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Understanding Cyclothymia

IMAGE Cyclothymia is a disorder characterized by numerous periods of elevated or irritable mood, alternating with mild depression. These episodes generally last a few days and do not follow a regular pattern. Cyclothymia disorder is related to, but not as severe as, bipolar disorder.

Mood Swings

Cyclothymia is classified as a chronic mood disorder. People with cyclothymia go through periods of elevated mood called hypomania. Hypomania is a less extreme version of mania that is not associated with psychotic breaks from reality and/or hallucinations. Hypomania more or less flies under the radar. Some people who have hypomania may exhibit behavior that is over and above their normal state, which for close friends and relatives, can be a tip off that something is wrong.

People in a hypomanic state do not sleep as often, do not feel tired, may engage in risky behaviors, and make bad decisions. Gambling, excess alcohol, and sexual promiscuity are common in people with cyclothymia because they do not see the negative consequences of their behavior. Mood swings during this period occur as well. During hypomania, a person can feel elated, irritable, and angry. Hypomanic episodes can also result in high productivity and creativity.

On the flip side, people with cyclothymia experience short episodes of mild depression. Symptoms of hopelessness, fatigue, apathy, and irritibility are common. During this time, a person may withdraw from friends and family and have problems concentrating or remembering.

These swings in mood and temperament often negatively impact a person's work and social life. Consequences often include instability with an uneven work and schooling history, impulsive and frequent changes of residence, repeated romantic or marital breakups, and an episodic abuse of alcohol and drugs.

Occurrence

Cyclothymia often becomes apparent during adolescence or early adulthood. It is more common in women than in men. Like bipolar disorder, cyclothymia tends to run in families. There may be a genetic link between the two.

Cyclothymia affects up to 1% of the population, but estimates may be higher because it is often diagnosed as another disorder or goes unnoticed.

Diagnosing Cyclothymia

Diagnosing cyclothymia can be more complicated than other mood disorders. Neither the highs or lows qualify for diagnosis of mania or depression. There are several criteria that must be met, but the crux is that hypomania and depressive symptoms need to be present for at least two years with no symptom-free period for more than two months.

It may be difficult to see changes in personality, making diagnosis more difficult. Some people work better when they are hypomanic or they manage the depressive symptoms well.

Although it is classified as a chronic mood disorder, cyclothymia may be viewed as a personality trait. It depends on the extremes of mood swings and how they affect the person. People may voice concern about depressive symptoms only when they become problematic.

For some people, cyclothymia eventually leads to full-blown bipolar disorder.

Treating Cyclothymia

Cyclothymia is treatable. Goals for cyclothymia treatment include reducing symptom severity, reducing the risk of bipolar disorder, and treating any social, work, or substance abuse problems. It involves a combination of medication and counseling.

Some may resist the loss of improved functioning they experience, unsure they want to be treated.

There has been some success with lithium, a mood stabilizing drug used to treat bipolar disorder. It may be used alone or in combination with other antipsychotic medications. Antidepressants are not recommended for treating the disorder because episodes do not last long and are not severe.

Even when medication lacks appeal, counseling can help buffer the ups and downs. Therapists may suggest maintaining a regular schedule: wake up, eat, and go to bed at the same times. Other techniques include avoiding situations that trigger cyclothymic episodes and developing strategies for controlling responses to events. Still other therapies focus on improving relationships.

If you or a loved one experience mood swings that affect daily life or relationships, call your doctor for more information.

  • Depression and Bipolar Support Alliance

    http://www.dbsalliance.org

  • National Institute of Mental Health

    http://www.nimh.nih.gov

  • Canadian Psychiatric Association

    http://www.cpa-apc.org

  • Mood Disorder Association of Canada

    http://www.mooddisorderscanada.ca

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