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Introduction: Cyclothymia: symptoms, causes, and treatment options
Cyclothymia, also known as a cyclothymic disorder, is a rare mood disorder. It’s often considered to be a milder form of bipolar disorder. People with this cyclothymia experience emotional highs and lows in cycles. These abrupt changes in mood can occur rapidly and at any time. They rarely experience long periods of normal moods. However, they’re not as extreme as those in Bipolar I or Bipolar II Disorder.
With cyclothymia, you experience periods of time when your mood noticeably shifts up and down from your baseline. You may feel on top of the world for some time, which is later followed by a lower period, where you feel depressed. In between the highs and lows, you may feel entirely stable and safe.
While the highs and lows of cyclothymia are less intense than those in bipolar disorder, it’s essential to get help to manage your symptoms. If left unaddressed they can interfere with your ability to function on a day-to-day basis, or even increase your risk of developing bipolar disorder.
Read on to learn more about cyclothymia, including symptoms, causes, and treatment options.
What is cyclothymia?
Cyclothymia has been reported to affect about 0.4-1 % of people in the general population. Due to the many symptoms of cyclothymia overlapping with bipolar disorder and BPD (borderline personality disorder), it may often be misdiagnosed or underdiagnosed by physicians. The ups and downs of cyclothymia aren’t clear-cut, and may also present similarly to anxiety, irritability, or depression, making it difficult not to misinterpret.
Symptoms of cyclothymia
Symptoms of cyclothymia alternate between emotional highs and lows. The highs of cyclothymia can look like an elevated, energetic mood. While the lows consist of Mild or moderate depressive symptoms.
Generally, when an individual has cyclothymia, they can typically function well in their day-to-day lives. However, changes in moods aren’t always predictable, making it disruptive because it’s difficult to determine how you’re going to feel.
Hypomanic symptoms
A “high” is typically defined as a specific period when someone experiences unusual and persistent elevated, or irritable moods. Sometimes this can also include an abnormal increase in a person’s energy or activity. Additional symptoms of the ‘highs’ may include:
- An exaggerated feeling of happiness or well-being (euphoria)
- Extreme optimism
- Being very talkative or more talkative than usual
- Racing thoughts
- Inflated self-esteem and self confidence
- Talking more than usual
- Poor judgment can result in risky behavior or unwise choices
- Racing thoughts
- Irritable or agitated behavior
- Excessive physical activity
- Increased drive and motivation to accomplish or achieve your goals
- Reduced need for sleep
- Getting easily distracted or having difficulty concentrating
- Getting overly engaged in risky activities or activities that lack judgment, such as spending sprees, sexual behaviors, or unwise financial decisions
Depressive or ‘low’ symptoms
A “low” is defined as a specific period of time when someone experiences a low, depressed mood or a lack of interest in previously enjoyed hobbies/activities. Additional symptoms that may be experienced during a “low” may include:
- Feeling sad, hopeless, or empty
- Tearfulness
- Irritability, especially in children and teenagers
- Loss of interest in activities once considered enjoyable
- Changes in weight
- Loss of appetite
- Feelings of worthlessness or guilt
- Trouble falling or staying asleep regularly
- Restlessness or irritability
- Social isolation
- Fatigue or a significant loss of energy
- Difficulty concentrating
- Thoughts of death or suicide
How is cyclothymia diagnosed?
The diagnosis process starts with a physical exam. This may include your provider gathering medical history and completing blood work to rule out any other medical concerns that may present similarly. You will also undergo a mental status exam and a psychiatric evaluation.
An adult can be diagnosed with cyclothymia when:
- Symptoms (alternating “highs” and “lows”) have been present for at least 50% of the time for at least 2 years.
- There hasn’t been more than a 2-month long period of being symptom free.
- Your symptoms aren’t a result of substance misuse or a medical condition.
Additionally, your symptoms need to cause some sort of distress or impairment in your day-to-day functioning. They cannot, however, be severe enough to meet the criteria for major depressive disorder or bipolar disorder. For kids and teens, symptoms must be present for at least 1 year.
Who is affected by cyclothymia?
Cyclothymia often appears in individuals during their teen years or as a young adult. While women and men are equally affected by cyclothymia, women have been reported to seek treatment more often than men.
When to see your doctor
If you or someone you know are experiencing symptoms of cyclothymia, it’s essential to follow up with your medical provider. While symptoms of cyclothymia don’t usually resolve on their own, taking the first step and scheduling an appointment with your doctor can provide some relief.
If you’re hesitant to take that first step in seeking treatment, talk to a loved one to see if they can support you in doing so. If you’re concerned for a loved one, talk to them. Do your best to talk openly and honestly about why you are concerned for their mental health. While you can’t force them to seek help, you can offer your support and help them take the right steps in finding a provider or exploring their treatment options.
Causes for cyclothymia
Like many mental health conditions, there isn’t one single cause for cyclothymia. Experts have shown that it may develop because of the following factors combined:
- Genetics. Many mental health disorders are genetic. If any of your family members have been diagnosed, your chances of developing cyclothymia are higher.
- Your brain’s neurobiology. Slight differences in your genetic Differences in the way the brain works, such as changes in the brain’s neurobiology
- Environmental issues. This can range anywhere from witnessing a traumatic event such as a natural disaster or experiencing a prolonged period of stress in your life.
Risk factors
Cyclothymia is thought to be relatively rare. However, accurate numbers are difficult to determine as many people go undiagnosed or be misdiagnosed as having another mood disorder, such as major depressive disorder or bipolar disorder. Cyclothymia typically affects both males and females and develops during your adolescent years or early adulthood.
If you or someone you know may be struggling with cyclothymia:
- Delaying treatment can result in worsening emotional issues that can affect day-to-day life.
- There may be a higher risk of developing Bipolar I or Bipolar II Disorder
Prevention
Unfortunately, there isn’t one single method when it comes to preventing cyclothymia. However, finding proper treatment as soon as you notice any signs or symptoms can help prevent cyclothymia from worsening. Long-term preventive treatment also can assist in preventing minor symptoms from turning into full-blown episodes of mania, hypomania, or depression.
Suicidal thoughts
Although suicidal thoughts may occur with cyclothymia, they’re more likely to occur if you have bipolar I or II disorder. If you are experiencing suicidal ideation or know someone who is, be sure to:
- Call 911 or your local emergency services number, or go to a hospital emergency department.
- Call a local crisis center or suicide hotline number — in the United States, you can call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or use the webchat at suicidepreventionlifeline.org/chat.
If you just can’t make that call, reach out to someone else — immediately — such as your doctor, mental health provider, family member, friend, or someone you can trust in your community.
Treatment options
Treatment options for cyclothymia include talk therapy (psychotherapy), medications, and close, ongoing follow-up with your doctor.
Medications
While there aren’t many medications specifically to treat cyclothymia, your doctor may prescribe medications used to treat bipolar disorder. These medications can help you manage your symptoms and prevent the ‘highs’ and ‘lows’ of cyclothymia.
Psychotherapy
Psychotherapy, also known as talk therapy, is an essential part of cyclothymia treatment. Several types of therapy can be helpful, such as:
- Cognitive behavioral therapy. As a commonly utilized, evidence-based treatment for cyclothymia, Cognitive behavioral therapy (CBT) focuses on identifying unhealthy, negative thoughts, beliefs, and behaviors, while replacing them with healthier and more positive alternatives. CBT can also help you learn effective coping strategies to manage stress and symptoms.
- Other therapies. Other therapies have been studied with some evidence of success. Talk to your doctor to see which options work best for you.
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