Cyclothymic disorder
Cyclothymia; Mood disorder - cyclothymia
Cyclothymic disorder is a mental disorder. It is a mild form of bipolar disorder (manic depressive illness), in which a person has mood swings over a period of years that go from mild depression to emotional highs.
If you, or a person close to you, have frequent episodes of extreme mood swings, going between periods of mania, or an exaggerated elevated good mood, to quickly experiencing a lowering or depressed mood often without reason, you may have bipolar disorder. Let's talk about this condition, and how it can be managed. As just stated, Bipolar disorder is a brain condition that causes unusual shifts in mood, energy, and ability to carry out daily tasks. Symptoms can be severe, lasting from days to months. Someone with bipolar disorder may be easily distracted, have little need for sleep, exercise poor judgment and temper control, and exhibit reckless behavior and a lack of self control. They may have very elevated moods, be very involved in their activities, and may occasionally seem very agitated or irritated. On the flip side, depressive symptoms of bipolar disorder may include daily sadness, a difficulty concentrating, eating problems, a lack of energy, feeling worthless, and thoughts of death or suicide. People with bipolar disorder have a higher risk of suicide than people without this condition. They also may abuse alcohol or other substances, which usually only make their symptoms worse. So, how is bipolar disorder treated? The main goals of treatment are to help the person avoid moving from one phase to another, avoid the need to stay in a hospital or treatment center, to help the patient function as well as possible between episodes, to prevent self-injury and suicide, and make bipolar episodes less frequent and less severe. Keep in mind periods of depression or mania often return in someone with bipolar disorder, even when they are treated. Drugs, called mood stabilizers, are usually the first line of treatment. Often accompanied by psychotherapy and psychoeducation. A person with bipolar disorder may need stronger medicines as well, such as anti-psychotic or anti-seizure drugs. Anti-anxiety drugs, antidepressants to treat depression, are problematic because they can increase the likelihood of a manic episode even when people also take a mood stabilizer. Some patients may have a procedure called electroconvulsive therapy, in which a small amount of electrical current will be delivered to their heads to cause seizure activity in the brain to treat either depression or mania. Evidence to support this treatment exists, but it limited. Support programs for people with bipolar disorder are important. Family programs that combine support and education about bipolar disorder may help families cope and reduce the odds of symptoms returning. Programs that offer outreach and community support services can help people who do not have family and social support. It is also important for people with bipolar disorder to learn to cope with their symptoms, get enough sleep, live a healthy lifestyle, avoid recreational drugs, and take their medications correctly, and learn to watch for the early signs of return symptoms, having a plan of action to know what to do if and when they do return. Also, keep in mind, support is very important in the treatment of bipolar disorder. Family members can help the patient find the right support services and make sure the patient takes their medication correctly.
Causes
The causes of cyclothymic disorder are unknown. Major depression, bipolar disorder, and cyclothymia often occur together in families. This suggests that these mood disorders share similar causes.
Cyclothymia usually begins early in life. Men and women are equally affected.
Symptoms
Symptoms may include any of the following:
- Periods (episodes) of extreme happiness and high activity or energy (hypomanic symptoms), or low mood, activity, or energy (depressive symptoms) for at least 2 years (1 or more years in children and adolescents).
- These mood swings are less severe than with bipolar disorder or major depression.
- Ongoing symptoms, with no more than 2 symptom-free months in a row.
Exams and Tests
The diagnosis is usually based on your mood history. Your health care provider may order blood and urine tests to rule out medical causes of mood swings.
Treatment
Treatments for this disorder include mood-stabilizing medicine, antidepressants, talk therapy, or some combination of these three treatments.
Some of the more commonly used mood stabilizers are lithium and antiseizure medicines.
Compared with bipolar disorder, some people with cyclothymia may not respond as well to medicines.
Support Groups
You can ease the stress of living with cyclothymic disorder by joining a support group whose members share common experiences and problems.
Outlook (Prognosis)
Less than one half of people with cyclothymic disorder go on to develop bipolar disorder. In other people, cyclothymia continues as a chronic condition or disappears with time.
Possible Complications
The condition can progress to bipolar disorder.
When to Contact a Medical Professional
Call a mental health professional if you or a loved one has alternating periods of depression and excitement that do not go away and that affect work, school, or social life.
If you or someone you know is thinking about suicide, call or text 988 or chat
You can also call 911 or the local emergency number or go to the hospital emergency room. DO NOT delay.
If someone you know has attempted suicide, call 911 or the local emergency number right away. DO NOT leave the person alone, even after you have called for help.
References
American Psychiatric Association. Cyclothymic disorder. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing, 2013:139-141.
Fava M, Østergaard SD, Cassano P. Mood disorders: depressive disorders (major depressive disorder). In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 29.
Version Info
Last reviewed on: 7/28/2022
Reviewed by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
