run in familiesYour body's biochemical processes, such as changes in brain chemistryEnvironment
COMPLICATIONS
Left untreated, cyclothymia can result in significant emotional problems that affect every area of your life — and it might develop into bipolar disorder I or II, based on worsening or more-extreme signs and symptoms.
DIAGNOSIS
Your doctor or other health care provider must determine if you have cyclothymia, bipolar disorder I or II, depression or another condition that may be causing your symptoms. To help pinpoint a diagnosis for your symptoms, you'll likely have several exams and tests, which generally include:
General medical exam. During this exam, your doctor measures your blood pressure and listens to your heart and lungs, among other things — or reviews results of recent physical exams — to determine if there could be any medical reasons for your symptoms.Lab tests. These may include a complete blood count as well as thyroid tests and other blood tests. You may also have a urinalysis or tests for drug and alcohol use.Psychological evaluation. A doctor or mental health provider will talk to you about your thoughts, feelings and behavior patterns. You may also fill out psychological self-assessments and questionnaires. You may be asked about substance or alcohol abuse. And with your permission, family members or close friends may be asked to provide information about your symptoms and possible episodes of mania or depression.
Diagnostic criteria for cyclothymia
To be diagnosed with cyclothymia, you must meet the criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
Diagnostic criteria for cyclothymia include those below.
You've had numerous periods of elevated mood (hypomania) and many periods of depressive symptoms for at least two years.Your periods of stable moods usually last less than two months.Your symptoms significantly affect you socially, at work, at school or in other important functions.You don't have manic episodes, major depression or schizoaffective disorder — a combination of schizophrenia symptoms, such as hallucinations or delusions, and mood disorder symptoms, such as mania or depression.Your symptoms aren't caused by substance abuse or a medical condition.
TREATMENT
Cyclothymia requires lifelong treatment — even during periods when you feel better — usually guided by a mental health provider skilled in treating the condition.
To treat cyclothymia, your doctor or mental health provider aims to:
Decrease your risk of bipolar disorder I or II, since cyclothymia carries a high risk of developing into more severe bipolar disorderReduce the frequency and severity of your symptoms, allowing you to live a more balanced and enjoyable lifePrevent a relapse of symptoms, through continued treatment during periods of remission (maintenance treatment)Treat alcohol or other substance abuse problems, since they can worsen cyclothymia symptoms
The main treatments for cyclothymia are medications and psychotherapy.
Medications
Medications may help control cyclothymia symptoms and prevent episodes of hypomania and depression. Medications used to treat cyclothymia include:
Mood stabilizers. Mood stabilizers help regulate and stabilize mood so that you don't swing between depression and hypomania. Lithium (Lithobid) has been widely used as a mood stabilizer. Anti-seizure medications, also known as anticonvulsants, are also used to prevent mood swings. Examples include valproic acid (Depakene), divalproex sodium (Depakote), carbamazepine (Tegretol, Equetro, others) and lamotrigine (Lamictal). Your doctor may recommend that you take mood stabilizers for the rest of your life to prevent and treat hypomanic episodes.Antipsychotics. Certain antipsychotic medications — such as olanzapine (Zyprexa), quetiapine (Seroquel) and risperidone (Risperdal) — may help people who don't benefit from the mood-stabilizing effects of anti-seizure medications.Anti-anxiety medications. Anti-anxiety medications, such as benzodiazepines, may help improve sleep.Antidepressants. Use of antidepressants for cyclothymia is typically not recommended, unless they're combined with a mood stabilizer or antipsychotic. As with bipolar disorder I or II, taking antidepressants alone can trigger potentially dangerous manic episodes. Before taking antidepressants, carefully weigh the pros and cons with your doctor.
If one medication doesn't work well for you, there are many others to consider. Keep trying until you find one that works well for you. Your doctor may advise combining certain medications for maximum effect. It can take several weeks after first starting a medication to notice an improvement in your cyclothymia symptoms.
All medications have side effects and possible health risks. Talk to your doctor about the benefits and risks.
Medications such as mood stabilizers may harm a developing fetus or nursing infant. Women with cyclothymic disorder who want to become pregnant or do become pregnant must fully explore with their health care providers the benefits and risks of medications.
Psychotherapy
Psychotherapy, also called counseling or talk therapy, can help you understand what cyclothymia is and how it's treated.
Types of therapy that may help cyclothymia include:
Cognitive behavioral therapy. Cognitive behavioral therapy helps you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones. In addition, you can explore what triggers your hypomanic or depressive episodes and learn how to manage stress and cope with upsetting situations.Family therapy. Family therapy helps you and your family members learn how to communicate, solve problems and resolve conflicts with each other. Family therapy helps identify stressors within the family that may contribute to unhealthy behavior patterns. Your family may also gain a better understanding of your condition and why you think and behave the way you do.Group therapy. Group therapy provides a forum to communicate with and learn from others in a similar situation. It may also help build better relationship skills.Interpersonal social rhythm therapy. This type of therapy helps you manage your daily routines (including your sleep schedule), improve your relationships and develop better communication skills so that interpersonal problems don't disrupt your routines.
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