Understanding Cyclothymia

Cyclothymia is a disorder characterized by numerous periods of elevated or irritable mood, alternating with mild depression. Mood swings generally last a few days and do not follow a regular pattern. Cyclothymia is related to bipolar disorder.

Mood Swings

Cyclothymia is classified as a chronic mood disorder. People with cyclothymia go through periods of elevated mood called hypomania. Hypomania is a less extreme version of mania that is not associated with psychotic breaks from reality and/or hallucinations. Hypomania may not be recognized or not considered a problem. However, some people who have hypomania may exhibit behavior that is over and above their normal state, which for close friends and relatives, can be a tip off that something is wrong.

People in a hypomanic state may feel eurphoric, creative, or productive, and operate on less sleep per night than usual. These feelings can be coupled with irritability, recklessness, and impulsiveness. Hypomania can lead some people to make poor decisions or take risky behavior that can have negative consequences.

On the flip side, people with cyclothymia experience short episodes of mild depression. Symptoms of hopelessness, fatigue, apathy, and irritibility are common. During this time, a person may withdraw from friends and family and have problems concentrating or remembering.

These swings in mood and temperament often negatively impact a person's work and social life. Consequences often include instability with an uneven work and schooling history, impulsive and frequent changes of residence, repeated romantic or marital breakups, and an episodic abuse of alcohol and drugs.

Occurrence

Cyclothymia often becomes apparent during adolescence or early adulthood. It is more common in women than in men. Like bipolar disorder, cyclothymia tends to run in families. There may be a genetic link between the two.

Cyclothymia is rare, affecting less than 1% of the population. Because it is often diagnosed as another disorder or goes unnoticed, it is possible this number is underestimated.

Diagnosing Cyclothymia

Diagnosing cyclothymia can be more complicated than other mood disorders. It may be difficult to see the smaller changes in behavior, making diagnosis more difficult. Some people may seem to work better when they are hypomanic or to manage the depressive symptoms well enough that the fluctuations may not be noticed.

There are several criteria that must be met, but the crux is that hypomania and depressive symptoms need to be present for at least 2 years with no symptom-free period for more than 2 months. Other criteria include:

• Your symptoms do not meet the criteria for other mood disorders
• Having impaired school, work, or personal relationships because of your symptoms
• Symptoms are not related to diseases, medications, or substance use

For some people, cyclothymia can lead to bipolar disorder.

Treating Cyclothymia

Cyclothymia is treatable. Goals for cyclothymia treatment include reducing symptom severity, reducing the risk of bipolar disorder, and treating any social, work, or substance abuse problems. It involves a combination of medication and counseling.

There has been some success with lithium, a mood stabilizing drug used to treat bipolar disorder. It may be used alone or in combination with other antipsychotic medications. Antidepressants are not recommended for treating the disorder because episodes do not last long and are not severe.

Even when medication lacks appeal, counseling can help buffer the ups and downs. Therapists may suggest maintaining a regular schedule: wake up, eat, and go to bed at the same times. Other techniques include avoiding situations that trigger cyclothymic episodes and developing strategies for controlling responses to events. Still other therapies focus on improving relationships. Some people may find support groups to be helpful.

If you or a loved one experience mood swings that affect daily life or relationships, call your doctor for more information.

Revision Information

• Reviewer: Michael Woods, MD
• Review Date: 01/2016
• Update Date: 01/25/2016