Cyclothymia is a mood disorder that causes hypomanic and mild depressive episodes. It is defined in the bipolar spectrum. Specifically, this disorder is a milder form of bipolar II disorder consisting of recurrent mood disturbances between hypomania and dysthymic mood. A single episode of hypomania is sufficient to diagnose cyclothymic disorder; however, most individuals also have dysthymic periods. The diagnosis of cyclothymic disorder is not made when there is a history of mania or major depressive episode or mixed episode. The lifetime prevalence of cyclothymic disorder is 0.4-1%. The rate appears equal in men and women, though women more often seek treatment. Unlike some forms of bipolar disorder (specifically, bipolar I disorder), people with cyclothymia are almost always fully functioning; sometimes even hyper-productive.
Cyclothymia is similar to bipolar II disorder in that it presents itself in signature hypomanic episodes. Because hypomania is often associated with exceptionally creative, outgoing, and high-functioning behavior, both conditions are often undiagnosed. Typically, like most of the disorders in the bipolar spectrum, it is the depressive phase that leads most sufferers to get help.
This disorder is common in the relatives of patients with bipolar disorder and some individuals with cyclothymia eventually develop bipolar disorder themselves. It may persist throughout adult life, cease temporarily or permanently, or develop into more severe mood swings meeting the criteria for bipolar disorder or recurrent depressive disorder in rare cases.
Difficulty making decisions; problems concentrating; poor memory recall; guilt; self-criticism; low self-esteem; pessimism; self-destructive thinking; continuously feeling sad; apathy; hopelessness; helplessness; irritability; quick temper; lack of motivation; social withdrawal; appetite change; lack of sexual desire; self-neglect; fatigue or insomnia
Unusually good mood or cheerfulness (euphoria); Extreme optimism; Inflated self-esteem; Poor judgment; Rapid speech; Racing thoughts; Aggressive or hostile behavior; Being inconsiderate of others; Agitation; Increased physical activity; Risky behavior; Spending sprees; Increased drive to perform or achieve goals; Increased sexual drive; Decreased need for sleep; Tendency to be easily distracted; Inability to concentrate
One is 2-3 times more likely to have the disorder if someone in the immediate family has it or if an identical twin has it. In a study by Bertelsen, Harvard, and Huage (1977), if an identical twin had depression, 59% of the identical twins had it also.
Serotonin regulates other hormones like norepinephrine and dopamine, so when serotonin is low, the other chemicals may fluctuate, causing irritability, impulsivity and mood irregularities such as dysthymia and depression.
Depressed individuals can have high cortisol levels. Cortisol is a stress hormone, and mood disorders often occur during stressful points in one’s life. Elevated stress hormones can affect functioning of the hippocampus, an important centre for memory and cognitive processes. Overproducing cortisol can also impair the brain’s ability to regenerate neurons in the hippocampus.
Stressful events, as perceived by the individual Job loss, relationship failure, identity change, natural disaster, learned helplessness and hopelessness, extreme feelings, negative thinking patterns.
It has been repeatedly demonstrated that regular, vigorous physical exercise can help with mood regulation and emotional stability.
* Lithium, a mood stabilizer
* Anti-seizure medication/anticonvulsants (e.g., valproic acid, divalproex, and lamotrigine) are options.
* Cognitive behavioural therapy (CBT)
* Interpersonal psychotherapy (IT)
* Group therapy
* Integrative Therapy
* Psychodynamic Therapy
Symptoms of Depression Symptoms of Hypomania
* Low energy or motivation; accomplishing tasks is an effort
* Sleeping too much or too little; difficulty falling asleep or staying asleep
* Problems with concentrating, thinking, or making decisions
* Changes in appetite; marked weight loss or gain
* Feeling slowed down or agitated
* Loss of interest or pleasure in activities that were once enjoyable
* Feelings of worthlessness or guilt
* Feelings of hopelessness
* Thoughts of death or suicide
* Elevated, overly gregarious, or irritable mood
* Increased self-esteem, grandiosity
* Reduced need for sleep, feeling rested with only a few hours of sleep
* Increased talkativeness, feeling pressure to keep talking
* Racing thoughts, continuous stream of ideas that may be fragmentary
* Being easily distracted
* Increase in activity that is goal-directed
* Being overly involved in pleasurable activities that are potentially risky or could have painful consequences
If you have cyclothymia, you may already know that a mood of one extreme or the other can last as long as several hours, days, or even weeks. Commonly, though, cycling from one mood to the next happens rather suddenly and irregularly, with periods of “normal” or even mood being rare.
As with other mood disorders, there appears to be some hereditary influence. It is common for those with cyclothymia to have first-degree relatives (parents, children, or siblings) who have struggled with cyclothymia, major depressive disorder, or bipolar disorder.