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Last reviewed by Dr. Raj MD on January 12th, 2022.

What is Cyclothymia?

This is also referred to as cyclothymic disorder. It is a mood disorder that is a milder form of Bipolar II disorder. It is a mood disorder that can cause your emotions to go up and down. A person who has this disorder has these types of mood swings between periods of mild depression and a mood that is elevated. In the United States there are approximately point four to one percent have this mood disorder and both women and men can have it. As to whether it affects more men than women cyclothymia affects both equally. It is frequently hard to identify when the onset of this mood disorder happens.

Symptoms of Cyclothymia

The symptoms of cyclothymia usually alternate between emotional lows and highs.

When a person is in an emotional high, the characterized symptoms, also known as hypomanic symptoms, can include:

  • A feeling of well-being or happiness that is exaggerated. This is also referred to as euphoria.
  • Optimism that is extreme
  • Self-esteem that is inflated
  • Having poor judgment
  • Speech that is rapid
  • Thoughts that race through their mind.
  • Hostile or aggressive behavior
  • Behavior that is risky
  • Sprees to spend money
  • Having an increased drive to achieve or perform goals.
  • Sexual drive that is increased
  • Needing to sleep is decreased
  • Can be distracted easily
  • Not being able to concentrate

The emotional lows consist of depressive symptoms that can range from mild to moderate which can include one or more of these symptoms.

  • Sadness
  • Thoughts or behavior of suicide.
  • Guilt
  • Hopelessness
  • Anxiety
  • Problems with sleep.
  • Problems with anxiety.
  • Loosing interest in doing things they use to find enjoyable.
  • Fatigue
  • Sex drive is decreased.
  • Having concentration problems.
  • Irritability
  • Having pain that is chronic but you do not know what is causing the pain.

These symptoms are similar to what a person who has bipolar disorder I or II but are usually not as severe. Normally when a person has cyclothymia they can function during their daily life but not always doing it well. The mood shifts they go through are unpredictable and can significantly disrupt your life. Normally during the beginning two years after you start having the symptoms they are not as extreme but later they can become more noticeable.

When a person has either the hypomania or depression symptoms they can last for a few days or up to weeks. When they are in between these moods one can have normal moods for longer than thirty days. There is also a possibility that a person have no normal period between the moods and symptoms of hypomanic to depressed. There are usually never more than two months in a row that are symptom free.

Cyclothymia Causes

The exact cause of cyclothymia is not known but what is known is that these types of mood disorders, including bipolar, usually happen in families so there is a possibility that it is inherited and that genetics play a factor in whether a person will develop it or not. When a person has this type of mood disorder it usually starts early in life. The cause could also be a combination of your environment, they body’s biochemical processes like having a change in your brain chemistry, and heredity.

Cyclothymia Diagnosis

In order for your physician to diagnosis whether you have cyclothymia they will usually do several tests and exams.

Medical examination

This will be just a general or routine exam in which the physician will take their blood pressure, listen to their lungs and heart, take your medical history, your weight, etc. This is done to see if there are any other medical reason for the symptoms that you are experiencing

Lab tests

This will probably include any blood tests the physician deems necessary. They may also request a test for alcohol and drug usage and a urinalysis.

Psychological evaluation

This is usually done by a mental health doctor who will ask you about your behavior, feelings, and thought patters. You might have to fill out a psychological self assessment, asked about any alcohol or substance abuse, etc. You may also be asked to give permission for them to talk to your friends and family members about any episodes of depression or mania you might have possibly had.

In order for a person to have a confirmed diagnosis of cyclothymia they have to meet certain criteria that are listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM) which include:

  • For at least twenty-four months you must have had many episodes of elevated mood and periods of depression.
  • The episodes of stable moods normally last fewer than sixty days.
  • The symptoms you are experiencing must affect you significantly at work, socially, or at school.
  • You do not have major depression, schizoaffective disorder or manic episodes.
  • The symptoms you are experienced are not caused by any other medical condition or substance abuse.

Cyclothymia Treatment

Many times cyclothymia goes untreated because it was not diagnosed. The reason that it goes undiagnosed is that the symptoms are usually so mild that a person will not seek medical treatment. There are many people who resist the idea of treatment which in turn will reduce their elevated moods and down moods. When person does seek treatment it is usually because of the feelings of instability or depression because these are the symptoms of cyclothymia that are more unpleasant, disabling, and frequent than the symptoms of an elevated mood. When treatment is started it will be lifelong.

When treating cyclothymia the physician will aim to decrease your risk of developing bipolar disorder I or II, they will also want to help reduce the severity and frequency of the symptoms you are having, and help to prevent a relapse of your symptoms. They can accomplish this by prescribing medication that will help to stabilize your moods and medication to help you sleep such as anti-anxiety medications. If a person does not respond well to the medication prescribed to stabilize their moods the physician may instead prescribe antipsychotic medications. Physicians will usually not prescribe anti-depressants because they can trigger manic episodes that could be dangerous. If anti-depressants are prescribed they are usually used in combination with antipsychotic or mood stabilizer medications.

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