Most people have heard of the condition referred to as bipolar disorder (also known as manic-depressive disorder). Individuals with bipolar disorder experience extreme shifts in their mood and cycles of highs and lows. These highs and lows are clinically referred to as mania and depression.
Interestingly enough, despite the majority of people being familiar with bipolar disorder, not many have heard of cyclothymic disorder when it fact, they are quite comparable.
What is Cyclothymia
Cyclothymia is a rare mood disorder that, while being a different condition, has similar symptoms of bipolar disorder. The major difference between cyclothymia and bipolar disorder is the severity. Cyclothymia has milder characteristics than those of bipolar disorder. Cyclothymia is also considered to be a chronic condition, meaning the diagnosis of cyclothymia will be lifelong.
Individuals who are diagnosed with cyclothymia experience cyclic highs and lows that persist for two or more years. With cyclothymia, the highs that the individual faces are characteristic of hypomania– a less severe form of mania. The lows that the individual endures are symptomatic of a mild, low-grade depression– not indicative of full major depression.
An individual experiencing cyclic highs will feel an elevated mood for a period of time before returning to their baseline. The same goes for cyclic lows. The individual may feel down for a period of time before returning to their baseline. However, these mood shifts are not nearly as severe as bipolar I or bipolar II disorder.
With that being said, what’s the difference between an individual with cyclothymia and an individual who is simply experiencing a rough patch or mood swings with ups and downs? An individual diagnosed with cyclothymia has an increased risk of developing bipolar disorder. The risk factor widely varies from 15%-50%. Therefore, if you feel that you may be suffering from cyclothymia it is imperative that you seek treatment in order to prevent it from advancing into something entirely disruptive and much more severe.
What is Hypomania
Hypomania is a milder form of mania. People with bipolar disorder typically have episodes of mania and severe depression. Individuals with cyclothymia will have highs that are symptomatic of hypomania.
Aforementioned, the “highs” of cyclothymia are symptomatic of hypomania whereas the “lows” are symptomatic of mild depression. The high symptoms of cyclothymia are not as severe as mania and the lows not as severe as major depressive disorder. Individuals with cyclothymia mood swings can generally function in their day to day lives, though not as well as they do when they are not experiencing a high or a low. The mood shifts of cyclothymia are unpredictable. Even the most prepared person may not be able to predict how the mood shift will affect them.
Individuals experiencing hypomania symptoms may feel as though they are on top of the world for a period of time before returning to their baseline (their “normal”).
Additional clinical signs and symptoms of hypomania include:
- An exaggerated feeling of happiness (euphoria)
- Excessive optimism
- Elevated opinions of oneself
- Inflated self-esteem
- Talking more than usual
- Poor judgment that can result in dangerous behavior
- Racing, uncontrollable thoughts
- Irritable or agitated mood
- Quick reactions, which can be nonsensical
- Excessive physical activity
- Increased drive to perform (this can be in the form of sexually, work-related or socially)
- Reduced need for sleep
- A tendency to be easily distracted
- Inability to concentrate
Individuals with cyclothymia experiencing a low shift will commonly have the following clinical signs and symptoms:
- Feelings of sadness, hopeless or emptiness
- Irritability (this is especially seen in children and teenagers)
- Loss of interest in activities that were once enjoyable
- Weight fluctuations
- Feelings of worthlessness
- Guilty feelings
- Sleep difficulties
- Difficulties concentrating
- Thinking of death
- Suicidal thoughts
Furthermore, individuals with cyclothymia are also at a higher risk of developing Attention-Deficit Hyperactivity Disorder (ADHD), substance abuse issues, and sleep disorders.
Causes of Cyclothymia
Comparatively to many mental disorders, the underlying cause of cyclothymia is unknown. However, studies and experts suggest that there is a genetic factor involved. For cyclothymia and bipolar mood disorders alike, a family history of mental illness indicates an increased risk of a disorder developing.
