Cyclothymia, also called cyclothymic disorder, is similar to bipolar disorder except the episodes of highs and lows are generally less severe and shorter in duration. The condition is chronic, a mood disorder characterized by alternating episodes of mild emotional and behavioral "highs" followed by mild to moderate depression, interspersed with episodes of emotional and behavioral stability. Cyclothymia does not necessarily predispose one to developing bipolar disorder nor is it the onset of bipolar disorder. However, individuals with cyclothymia may later develop bipolar disorder. It is estimated that nearly one percent of the general population in the United States suffers from cyclothymia. Onset usually occurs during adolescence or in young adults. While the exact cause of cyclothymia is unknown, studies indicate a combination of genetic, biological, and environmental factors may lead to the disorder.

Individuals suffering from the hypomanic and depressive episodes of cyclothymia are generally still able to engage in normal activities at work, school, and social situations. However, the continuous cycling of mood states often causes a strain on relationships making some short lived. It also can cause poor self-esteem, job changes, fluctuating school performance, a history of tasks never finished, patterns of risky sexual behavior, drug, and alcohol abuse.

The individual suffering with the disorder probably won't recognize the signs and symptoms. Nor will they understand the why their hypomanic phases are a problem. You may need to suggest to the individual displaying symptoms to see a doctor to discuss how to cope more effectively with depression or distress. As always, if you are worried about an individual inflicting self-harm seek help at a local emergency room.

Diagnosis is usually made by a psychiatrist, psychologist or licensed clinical social worker. Usually people with cyclothymia seek medical advice for symptoms of depression therefore, the therapist may not be aware of the hypomanic episodes during the initial interviews. Sometimes, input from those closest to the individual can help the professional make a correct diagnosis.

There should be evidence of cyclic behavior for at least two years in adults or one year in children and adolescents to obtain a diagnosis of Cyclothymia. The periods of stable mood haven’t lasted for longer than two months. The individual hasn’t suffered from manic episode or major depressive episode. The doctor has ruled out substance abuse or a medical condition, such as a thyroid disorder as the cause of the symptoms.

Many psychiatric disorders share symptoms and cyclothymia may coexist with other disorders. Therefore, a diagnosis may change or evolve over time. Other psychiatric disorders that share similar symptoms are Attention-deficit/hyperactivity disorder (ADHD)and
Borderline personality disorder.

Between 15 and 50 percent of people with cyclothymia will develop bipolar disorder. Treatment strategies for cyclothymia are similar to those used for treating bipolar disorder.

Medications commonly prescribed include:

Lithium (Eskalith, Lithobid)
Anticonvulsants, such as valproic acid (Depakene), divalproex (Depakote) and carbamazepine (Carbatrol, Tegretol)
Antipsychotics, such as risperidone (Risperdal), olanzapine (Zyprexa) and quetiapine (Seroquel).
Common drug treatments for ADHD may worsen hypomanic symptoms.

Psychotherapy is used to help the person with cyclothymia know when to seek help, modify thoughts or behaviors that trigger symptoms, create manageable daily routines, and improve choices.

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Photo Credit 2006 Julia Fuller