Cyclothymic Disorder

Cyclothymic Disorder

Cyclothymic Disorder

Cyclothymia or cyclothymic disorder, is a mood disorder that looks like a milder form of bipolar disorder types I and II. Cyclothymia is characterized by episodes of depressive symptoms and hypomanic symptoms which are not severe enough to warrant a diagnosis of major depressive disorder or hypomania.

Many people with cyclothymia are not even aware they have it, their highs and lows or unpredictable mood swings accepted as part of their personality makeup. Despite symptoms being milder, forming a treatment plan with a mental health specialist will help one mange the symptoms and reduce the chances of developing bipolar disorder.

Prevalence

The rates for cyclothymia range from 0.4 to 8% depending on the study, and it affects males and females equally. The typical age of onset of cyclothymia is from late childhood to early adulthood.

Symptoms of Cyclothymic Disorder:

Mild hypomanic symptoms last for varied amounts of time depending on the person. They include:

  • An exaggerated feeling of happiness or well-being – euphoria
  • A high amount of cheerfulness
  • Inflated self-esteem
  • Loquacity – talking more than usual
  • Impulsivity, risky behaviors
  • Racing thoughts and/or rapid speech
  • Irritability and/or agitation, overreacting to conversations or events
  • Increased energy, physical activity, and/or libido (sex drive)
  • Decreased desire and/or need for sleep
  • High drive to perform or achieve
  • Difficulty concentrating or listening

Depressive symptoms in cyclothymia are similar to those of major depressive disorder. Symptoms include:

  • Low mood, irritability, restlessness, critical comments, complaining
  • Anhedonia – loss of joy in activities that were once pleasurable
  • Feelings of hopelessness, worthlessness, and guilt that can switch without warning to episodes of hypomania
  • Suicidal thoughts
  • Prone to tears
  • Fatigue, slowed down feeling, desiring more sleep
  • Sleep disturbances like insomnia
  • Inability to concentrate, submissive, difficulty making decisions or handling conflict
  • Reduced energy
  • Weight changes, headaches, chest tightness, hair loss, weakness

Diagnosing Cyclothymic Disorder:

Cyclothymia tends to be underdiagnosed due to its relatively milder symptomatology and because DSM-5 criteria are limiting. This could mean that some people are given the wrong diagnosis and treatment plan for their condition because their symptoms don’t match all the criteria.

Once all possible medical reasons for the mood swings are ruled out, diagnosis of cyclothymia depends on the following factors:

  • There are no episodes of mania or hypermania, nor do episodes of major depression manifest. Symptoms of cyclothymia must persist for at least one year in children and adolescents and two years in adults.
  • People with cyclothymia can experience periods of a stable mood; however, the stability does not last any longer than two months.
  • The symptoms impact everyday life significantly.
  • Other mental or mood disorders have been ruled out.

Symptoms can often look like mood swings that are passed off by the individual or family as part of the person’s personality. A daily journal of when mood swings occur can help greatly in the diagnosis. Some mental health professionals argue that cyclothymia is more of a personality disorder than a mood disorder, but as of 2020, no additional criteria for diagnosis are available.

Causes of Cyclothymic Disorder

The cause of cyclothymia remains unknown. Individuals who have a family history of cyclothymia are at increased risk of developing this mood disorder.

Cyclothymia commonly coexists with other mood disorders such as depression, atypical depression, ADHD, eating disorders, separation anxiety, and anxiety disorder. Adults with impulse control issues are also prone to it.

Risks of Cyclothymic Disorder:

People with cyclothymia are at increased risk of developing full-blown bipolar affective disorder — bipolar type I or bipolar type II.

They are also at increased risk of suicide and self-harm.

Treatment of Cyclothymic Disorder:

Treatment options for cyclothymia include psychotherapy and medication. Cyclothymia requires ongoing, lifelong treatment to lessen the number and severity of symptoms and prevent relapse or the disorder developing into bipolar disorder.

  • Psychotherapy/Talk Therapy – such as cognitive behavioral therapy gives understanding of the disorder, helps identify triggers, provides stress management tools, and teaches positive beliefs and behaviors to replace negative ones.
  • Psychoeducation – helps individuals and family members learn more about the disorder and about the signs of relapse so as to avoid more severe episodes.
  • Family therapy – can help family members talk through their difficulties and strengthen their relationships while living with or supporting the individual.
  • Interpersonal and social rhythm therapy (IPSRT) – offers the chance of better mood management when daily activities are scheduled and work, meal, and sleep times follow a set routine.
  • A life chart – can also help those with BPAD track their symptoms better and gauge when to see their doctor to adjust their treatment plan.
  • Modifying lifestyle – exercise, a healthy diet, and discontinuation of smoking and alcohol and drug abuse increase the chances of the disorder not developing into bipolar disorder.
  • Medications – preferably prescribed by a psychiatrist.

      • Mood-stabilizing medicines such as lithium might be prescribed if the mood swings are causing distress at home or at work.
      • Antidepressants are usually not prescribed because of the risk of triggering a hypomanic switch.
      • Short-term benzodiazepines can be prescribed to help with insomnia.
      • A full record of all medications and supplements should be examined to avoid drug combination reactions.

Cyclothymic Disorder Complications:

The symptoms of cyclothymia can interfere significantly with the ability to function well in social, academic, occupational, and relational settings.

With regards to romantic relationships, people with cyclothymia can experience increased libido (desire for sexual activity) that be intense during hypomanic phases; and they can become reclusive and can have reduced sex drive during depressive phases. This can lead to individuals with cyclothymia having short-lived and tumultuous relationships.

