American Psychological Association refers cyclothymic disorder as a mood disorder characterized by periods of hypomanic symptoms and periods of depressive symptoms that occur over the course of at least 2 years. The number, duration, and severity of these symptoms do not meet the full criteria for a major depressive episode or a hypomanic episode. It often is considered to be a mild bipolar disorder. Also called cyclothymia.
A milder but more chronic version of bipolar disorder called cyclothymic disorder. It is similar in many ways to persistent depressive disorder. Like persistent depressive disorder, cyclothymic disorder is a chronic alternation of mood elevation and depression that does not reach the severity of manic or major depressive episodes. Individuals with cyclothymic disorder tend to be in one mood state or the other for years with relatively few periods of neutral (or euthymic) mood. This pattern must last for at least 2 years (1 year for children and adolescents) to meet criteria for the disorder.
Much of the time, such individuals are just considered moody. However, the chronically fluctuating mood states are, by definition, substantial enough to interfere with functioning. Furthermore, people with cyclothymia should be treated because of their increased risk to develop the more severe bipolar I or bipolar II disorder.
Diagnostic Criteria for Cyclothymic Disorder.
A. For at least 2 years (at least 1 year in children and adolescents) there have been numerous periods with hypomanic symptoms that do not meet criteria for a hypomanic episode. And numerous periods with depressive symptoms that do not meet criteria for a major depressive episode.
B. During the above 2-year period (1 year in children and adolescents), the hypomanic and depressive periods have been present for at least half the time. The individual has not been without the symptoms for more than 2 months at a time.
C. Criteria for a major depressive, manic, or hypomanic episode have never been met.
D. The symptoms in criterion A are not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.
E. The symptoms are not attributable to the physiological effects of a substance. (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism).
F. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Specify if: With anxious distress.
It’s not known specifically what causes cyclothymia. As with many mental health disorders, research shows that it may result from a combination of:
- Genetics, as cyclothymia tends to run in families.
- Differences in the way the brain works, such as changes in the brain’s neurobiology.
- Environmental issues, such as traumatic experiences or prolonged periods of stress.
Symptoms of cyclothymia include mood swings that alternate between mild to moderate “highs” and “lows.” A “high” is defined as a distinct period of time in which a person experiences abnormal and persistently elevated or irritable mood along with an abnormal increase in activity or energy. Additional symptoms include:
- Having a high level of self-esteem
- Being very talkative
- Having racing thoughts
- Getting easily distracted
- Having an increased focus on goals – work, school, social and also sexual goals.
A “low” is defined as a distinct period of time in which a person experiences depressed or hopeless mood and/or a decreased interest in previously enjoyed activities. Other symptoms that may be experienced during a “low” include:
- Feelings of social isolation, low self-worth and guilt
- Loss of appetite with weight loss
- Difficulty falling asleep (insomnia) or trouble staying awake (hypersomnia) nearly every day
- Fatigue or significant loss of energy.
Treatment for cyclothymic disorder.
There are no medications that are specifically approved for the treatment of cyclothymia; however, sometimes psychiatrists may prescribe a mood stabilizer to help reduce the swings in mood.
In addition, psychotherapy may help reduce distress by teaching one to recognize, monitor and manage the symptoms of cyclothymia; cope with stressful situations; change the way one thinks and reacts and problem solves; and improve communication and interpersonal interactions.
No medicines are specifically approved for the treatment of cyclothymia, although mood stabilizers such as lithium or lamotrigine are sometimes recommended as a possible strategy to reduce mood fluctuations. Antidepressants such Prozac, Paxil, or Zoloft are generally not recommended unless someone develops a full major depression, which, by definition, does not occur in cyclothymic disorder. There is also a small risk that antidepressants could trigger or worsen mania symptoms in a subgroup of vulnerable people.
David H. Barlow, V. Mark Durand. Abnormal Psychology, An Integrative Approach. (7th ed).