Clyclothymia

Cyclothymia, or cyclothymic disorder, is a mild mood disorder with symptoms similar to bipolar II disorder.

Cyclothymia is characterized by fluctuating low-level depression along with periods of hypomania. Symptoms must be present for at least two years before a diagnosis of cyclothymia may be made (one year in children). 

It is estimated that approximately one percent of the population has the disorder and, unlike other depressions which are typically more common in women than men, both genders are equally likely to suffer from cyclothymia.

The condition usually develops in adolescence. Individuals with the disease often appear to function more or less normally, although they may seem "moody" or "difficult" to others. Often, sufferers will not seek treatment because the mood swings do not seem severe. People with cyclothymia may occasionally even be hyper-productive.

According to the most recent Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), cyclothymia is distinguished from bipolar disorder because it lacks the full criteria of major depression, mania, or a mixed episode disorder. However, approximately one third of those with cyclothymia will develop bipolar I or bipolar II disorder later in life.

Symptoms

People with cyclothymia usually experience many weeks of low-level depression followed by an episode of mild mania that lasts several days.

Depressive symptoms of cyclothymia may include:

  • irritability
  • aggressiveness
  • insomnia or hypersomnia (sleeping too much)
  • changes in appetite
  • weight loss or gain
  • fatigue or low energy
  • low sexual desire and function
  • feelings of hopelessness, worthlessness, or guilt
  • inattentiveness, lack of concentration, or forgetfulness
  • unexplained physical symptoms

The manic symptoms of cyclothymia may include:

  • extremely high self-esteem
  • excessive talking or speaking very quickly, sometimes so fast others have trouble following what the person is saying
  • racing thoughts (muddled and disorganized)
  • lack of focus
  • restlessness and hyperactivity
  • increased anxiety
  • going for days with little or no sleep (without feeling tired)
  • argumentative
  • hypersexuality
  • reckless or impulsive behavior

Some patients experience "mixed periods," in which a combination of both manic and depressed symptoms occur within a very short time—one followed immediately by the other.

Diagnosing Cyclothymia

Researchers are not sure what causes or triggers symptoms of cyclothymia. It is, however, known to run in families.

A person does NOT have cyclothymia if he feels symptom-free for more than two months.

In order to diagnose cyclothymia, a doctor or mental health professional will discuss symptoms with the patient about her medical history and any alcohol or drug use. Lab tests may also be performed to rule out other medical conditions that may be causing the symptoms.

Treatments for Cyclothymia

Cyclothymia is a chronic condition that will require lifelong treatment. If a patient stops taking medications—even during periods of remission—his symptoms will return.

Because cyclothymia may develop into bipolar disorder, it is crucial that patients receive appropriate treatments. Alcohol and drug use may increase cyclothymic symptoms as well.

The main types of medications used to treat cyclothymia include:

  • mood stabilizers such as lithium
  • anti-seizure medications (also known as anticonvulsants) include divalproex sodium (Depakote), amotrigine (Lamictal), and valproic acid (Depakene)
  • atypical antipsychotic medications such as olanzapine (Zyprexa), quetiapine (Seroquel) and risperidone (Risperdal) may help help patients who don't respond to anti-seizure medications
  • anti-anxiety medications such as benzodiazepine
  • antidepressants should only be used in conjunction with a mood stabilizer as they may cause potentially harmful manic episodes when taken on their own

Psychotherapy is considered a vital part of the treatment of cyclothymia.

Cognitive behavioral therapy focuses on identifying negative or unhealthy beliefs and behaviors and replacing them with positive or healthy ones. It may also help patients manage stress and develop coping techniques. Other types of therapy that may benefit patients include talk, family, or group therapy.

There are currently no herbal or natural remedies that have been proven effective in treating either cyclothymia or bipolar disorder. However, ingesting omega-3 fatty acids (found in fish or flaxseed oils) may help reduce cyclothymic symptoms.