What You Need to Know About Cyclothymia

In the world of mental health, there’s a vast difference between an acute disorder and less drastic mental issues. However, when it comes to mood disorders, it’s important to understand how minor versions of a disorder can still negatively impact the quality of life. This is especially important to help these patients get the treatment they need to move forward.

Bipolar disorder is one of the most misunderstood mood disorders. Bipolar disorder does not necessarily involve rapid mood swings between manic episodes and depression; rather, it is a long duration of a major depressive and manic episode. These episodes can last weeks at a time. 

Without treatment, patients who suffer from bipolar disorder struggle with interacting with the world. This is because their mood disorder prevents them from overcoming their intense emotions and manic state in order to enjoy productive and healthy interactions and behaviors.

One area of bipolar disorder that slips past people is cyclothymia. Unlike traditional bipolar disorder, cyclothymia is more subtle. As a result, many patients with this particular mental disorder are at risk for not receiving the proper treatment.

<H2>What is Cyclothymia?</H2>

Cyclothymia is a type of bipolar disorder characterized by mild mood swings. For example, cyclothymic disorder is characterized by mild depression. Unlike bipolar disorder, where symptoms can last weeks to months, cyclothymic symptoms tend to last only a few days before returning to baseline. 

Cyclothymia comes with many risks. One of the biggest risks is that this particular disorder can turn evolve into full-blown bipolar disorder. If cyclothymia reaches the point of bipolar disorder, treatment is much more difficult. 

Believe it or not, approximately 1 percent of the population is currently diagnosed with cyclothymia. That said, it is possible that this 1 percent figure is a low representation of the number of people who suffer with the cyclothymic cycle of depressive and hypomanic moods. 

Although it is often confused with a personality disorder, cyclothymia is actually a mood disorder. This is  a common error as many people incorrectly categorize moods as personality traits. Also, because the hypomania in cyclothymia may be difficult to notice, some patients are misdiagnosed with dysthymia (persistent low-grade depression). 

Dysthymia and cyclothymia are different: One is a mild depressive state while the other fluctuates between up and down cycles. Fortunately, this particular manic-depressive psychosis does respond to well to cyclothymia treatment.

<H2>Cyclothymia Symptoms</H2>

There are a number of symptoms associated with cyclothymia, which makes it easier for mental health practitioners to diagnose cyclothymia. Cyclothymia can arise from other mental disorders, including attention-deficit hyperactivity disorder (ADHD), schizophreniform disorder, borderline personality disorder, affective disorders, and others. 

The keys to pay attention to are the presence of hypomanic symptoms and depressive symptoms. This manic-depressive illness is notable on the depressive side for the following symptoms:

  • Lack of motivation: When an individual is unable or unwilling to take part in their normal activities. There is a malaise or general lack of interest in their work.
  • Impaired judgement: Less likely to try and make good choices. There is typically some faulty logic behind the decision-making process.
  • Feelings of guilt and/ or worthlessness: Depressive episodes are characterized by people with guilty feelings over benign issues and feel they have little to no value.
  • Low self-esteem: When a person does not think highly of him or herself, or believe his or her life has value.
  • Fatigue: Many people in depressive episodes will sleep for abnormally long periods of time, or have little to no energy.
  • Concentration problems: An inability to focus on a task for a normal duration.
  • Fluctuations in weight: Unusual weight fluctuation due to eating too much or too little. This is also characterized as stress eating or stress dieting.
  • Difficulty handling conflict: Depressive episodes are typically characterized by people who will do anything to avoid a conflict, real or perceived.
  • Social withdrawal: The depressive person does not want to engage socially. As a result, he or she will likely fall into an unhealthy pattern of isolation.

Of course, these are just some symptoms. If these symptoms are experienced acutely for a prolonged period of time, then a major depressive disorder might be the bigger issue. Cyclothymia is more likely to present a mix of symptoms.

<H3>Hypomania Symptoms</H3>

Most people would say that they understand what a depressive disorder is, or can recognize one. However, because Western culture puts such an emphasis on being energetic and upbeat, hypomania is often more difficult to detect for people who are not mental health professionals. 

For example, hypomanic episodes are characterized by hyperthymic temperament. This means a person will exhibit more of an upswing and maintain these symptoms. 

