What Exactly is Cyclothymic Disorder?

What Exactly is Cyclothymic Disorder?

Fridar Gichuki |Apr 8, 2021

Cyclothymic Disorder: A Mood Disorder

The cyclothymic disorder, also known as cyclothymia, is a mood disorder milder than bipolar I or II. It is characterized by a successive series of hypomania and depressive lows. The highs and lows are mild, with the depressive lows never reaching major depression and the hypomania never culminating in actual mania.

However, since all mental illnesses are on a continuum, cyclothymia may also range from normal mood variations to severe functional impairment because of the disorder. Individuals with cyclothymia are at risk of developing bipolar or other severe mood disorders if they cannot manage the condition properly with the help of a doctor.

The high and low periods are irregular and unpredictable. The low periods may last several days or weeks, but the person may experience normal moods for more than a month between the high and low.

Symptoms of Cyclothymic Disorder

Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorizes cyclothymia’s symptoms into depressive and manic symptoms.

Depressive related symptoms may include:

  • Aggressiveness
  • Changes in appetite
  • Chronic fatigue or low energy
  • Feelings of worthlessness and guilt
  • Inattentiveness and forgetfulness
  • Irritability
  • Insomnia or hypersomnia without fatigue
  • Weight changes
  • Low libido
  • Tearfulness, sadness, or feeling empty
  • Loss of interests in things that were once enjoyed
  • Poor concentration
  • Suicidal thoughts

The manic symptoms of cyclothymia may include:

  • Extremely combative
  • Extreme optimism
  • When talking, they speak fast and excessively
  • Having little or no sleep for days (without feeling tired)
  • Hypersexuality
  • Increased anxiety
  • Inflated self-esteem
  • Irregular sleep cycle
  • Lack of focus
  • Racing thoughts
  • Poor judgment and risky behavior
  • High drive and a strong desire to achieve goals
  • Restlessness and hyperactivity

Causes of Cyclothymic Disorder

The underlying causes of the cyclothymic disorder are unknown. However, there is a heredity aspect of it since it may run in families. Cyclothymia may also result from negative neurological changes of the brain caused by:

  • Alcohol use disorder
  • Stroke
  • PTSD
  • Alzheimer disease
  • Migraines
  • Brain aneurysm
  • Concussion
  • Multiple sclerosis

Cyclothymic Diagnosis

In the diagnosis of a cyclothymic disorder, your doctor may:

  • Perform a physical exam which may include a lab test to find an explanation of your symptoms.
  • Undertake a psychological evaluation, which entails talking about your thoughts and how they affect your feelings and behavior. The doctor may engage your family members and close friends to discuss your behavior but only with your express consent. Your doctor may also ask you to fill out a self-assessment questionnaire.
  • Your doctor may require that you keep a journal recording your mood and sleep patterns.

According to the DSM-5, you may have cyclothymia if your doctor discovers that you have:

  • Periods of elevated mood and depressive episodes lasting two years for adults and one for children and teens.
  • You’ve not had a stable mood for periods not exceeding two months.
  • Your symptoms significantly affect your social life, work, or school.
  • There is no other explanation for your symptoms (such as substance abuse).
  • Your symptoms do not meet the criteria for bipolar, depression, or other mental disorders.

Cyclothymic Disorder Treatment Options

People with cyclothymia need full-time medication to manage their condition, primarily because of the risk that the disease may progress into bipolar disorder if not treated. Whereas there is no medication specifically to treat cyclothymia, your doctor may rely on treatments used to treat other conductions such as:

  • Anti-anxiety medication
  • Antidepressants such as Prozac, Paxil, or Zoloft
  • Anti-epileptic medication
  • Anti-seizure meds
  • Avoid alcohol and substance use or abuse
  • Mood stabilizers such as lithium or lamotrigine
  • Atypical antipsychotic medication

These medications can help manage the symptoms of the disorder and prevent the hypomanic and depressive cycles.

Cognitive-behavioral therapy (CBT) is another treatment option. Your doctor may recommend CBT combined with medication. It focuses on identifying negative thought patterns that lead to behavioral problems. CBT also imparts mechanisms to cope with stress. CBT is an effective form of psychotherapy that allows the patient to identify, avoid, or cope with triggers.

The other psychotherapeutic option is interpersonal and social rhythm therapy (IPSRT). IPSRT supports the patient to achieve a daily rhythm of activities such as sleeping, waking up, and mealtimes. A predetermined and consistent routine is one way of guaranteeing a better mood. Your therapies may also recommend physical exercises and diet or connect you to a professional.

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Sinead Carey | April 8, 2021

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Krista Bugden | April 8, 2021

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