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Cyclothymia (cyclothymic disorder) is a less severe variant of bipolar disorder characterized by repeated hypomanic and moderate depressive episodes. 

Cyclothymia affects between 0.4 percent and 1 percent of the population in the U.S. Many researchers believe that cyclothymia is significantly misdiagnosed and underdiagnosed since many of its symptoms overlap with those of other mental health disorders.

It is treatable with talk medication and therapy and sometimes with natural remedies, however many individuals with cyclothymia do not believe they require treatment.

Girl sitting on the floor with her back to the bed

Most people are familiar with bipolar disorder (manic depressive disorder), in which patients have alternating periods of highs and lows (depression and mania). What is cyclothymia? Cyclothymia is an uncommon mood disorder that resembles bipolar disorder, albeit in a relatively mild and much more chronic form. Bipolar cyclothymia is characterized by persistent cyclic ups and downs of mood lasting at least two years. With cyclothymic disorder, you have mild depression, which is not typical of major depression.

Your elevated moods indicate hypomania, a less serious form of mania. During highs, your mood is briefly elevated before reverting to its normal level. During low moments, you experience mild depression. You probably feel like yourself amid your euphoric and depressed moods.

Everyone experiences ups and downs. So what is the difference between cyclothymia and normal mood swings Cyclothymia can raise your likelihood of developing bipolar disorder (estimates range from a 15-50 percent increased risk if diagnosed with cyclothymia) and your lows and highs can affect your daily life and relationships, so it’s important to seek treatment to gain control of the disorder before it turns into fully disruptive.

Estimates place the incidence of cyclothymia in the general population at 0.4 percent and 1 percent, affecting both men and women equally. Women are more likely to seek treatment, however. While the typical onset of the disorder is during adolescence, its onset is always difficult to determine. Individuals with cyclothymic disorder are more likely to develop Attention-Deficit/Hyperactivity Disorder, drug dependence, and sleep difficulties.

Cyclothymia symptoms are characterized by mood swings that oscillate between mild depression and hypomania.

In contrast to bipolar I and II disorders in which mood swings might last for weeks, months, or even years, mood swings in cyclothymia can occur immediately over small intervals – even on the same day.

Hypomania symptoms associated with Cyclothymia

Hypomania is a condition characterized by periods of abnormally heightened, extreme emotions or mood changes, activity levels, or energy level,  fluctuations. This heightened vigor, disposition, and demeanor must differ from your natural self and be obvious to others. Hypomania is a milder variant of manic disorder.

Among the symptoms and signs of hypomania are:

  • Increased vigor and less sleepiness.
  • Rapid speech and rapid thinking
  • Being prone to distraction.
  • Increased attention to goals, including professional, academic, and social objectives.
  • Participating in dangerous or imprudent behaviors, like sexual encounters without forethought, spending sprees, or rash business decisions.
  • The self-confidence that exceeds the norm.

Depressive symptoms associated with cyclothymia

A depressive episode is characterized by thoughts of pessimism and diminished interest in formerly enjoyable activities. Cyclothymia is characterized by milder depression symptoms than clinical (major) depression.

Included among the signs of a depressed episode are:

  • Depression is characterized by a sense of social isolation, low self-esteem, and guilt.
  • Alterations in eating habits (eating less or more than usual).
  • Sleeplessness (insomnia) or difficulty remaining awake (hypersomnia).
  • Fatigue or substantial lack of energy.
  • Reduced ability to focus.

Cyclothymia may coexist with several other mental health conditions. Some common psychological conditions that may coexist with or be confused with cyclothymia are listed here.

Cyclothymia with anxious distress: Like other forms of bipolar disorders, cyclothymia may emerge with the preprocessor “anxious distress.” People with cyclothymia with generalized anxiety may feel tense, agitated, frequently nervous, or have a feeling of imminent doom. Cyclothymia with anxious distress is associated with a higher risk for suicidal thoughts than cyclothymia without anxious distress; hence, thorough diagnosis and timely treatment are typically crucial.

Cyclothymia and ADD/ADHD: Individuals with the cyclothymic disorder may also have ADD/ADHD. According to one study, those with ADHD might be more likely to have cyclothymia. Another study indicated that kids identified with cyclothymia are prone to have a co-occurring mental health disorder, with ADHD being the most frequent.

Cyclothymia and dysthymia: Persistent depressive disorder, dysthymia is a mild to severe type of chronic depression. Individuals with cyclothymia may exhibit dysthymic symptoms but may also have hypomanic emotions characterized by increased activity and euphoria.

Cyclothymia and borderline personality disorder (BPD): According to some studies, cyclothymia is more prevalent in those with borderline personality than other personality disorders. Based on the DSM-5, co-occurrence of these conditions is possible if the criteria for both diagnoses are met.