Additionally, certain environmental conditions indicate a higher risk of cyclothymia developing. For example, traumatic experiences such as sexual or physical abuse may often lead to major depression, bipolar disorder, and cyclothymia.
The American Psychiatric Association states that in order for an accurate cyclothymia diagnosis to be made, an individual must meet all of the following:
Multiple periods of hypomanic symptoms and multiple periods of depressive symptoms. These periods do not meet criteria for a hypomanic episode and do not meet criteria for a major depressive episode. The fluctuated periods occurs over a span of at least two years (one year for children and adolescents).
Throughout the two-year time span, symptoms of hypomania and depression have been present for at least half the time. Additionally, no more than two consecutive months have passed showing no symptoms.
The criteria for major depressive episodes, hypomanic episodes, or manic episodes have never been met.
Additionally, other mental health disorders (such as schizoaffective disorder, schizophrenia, delusional disorder) have been ruled out as the contributing factor to hypomanic and depressive symptoms.
Furthermore, the hypomanic and depressive symptoms are not related to medications, substance abuse, or other medical conditions.
Finally, the hypomanic and depressive symptoms cause significant disruption in social, occupational, and/or other areas of the individual’s day-to-day life.
If you feel that you may have cyclothymia mood swings, your mental health professional will likely perform a series of tests in order to ensure that your depressive and hypomanic symptoms are not due to any other underlying conditions or medications.
Treating cyclothymia will usually consist of medications, such as mood stabilizers, and psychotherapy. Cyclothymia treatment will also typically be a lifelong, chronic process. The goal is to reduce and manage the hypomanic and depressive symptoms in order to help the individual living with cyclothymia to decrease the risk of developing bipolar disorder.
While there are currently no medications that specifically treat cyclothymia, your doctor may prescribe medications used to treat bipolar disorder in order to help manage your symptoms. Thus far, antidepressants have not proved to be effective in treating cyclothymia.
Additionally, mental health professionals may use psychotherapy, or talk therapy, to treat cyclothymia. Psychotherapy still requires additional research before specialists will consider it a highly effective form of treatment for cyclothymia. However, due to its positive results in individuals with bipolar disorder, mental health specialists may use it to treat cyclothymia. Forms of psychotherapy include:
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) focuses on stress management and concentrates on turning negative thoughts and beliefs into positive ones. CBT also works to identify triggers points that may lead to the fluctuating highs and lows.
Dialectical Behavioral Therapy (DBT)
Dialectical Behavioral Therapy (DBT) focuses on teaching awareness and tolerating distress. DBT also teaches emotional regulation.
Interpersonal and Social Rhythm Therapy (IPSRT)
Interpersonal and Social Rhythm Therapy (IPSRT) focuses on stabilizing daily routines such as sleep schedules and regular meal times. Creating specific routines will help regulate and stabilize moods.
Cyclothymia: A Final Thought
Statistically, less than half of the individuals diagnosed with cyclothymia will develop bipolar disorder. In the majority of cases, cyclothymia is a chronic condition and the associated mood swings will continue throughout the lifetime of the diagnosed individual. Therefore, understanding the condition and managing the symptoms is not only important but incredibly beneficial for the individual experiencing cyclothymia.
In some cases, cyclothymia tends to resolve itself over time. However, an individual questioning whether or not they have cyclothymia should without question seek medical attention. No one should hope for the best in terms of the condition dissipating over time.
Additionally, due to the fact that there is not a specific underlying cause of cyclothymia, it is difficult to prevent entirely. Therefore, the most efficient way of managing cyclothymia is early detection and action with the help of a psychiatrist. With that being said, research shows that individuals with cyclothymic disorder benefit from avoiding alcohol and recreational drug use.
If you feel as though you may have cyclothymia, we highly recommend seeking a proper diagnosis from a medical health profession as it can make a world of difference. Through development a treatment plan and fully understanding the diagnosis, individuals living with cyclothymia can better manage their personal, work, and social lives without being in fear of how an unpredicted mood swing may affect their well-being.
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