Furthermore, in the cyclothymic cycle, a person with hypomania will exhibit these symptoms for a short period of time. These symptoms typically abate after several days. Then, the individual with cyclothymia will return to a more depressed state. 

Here are some symptoms of hypomania:

  • Inflated Self-Esteem: Not quite narcissism, but a person with inflated self-esteem thinks highly of him or herself as well as his or her abilities.
  • Unnatural Optimism: This refers to soaring optimism with little basis in reality. For example, think of a person who has been repeatedly unsuccessful with business claim that they have a million-dollar idea.
  • Racing Thoughts: People in hypomanic states can’t maintain a train of thought; their thoughts are all over the place. These individuals typically recall their thoughts in a disorganized, rapid-fire fashion.
  • Risky Behavior: Hypomanic episodes involve many moments when a person will engage in risky behavior due to perceived invincibility.
  • Hyperactivity: This is when a person literally can not sit still. If a person with cyclothymia also has ADHD, then this is definitely a huge risk factor.
  • Impulsivity: A depressed person doesn’t want to do anything, but hypomania is the opposite; there is lots of impulsive acts and in many cases risky impulsive acts

There is much to understand about hypomania. The main takeaway is that a person who is constantly on the go, rambles in his or her speech, or generally seems too busy is probably suffering with hypomania. Usually a hypomanic person is occupied with many different tasks, many of which are never completed. 

<H2>Cyclothymia Test</H2>

Many times, living with cyclothymia can appear as if it’s just the normal ebb and flow of life. However, keeping a log of moods and feelings is very helpful for therapists. Cyclothymia tests all involve duration. The duration of the up and down swings do not typically last for more than a few days. The duration of these cycles typically appear for an extended period of time, usually at least six months to one year or longer. 

Depending on the severity, bipolar disorder cyclothymia may be conflated. However, accurate journaling from patients is extremely helpful. Family members and loved ones can also keep journals, especially since self-perception in depression cyclothymia is often misleading. 

<H2>Cyclothymia Treatment</H2>

Treatment of cyclothymia can run many different courses. The good news is that when correctly diagnosed, cyclothymia is a mental disorder that can be arrested. A good therapist can help a patient take control of their moods with ease. 

A psychiatrist may prescribe mood stabilizers or other psychotropic medications, such as lithium in order to avoid a person damaging him or herself, or harming others. In these cases, once the person is responding to the medication, the therapist will begin to wean the patient off these medications. 

At this point, more traditional non-pharmaceutical modalities may be used. If a person risks further issues when taken off medication, then the therapist may decide to keep them on a steady dosage.

Types of therapies that are successful with cyclothymia are cognitive-behavioral therapy (CBT), dialectical behavioral therapy (DBT), and Interpersonal and Social Rhythm Therapy (IPSRT). These different therapies focus on how the patient deals with themselves as well as the different factors that affect their moods. 

Furthermore, the goal of these therapies is to provide patients with the tools they can easily use to self-regulate and eliminate the need for medication and other interventions. A good therapist can make a huge difference in the life of a patient with cyclothymia. Therefore, it’s important for patients to find therapists well-versed in these techniques.

<H2>Living with Cyclothymia</H2>

Of course, bipolar disorder is the most common and notable mood disorder. However, understanding the characteristics of cyclothymia allows patients and therapists an opportunity to successfully treat this particular mood disorder. 

In many cases, the symptoms of cyclothymia can be mistaken for other types of mood disorders. However, once you fully understand the ebbs and flows of the disorder along with the duration of cycles of cyclothymia, you can then find the best treatment for yourself or a loved one. As mentioned above, treatment is also the best way to avoid mood disorders progressing to more serious disorders. And finding the best treatment also leads to a happier, healthier, quality life.

Sources:

https://www.psycom.net/depression.central.cyclothymia.html

https://www.mayoclinic.org/symptoms-causes/syc-20371275

https://psychcentral.com/lib/understanding-coping-with-cyclothymia/

author avatar
Angel Rivera
I am a Bilingual (Spanish) Psychiatrist with a mixture of strong clinical skills including Emergency Psychiatry, Consultation Liaison, Forensic Psychiatry, Telepsychiatry and Geriatric Psychiatry training in treatment of the elderly. I have training in EMR records thus very comfortable in working with computers. I served the difficult to treat patients in challenging environments in outpatient and inpatient settings
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