As cyclothymia frequently makes emotional control more challenging for persons who have it, the illness may also cause difficulties in interpersonal relationships. Hypomanic episodes may enhance a person’s propensity to overreact to outside stimuli, which may exacerbate interpersonal conflict. Counseling for couples may aid spouses of those with cyclothymia in understanding and overcoming their specific issues.

Less than fifty percent of cyclothymic persons develop bipolar disorder. In most cases, cyclothymia is a chronic condition that persists throughout life. Cyclothymia appears to fade and resolve itself in others over time.

Cyclothymia can negatively impact social, familial, professional, and romantic relationships. Moreover, the impulsivity linked with hypomanic symptoms might result in poor life decisions, legal troubles, and financial challenges. Additionally, research indicates that those with the cyclothymic disorder are more likely to use alcohol and drugs.

According to research reported in Current Neuropharmacology, persons with cyclothymia may find it more challenging to deal with criticism or rejection from others. This tendency may enhance a person’s likelihood of engaging in an abusive relationship, since it may induce them to comply with an abusive partner’s requests to prevent retaliation.

To lessen the impact of cyclothymia on your everyday life, take your medications as prescribed, abstain from alcohol and recreational drugs, record your moods to provide your mental health provider with information regarding the efficacy of your therapy, exercise regularly, and get plenty of sleep.

How to Succeed in a Bipolar Relationship

  • Attend Couples Therapy.
  • Actively Involve in Treatment
  • Engage in Self-Care

Cyclothymia is a chronic illness that requires therapy for a lifetime. Even during the remission period or recovery, if you stop taking your drugs, your depression issues will return.

Because cyclothymia can lead to bipolar disorder, you must seek the proper treatment. Drug and alcohol usage may also exacerbate your symptoms.

Cyclothymia treatment involves a mix of medications and talk therapy. The main medications that are used to manage bipolar cyclothymia are:

  • Mood-stabilizing medications like lithium
  • Anticonvulsant or anti-seizure drugs include lamotrigine, divalproex sodium, and valproic acid.
  • Patients who do not respond to anti-seizure drugs may benefit from atypical antipsychotics like quetiapine, olanzapine, and risperidone.
  • Anti-anxiety drugs including benzodiazepines
  • Antidepressants should be taken only in combination with a mood stabilizer, as antidepressants alone may produce potentially dangerous manic episodes.

More research is needed to determine the benefits of talk therapy or psychotherapy in the treatment of bipolar cyclothymia. That said, currently, psychotherapy is an essential component of the treatment for cyclothymia.

Cognitive behavioral therapy is the most common method of psychotherapy for treating cyclothymia.

High-end luxury inpatient treatment provides a number of upscale talk therapies and non-conventional but evidence methods to help with Cyclothymia. Some of these are discussed here.

Cognitive Behavioral Therapy – an emphasis on replacing negative beliefs and thoughts with positive ones; stress management strategies; identification of trigger points.

Dialectical Behavioral Therapy – teaches mindfulness, coping skills, mood, and emotional regulation.

Interpersonal and Social Rhythm Therapy (IPSRT) – focuses on the stabilization of everyday rhythms, particularly those associated with sleep, wakefulness, and mealtimes; routines are suggestive of helping to stabilize moods. This strategy educates individuals with a cyclic mood disorder to maintain a more consistent schedule for all parts of their lives, including awake hours, sleeping, eating, and exercising. In a study published in Bipolar Disorders in 2015, IPSRT has been demonstrated to improve daily functioning.

Eye Movement Desensitization and Reprocessing Therapy – involves a supervised practice of eye movements coupled with an active recall of traumatic situations. People with cyclic mood disorder with a history of trauma may benefit from this strategy, as per a study published in the journal Psychiatry Research in 2014.

Light Therapy – People with a cyclic mood disorder may have disrupted circadian rhythms, which means that their daily biological clock is not functioning properly. Based on a 2012 review study published in Dialogues in Clinical Neuroscience, there may be several treatments that can help reset this internal clock and make it easier to deal with a cyclic mood disorder. These include being exposed to alternating periods of light and dark and changing your sleep schedule. Before attempting these or comparable methods on your own, you should consult your physician.

  1. Cyclothymia personality, symptoms, causes, and treatment. Psycom. Available at: https://www.psycom.net/cyclothymia.
  2. Cyclothymia. GoodTherapy. Available at: https://www.goodtherapy.org/learn-about-therapy/issues/cyclothymia.
  3. 9 natural therapies for bipolar depression, EverydayHealth.com. Available at: https://www.everydayhealth.com/bipolar-disorder/alternative-treatments-for-bipolar-disorder.aspx.
  4. Cyclothymia: Symptoms, diagnosis, and treatments, Healthline. Healthline Media. Available at: https://www.healthline.com/health/depression/cyclothymia#treatments.

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