Cyclothymia

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at March 30, 2016
StartDiseasesCyclothymia

Cyclothymia is an uncommon mood disorder that is also known as cyclothymic disorder. The term comes from Greek words meaning 'cycle' and 'emotion.'

Contents

Definition & Facts

Cyclothymia is characterized by emotional fluctuations, but it is not as intense as bipolar disorder. Cyclothymia, however, is similar to bipolar disorder in that there are high periods contrasted by low ones. Cyclothymia typically appears in the late teens to early twenties, and both men and women have an equal chance of developing the condition.

Symptoms & Complaints

Cyclothymia is characterized by an elevated mood followed by mild to moderate depression. The elevated mood state carries hypomanic symptoms, and the low periods present depressive symptoms. Hypomanic symptoms include:

  • An inflated state of optimism
  • Euphoria
  • Extremely high self-esteem
  • Fast-moving thoughts
  • Excessive talkativeness
  • Extreme physical activity
  • Less need for sleep
  • Easily distracted
  • Difficulty concentrating
  • Increased ambition
  • Poor choice-making

Depressive symptoms include:

  • Irritability
  • Hopelessness
  • Fatigue
  • Weight changes
  • Feelings of guilt
  • Feelings of worthlessness
  • Difficulty concentrating
  • Sleep problems
  • No interest in activities once enjoyed
  • Excessive crying

Any of these symptoms require assistance from a doctor, but the onset of suicidal thoughts requires medical help immediately. Seeking the assistance of a friend, family member or mental health provider is vital. Untreated cyclothymia can lead to substance-related disorder, anxiety disorders or the development of bipolar I or II.

Causes

The specific cause of cyclothymia is unknown, but genetic factors, brain processes, and an individual’s environment have been linked to the condition. Childhood experiences with erratic, neglectful, overbearing, or inconsistent parenting may also contribute to cyclothymia.

Diagnosis & Tests

It is a doctor’s job to distinguish if an individual is dealing with depression, bipolar I or II disorder or cyclothymia. Before the initial visit, an individual should take the following steps for the best diagnosis:

  • List all symptoms being experienced
  • List any prescription and over-the-counter medications being taken as well as vitamins
  • Prepare a thorough medical history
  • Write down any questions such as, “What is causing my symptoms?” “What treatments would be helpful for my situation?” and “Am I at risk for other mental health issues?”

A mental health provider or doctor may ask the following questions during diagnosis:

  • How do people close to you describe your symptoms?
  • Can you describe the high and low periods?
  • How long do the high and low periods typically last?
  • Do you have any periods of relative stability?
  • Do your symptoms affect your everyday life such as relationships, work and school?
  • Do you experience any changes in physical needs during high or low periods?
  • Do any relatives that you know of have similar symptoms?
  • How often do you use recreational drugs or drink alcohol?
  • Have you had harmful thoughts towards yourself or others?

After all questions are answered on both sides, exams and tests are next taken to determine if cyclothymia is the cause of an individual’s symptoms. A physical examination along with lab tests first identify if there are any physical or medical issues that are causing the symptoms.

A psychological evaluation that involves talking about an individual’s behavior patterns, thoughts and feelings, a psychological self-assessment and possibly conferences with family or close friends are the next steps in determining if cyclothymia is the cause of symptoms. A mood chart is also sometimes used to monitor factors such as moods and sleep patterns.

Mental health providers and doctors often consult the Diagnostic and Statistical Manual of Mental Disorders to help diagnose cyclothymia. The manual, presented by the American Psychiatric Association, states these symptoms as indicators of cyclothymia:

  • Stable moods that last less than two months
  • An individual has experienced high and low periods for months for at least two years
  • Symptoms are not caused by a medical issue or substance abuse
  • Symptoms affect important factors in life such as work or school
  • Symptoms are not the cause of other mental disorders such as bipolar I and II

Treatment & Therapy

Cyclothymia treatment continues throughout high, low, and stable periods for a lifetime. Treatment focuses on reducing the risk of bipolar disorder, treating substance abuse problems, reducing symptoms and preventing symptom relapse. There are no medications specifically used to treat cyclothymia, but bipolar medications are oftentimes used to prevent high and low periods and control overall symptoms.

Psychotherapy in the form of cognitive behavioral therapy and interpersonal and social rhythm therapy is provided in an individual, group or family setting. Cognitive behavioral therapy focuses on replacing unhealthy behaviors and thought processes with positive ones. Stress management and coping strategies are also taught during these sessions.

Interpersonal and social rhythm therapy stabilizes everyday tasks such as mealtimes, exercise and sleeping patterns, which helps individuals with mood disorders. Lifestyle changes and home remedies are also effective treatments for cyclothymia; simple, yet important tasks include:

  • Sleeping regularly
  • Quitting recreational drugs and drinking
  • Keeping a close eye on warning signs
  • Keeping a record of important life events, moods and daily routines
  • Exercising regularly
  • Consulting mental health provider before taking new medications
  • Taking all medications as prescribed or directed

Support and coping provisions are also important factors in effective cyclothymia treatment. An individual should learn all that they can about the condition, stay focused on management even during stable times, join a support group and learn relaxation techniques such as yoga, meditation or tai chi. Partaking in healthy recreational activities such as sports or hobbies also provides an outlet and helps to stabilize the mood.

Prevention & Prophylaxis

Since there is no determined cause for cyclothymia, there are no known methods to prevent cyclothymia. Early treatment at the first onset of symptoms prevents the condition from becoming severe and inhibiting everyday life or progressing into bipolar disorder. Preventative actions once the onset of cyclothymia occurs prevent episodes of major depression, hypomania, or mania.