Symptoms of Cyclothymic Disorder:

Mild hypomanic symptoms last for varied amounts of time depending on the person. They include:

  • An exaggerated feeling of happiness or well-being – euphoria
  • A high amount of cheerfulness
  • Inflated self-esteem
  • Loquacity – talking more than usual
  • Impulsivity, risky behaviors
  • Racing thoughts and/or rapid speech
  • Irritability and/or agitation, overreacting to conversations or events
  • Increased energy, physical activity, and/or libido (sex drive)
  • Decreased desire and/or need for sleep
  • High drive to perform or achieve
  • Difficulty concentrating or listening

Depressive symptoms in cyclothymia are similar to those of major depressive disorder. Symptoms include:

  • Low mood, irritability, restlessness, critical comments, complaining
  • Anhedonia – loss of joy in activities that were once pleasurable
  • Feelings of hopelessness, worthlessness, and guilt that can switch without warning to episodes of hypomania
  • Suicidal thoughts
  • Prone to tears
  • Fatigue, slowed down feeling, desiring more sleep
  • Sleep disturbances like insomnia
  • Inability to concentrate, submissive, difficulty making decisions or handling conflict
  • Reduced energy
  • Weight changes, headaches, chest tightness, hair loss, weakness

Diagnosing Cyclothymic Disorder:

Cyclothymia tends to be underdiagnosed due to its relatively milder symptomatology and because DSM-5 criteria are limiting. This could mean that some people are given the wrong diagnosis and treatment plan for their condition because their symptoms don’t match all the criteria.

Once all possible medical reasons for the mood swings are ruled out, diagnosis of cyclothymia depends on the following factors:

  • There are no episodes of mania or hypermania, nor do episodes of major depression manifest. Symptoms of cyclothymia must persist for at least one year in children and adolescents and two years in adults.
  • People with cyclothymia can experience periods of a stable mood; however, the stability does not last any longer than two months.
  • The symptoms impact everyday life significantly.
  • Other mental or mood disorders have been ruled out.

Symptoms can often look like mood swings that are passed off by the individual or family as part of the person’s personality. A daily journal of when mood swings occur can help greatly in the diagnosis. Some mental health professionals argue that cyclothymia is more of a personality disorder than a mood disorder, but as of 2020, no additional criteria for diagnosis are available.

Causes of Cyclothymic Disorder:

The cause of cyclothymia remains unknown. Individuals who have a family history of cyclothymia are at increased risk of developing this mood disorder.

Cyclothymia commonly coexists with other mood disorders such as depression, atypical depression, ADHD, eating disorders, separation anxiety, and anxiety disorder. Adults with impulse control issues are also prone to it.

Risks of Cyclothymic Disorder:

People with cyclothymia are at increased risk of developing full-blown bipolar affective disorder — bipolar type I or bipolar type II.

They are also at increased risk of suicide and self-harm.

Treatment of Cyclothymic Disorder:

Treatment options for cyclothymia include psychotherapy and medication. Cyclothymia requires ongoing, lifelong treatment to lessen the number and severity of symptoms and prevent relapse or the disorder developing into bipolar disorder.

  • Psychotherapy/Talk Therapy – such as cognitive behavioral therapy gives understanding of the disorder, helps identify triggers, provides stress management tools, and teaches positive beliefs and behaviors to replace negative ones.
  • Psychoeducation – helps individuals and family members learn more about the disorder and about the signs of relapse so as to avoid more severe episodes.
  • Family therapy – can help family members talk through their difficulties and strengthen their relationships while living with or supporting the individual.
  • Interpersonal and social rhythm therapy (IPSRT) – offers the chance of better mood management when daily activities are scheduled and work, meal, and sleep times follow a set routine.
  • A life chart – can also help those with BPAD track their symptoms better and gauge when to see their doctor to adjust their treatment plan.
  • Modifying lifestyle – exercise, a healthy diet, and discontinuation of smoking and alcohol and drug abuse increase the chances of the disorder not developing into bipolar disorder.
  • Medications – preferably prescribed by a psychiatrist.

      • Mood-stabilizing medicines such as lithium might be prescribed if the mood swings are causing distress at home or at work.
      • Antidepressants are usually not prescribed because of the risk of triggering a hypomanic switch.
      • Short-term benzodiazepines can be prescribed to help with insomnia.
      • A full record of all medications and supplements should be examined to avoid drug combination reactions.

Cyclothymic Disorder complications:

The symptoms of cyclothymia can interfere significantly with the ability to function well in social, academic, occupational, and relational settings.

With regards to romantic relationships, people with cyclothymia can experience increased libido (desire for sexual activity) that be intense during hypomanic phases; and they can become reclusive and can have reduced sex drive during depressive phases. This can lead to individuals with cyclothymia having short-lived and tumultuous relationships.

Sources MAYO CLINIC – Cyclothymia | WILEY ONLINE LIBRARY – Affective disorders, personality and personality disorders | ARCHIVE.org – DSM-5 – Diagnostic Features | ARCHIVE.org -DSM-5 – Diagnostic Criteria | Perugi, G; Hantouche, E; Vannucchi, G; Pinto, O (1 September 2015). “Cyclothymia reloaded: A reappraisal of the most misconceived affective disorder”. Journal of Affective Disorders. 183: 119–33. | Koukopoulos, A (January 2003). “Ewald Hecker’s description of cyclothymia as a cyclical mood disorder: its relevance to the modern concept of bipolar II”. Journal of Affective Disorders. 73 (1–2): 199–205. | Perugi, G; Hantouche, E; Vannucchi, G; Pinto, O (1 September 2015). “Cyclothymia reloaded: A reappraisal of the most misconceived affective disorder”. Journal of Affective Disorders. 183: 119–33.