Cyclothymia (Cyclothymic Disorder)

What is cyclothymic disorder?

Cyclothymia is a relatively mild mood disorder that causes mood swings. People suffering from cyclothymia experience cyclical fluctuations in their mood from mild depressive lows to hypomanic episodes.

Symptoms experienced by someone with cyclothymia can often negatively impact a person’s daily routine, causing issues at work or with their personal relationships for instance. However, symptoms are often mild enough that they do not seek treatment.

Cyclothymic disorder is very similar to bipolar disorder. The major difference between cyclothymia and bipolar I or II disorder, is that the symptoms are less extreme. Individuals with bipolar disorder can experience major depression and manic episodes. ^[1]

Symptoms of cyclothymic disorder

The main symptom of cyclothymia is mood swings from moderate or mild depressed mood to hypomania (a mild to moderate elevation in mood that usually lasts 4-5 days). These mood swings may be irregular and hard to predict.

Signs of depressive symptoms of cyclothymia include:

• Fatigue
• Aggression or anger
• Weight loss
• Hair loss
• Insomnia or hypersomnia
• Concentration problems
• Suicidal thoughts
• Headaches

Signs of hypomanic symptoms of cyclothymia include:

• Grandiosity
• Unusually talkative
• Irritable mood
• Euphoric mood
• Difficulty focusing
• Agitation
• Hypersensitivity
• Reduced tiredness/ need for sleep
• Unusually reckless or risky behavior
• Increased sex drive ^[3]

Is cyclothymia the same as bipolar disorder?

Cyclothymia is similar to bipolar disorder I and II, as they are both distinguished by mood swings, but cyclothymia is a milder form.

Bipolar I disorder presents with severe mood changes from mania to depression and bipolar II is a less extreme high, defined as hypomania, with depressive lows.

Cyclothymia differs from both, due to the less extreme lows and highs. The depressive episodes associated with cyclothymia never reach the level of major depression, and the elevated moods never meet the criteria for mania.

Although they are different disorders, people with cyclothymia can develop bipolar disorder if they are not treated properly. ^[1]

Who is at risk of having cyclothymia?

Research suggests that cyclothymia occurs in around 0.4% to 1% of the US population.^[3] It can affect both men and women equally, although women usually seek treatment more than men do, which could mean the numbers are slightly skewed. Symptoms often start presenting in early adulthood or adolescence.

Diagnosing cyclothymic disorder

In order to diagnose cyclothymia, a doctor or mental health professional will need to discuss symptoms and medical history, as well as rule out substance use disorders, to ensure symptoms aren’t caused by another medical condition.

A psychological evaluation will also be required, in order to differentiate symptoms from normal changes in mood.

To confirm cyclothymia doctors will look for criteria such as:

• Repeated cycles of hypomania and mild depression presenting at least half of the time, over a minimum of two years (this is reduced to one year in teenagers and children)
• Regular moods never lasting more than 2 months in that period
• Symptoms affecting daily life, such as work performance, household responsibilities, and relationships
• Symptoms not extreme enough to be classed as major depressive disorder or bipolar disorder
• No indications that mood swings could be caused by drug use, alcohol use disorder, or other medical conditions ^[2]

Causes of cyclothymic disorder

The cause of cyclothymia is currently unknown, although some contributing risk factors have been identified. As with other mental health disorders, genetics can be a factor and cyclothymia can run in families. Environmental factors can also play a part in someone developing cyclothymia after experiencing trauma or prolonged periods of stress. ^[3]

Prevention of cyclothymic disorder

Cyclothymia often starts in early adults and teenagers and can be hard to identify early on. It is important to seek treatment as soon as possible to prevent this relatively mild mental health condition from developing into something more severe.

As there is no known cause for cyclothymia, there is no guaranteed way to prevent it.

Treatment for cyclothymic disorder

Cyclothymia is a long-lasting condition, so long-term treatment may be required. To reduce the risk of developing bipolar disorder it is vital that you seek the appropriate treatment. ^[1]

There are no medications designed specifically to treat cyclothymia, however, mood stabilizers such as lithium may be prescribed to lessen mood swings.

Psychotherapy is an effective way of treating cyclothymia, which can help you recognize and manage the symptoms. This may include therapy such as Cognitive Behavioral Therapy (CBT), which has been shown to be one of the most robust ways of treating the disorder. The goal of CBT is to help identify the causes of your symptoms and negative beliefs and learn to better manage them. It focuses on understanding harmful beliefs or behaviors and implementing positive ones instead.^[3]

Various other therapies can also be effective, such as well-being therapy or interpersonal and social rhythm therapy (IPRST). You should consult a medical professional to understand which options could work best for you.

Living with someone with cyclothymic disorder

Cyclothymia can be a difficult disorder to deal with as the mood swings are so unpredictable. Educating yourself on the disorder is key so that you can be more understanding of what the person with cyclothymia is going through.

People with cyclothymia may not think they really need treatment, because the condition can be mild, but it is important to try and support them regardless. Offering to help them find suitable treatment and take them to appointments can be a helpful step in the right direction.

Frequently asked questions about cyclothymia

What complications are associated with cyclothymia?

If left untreated, cyclothymia can lead to emotional distress in many elements of your life such as:

• Higher risk of suicidal thoughts
• Higher chance of substance misuse
• Increased risk of developing bipolar disorder
• Increased risk of anxiety disorders ^[3]

What is the long-term outlook for cyclothymia?

Cyclothymia persists for a long time and can lead to serious complications so, to minimize further issues, it is important to seek treatment as early as possible.

Although there is no cure for cyclothymia, suitable treatment plans can help to manage and significantly reduce symptoms. Treatment may need to be lifelong, to prevent recurrences and avoid complications.