Cyclothymia is a mood disorder in which a person experiences periods of mild depressive symptoms followed by periods of mild mania.
Cyclothymia is similar to both bipolar I and bipolar II disorder. However, with cyclothymia, a person experiences less intense fluctuations in mood.
This article will explore the symptoms of cyclothymia and discuss how it differs from bipolar I and bipolar II disorder. It will also provide information on diagnosis and treatment and offer tips on how to seek support.
Cyclothymia is a type of bipolar mood disorder.
These conditions cause periods of depressive symptoms that alternate with periods of mania, in which a person experiences increased excitement, euphoria, or overactivity, as well as agitation.
Cyclothymia causes a less intense form of mania called hypomania. Some possible characteristics of hypomania include:
- an increased sense of self-esteem
- increased happiness
- increased talkativeness
- racing thoughts and ideas
- a reduced need for sleep
- increased risk-taking behavior
The depressive symptoms of cyclothymia may include:
- a lack of energy
- a loss of interest in previously enjoyable activities
- feelings of worthlessness
- difficulty concentrating
- changes in eating habits
A person with cyclothymia tends to cycle between hypomania and depression. During the cycle, there may also be periods wherein the person feels that their mood is stable.
The risk factors for developing cyclothymia are similar to those of other bipolar mood disorders.
- a genetic predisposition to the condition
- environmental triggers, such as negative life events or negative thinking styles
- certain drugs
A doctor or psychiatrist will use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to determine whether or not a person has cyclothymia.
The DSM-5 is a book that provides detailed information about various mental health conditions and their symptoms.
According to the DSM-5, a person will need to meet the following criteria in order to receive a diagnosis of cyclothymia:
- The person has had hypomanic symptoms and depressive symptoms for at least 2 consecutive years (or for 1 year in children and adolescents).
- The symptoms have been present for at least half of the 2-year time period (or 1 year in children and adolescents). During this time, the person should not have been symptom-free for more than 2 months at a time.
- The person does not have a previous diagnosis of manic, hypomanic, or depressive episodes.
- The symptoms are not due to a psychotic condition, such as schizophrenia or schizoaffective disorder.
- The symptoms are not due to substance use or a medical condition.
- The symptoms are causing the person distress and affecting their day-to-day life.
Bipolar disorder is an umbrella term that encompasses the following mood disorders:
- bipolar I
- bipolar II
The main difference between these conditions is the intensity of a person’s mood changes. However, there are also some subtle differences in the symptoms of each condition.
The following sections will outline these differences in more detail.
Bipolar I and bipolar II
The main difference between a diagnosis of bipolar I and bipolar II disorder relates to the intensity of the manic episodes.
A person with bipolar I will experience manic episodes, but a person with bipolar II will experience hypomanic episodes. These are less intense.
Cyclothymia and bipolar disorder
A person with cyclothymia will experience hypomanic and depressive symptoms. However, the severity and duration of these symptoms are not sufficient to meet the criteria for bipolar II disorder.
If a person with cyclothymia experiences a major depressive, hypomanic, or manic episode, a doctor or psychiatrist may change the diagnosis to another bipolar-related disorder.
According to the DSM-5, there is a 15–50% chance that a person with cyclothymia will later develop bipolar I or bipolar II disorder.
The treatment for cyclothymia involves a combination of psychotherapy and medication.
The sections below list some medications that a doctor or psychiatrist may prescribe to help treat cyclothymia.
The goal of mood stabilizers is to help balance a person’s mood.
A person with cyclothymia may require the mood stabilizer lithium. People who have a diagnosis of bipolar I or bipolar II disorder may also receive this drug.
Alternatively, a doctor or psychiatrist may prescribe anti-epileptic drugs, such as oxcarbazepine. These can also act as mood stabilizers.
A person who takes antidepressants for cyclothymia may require careful monitoring to ensure that they do not experience an increase in hypomania symptoms.
As well as medication, it is likely that a person with cyclothymia will require some form of psychotherapy. The sections below will outline some types of psychotherapy in more detail.
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is a type of talking therapy that helps change negative thought and behavior patterns. An older study from 2012 suggests that CBT can help people with cyclothymia gain greater control of their moods.
Dialectical behavioral therapy
Dialectical behavioral therapy (DBT) is similar to CBT but is better suited to people who feel emotions very intensely. A 2017 study suggests that DBT has positive effects in people with bipolar disorder.
Well-being therapy focuses on self-observation. It involves using a structured diary to record interactions with therapists and other people who have the condition.
An older study from 2011 combined well-being therapy with CBT for people with cyclothymia. It found that the combination led to a decrease in both hypomanic and depressive symptoms.
In some cases, the symptoms of cyclothymia may be mild enough that a person does not seek mental health treatment. In other cases, the symptoms may severely disrupt a person’s day-to-day functioning.
In either case, a person who believes that they may have symptoms of cyclothymia should seek help from their doctor. People with cyclothymia have a higher chance of developing bipolar I or bipolar II disorder.
There is currently no cure for cyclothymia. However, a doctor or psychiatrist can help a person develop a treatment plan to help manage their symptoms. This plan may consist of a combination of medication and psychotherapy.
If a person feels that their treatment plan is not working well for them, they should discuss this with their doctor or psychiatrist. There are many different approaches to treatment, and a person may have to try several options before finding one that works for them.