Cyclothymia (Cyclothymic Disorder): Symptoms & Causes

What is Cyclothymia (Cyclothymic Disorder)?

Cyclothymia, or Cyclothymic Disorder, is a mood disorder with elevated and depressed moods, where the person cycles between the two moods with periods of stability in between. While the mood swings aren’t as severe as Bipolar Disorder, the ups and downs can be quite destabilizing and don’t generally get better on their own. Periods of stability usually last around eight weeks.

It is unclear what the cause is, but if the condition doesn’t get better on its own, it is best to seek professional help.² This diagnosis shares diagnostic features of other mood disorders, making Cyclothymia an elusive diagnosis at times.³ The diagnosis seems to emerge during early adulthood and affects .4%-1% and affects males and females at the same rate.⁴

Cyclothymia Vs. Bipolar Disorder

Cyclothymia is a milder version of bipolar disorder in that the person still experiences the ups and downs of bipolar disorder, though the mood swings are not as severe and frequent.⁵ In Cyclothymia, the mood swings last at least two years but don’t meet the criteria for hypomania or a depressive episode. The other aspect is that the mood swings keep occurring and don’t stop for two consecutive months.⁶

Cyclothymia Vs. ADHD

Cyclothymia is a mood disorder, while ADHD is a neurodevelopmental disorder. Characteristics of Cyclothymia include mood swings up and down, while ADHD is characterized by inattentiveness, hyperactive-impulsivity, or some combination of both behaviors.  Though they are quite different disorders, both conditions can occur together. Researchers continue to explore if there is a relationship between the two disorders.⁷

Symptoms and Stages of Cyclothymia

The primary symptoms of Cyclothymia are cycling between low-level depressive symptoms and mild mania (hypomania), and the swings are less severe than Bipolar Disorder. The symptoms also need to last for two years, with mood cycles at least every two months. The swings tend to occur in cycles, feeling highs and lows during one cycle. In between the mood swings, people generally feel stable.⁸

Hypomanic Symptoms

In Cyclothymia, the hypomanic symptoms are less severe than the mania in Bipolar Disorder. People can function, but cycling can be disruptive. The hypomanic symptoms can last a few days to a week and can be quite dysregulating because the lows, or depressive symptoms, usually follow the elevated mood.

Signs and symptoms of hypomanic symptoms in cyclothymia include:

• Exaggerated feeling of happiness or well-being (euphoria)
• Extreme optimism
• Pressured speech or talking more than usual.
• Racing thoughts
• Increased or inflated self-esteem
• Increased drive to perform or achieve.
• Inability to concentrate.
• Tendency to become easily distracted
• Agitated mood
• Decreased need for sleep

Depressive Symptoms

The lows of Cyclothymia are less severe than Bipolar Disorder or a diagnostic form of depression. The unpredictable nature of your mood, when you have Cyclothymia, can be destabilizing. People generally continue to function, but they can have a challenging time with symptomatic behavior.

Signs and symptoms of depressive symptoms in cyclothymia include:

• Feeling hopeless, sad, or empty
• Feeling tearful
• Irritability
• Loss of interest in activities you once enjoyed
• Feeling worthless
• Feeling hopeless
• Problems concentrating
• Changes in sleep
• Changes in appetite
• Thoughts of suicide

Impacts of Cyclothymia

Cyclothymia can have a big impact on one’s life, especially if it remains untreated. The ups and downs of a consistent, cycling mood will impact relationships, including personal and professional ones. If untreated, the person’s moods may take over, making day-to-day activities, work, and relationships hard to maintain. The good news is that people with Cyclothymia can lead normal lives if they are treated for the condition.

Causes and Risk Factors of Cyclothymia

The exact causes and risk factors of Cyclothymia are unknown. Cyclothymia is also under-reported because of the low-intensity symptoms. It appears that Cyclothymia seems to affect men and women at the same rates, though women tend to seek treatment more often.⁹

In addition, the etiology and risk factors are unknown for cyclothymia. It does seem that first-degree relatives are more likely to be diagnosed with Major Depressive Disorder or Bipolar Disorder. Studies also demonstrate that between 20% and 50% of people with mood disorders such as depressive disorders or bipolar disorder.⁹

How is Cyclothymia Diagnosed? 

Cyclothymia has its own diagnostic criteria, but it has many overlapping diagnostic characteristics as other diagnoses, which can make it hard to diagnose. The best way to diagnose Cyclothymia is by meeting with a licensed mental health clinician. Through a mental status exam and intake meeting, clinicians will be able to evaluate if the following criteria are present for a diagnosis:

Other mental health conditions with overlapping symptoms include:

• Major Depressive Disorder
• Bipolar II Disorder
• Generalized Anxiety Disorder
• ADHD
• Borderline Personality Disorder

Coping Tips for Cyclothymia

The best way to manage Cyclothymia is from a holistic approach to health working with the mind and the body. Finding a licensed clinical therapist is important to being able to manage one’s moods, process feelings, and find healthy ways of managing emotions. Therapists will likely refer to prescribers if they feel that medication is a consideration in the case.

Paying attention to levels of stress is also critical to being able to manage Cyclothymia. People who are diagnosed with Cyclothymia or those who think they may have it, usually need to pay extra attention to managing stress levels and the triggers to stress.

It will be important to pay attention to the following:

• Exercise: Exercise has a variety of benefits. Exercise can help mental health issues. It can also help you to feel better overall.
• Diet: Eating a healthy diet of mostly whole foods can help stabilize the mood¹⁰
• Self-care: Self-care is so important, particularly when you suffer from mood swings. Self-care techniques for depression can help with caring for yourself during difficult times.
• Stress management: Stress cycles can exacerbate moods and therefore, it is so important to pay attention to managing stress levels.
• Meditation: Meditation has the potential to lower stress and increase our awareness of our feelings, moods, and thoughts. It is a useful practice to start to help manage moods.
• Journaling: Journaling for mental health helps to release the burden of overwhelming thoughts onto paper.
• Relaxation: Learning how to relax is beneficial in managing mood swings.
• Good Sleep Hygiene: Sleep has a significant effect on mood, and adequate sleep hygiene is really necessary to help maintain stable moods.

Treatment Options for Cyclothymia

There is no one right or best treatment option for Cyclothymia. Successful treatment depends so much upon the fit of the therapist and client. Some treatments tend to be more behavioral while others focus more on an insight-related approach. The focus of treatment would be needed to focus on the stability of moods.

Medication

At this point, there is no specific Food and Drug Administration-approved drug specifically for cyclothymia.¹¹

The most common medications prescribed for Cyclothymia are mood stabilizers, antidepressants, some atypical antipsychotic medications, and some anti-seizure medications. Medication is helpful in managing an unstable mood, but it can be trial and error to find the right medication. Medication is most useful when moods feel out of someone’s control.

Therapy

Therapy is a vital part of treatment for Cyclothymia. Therapy can be in the form of individual, group, family, or other possibilities. There are many different approaches to therapy, such as Gestalt, Psychodynamic, CBT, DBT, Group, and more. The relationship between the therapist and client is important for a good outcome of psychotherapy.

Common therapy options for cyclothymia treatment include:

• Cognitive behavioral therapy(CBT): Cognitive behavioral therapy works with identifying and challenging unwanted thoughts and behaviors. There is a great article, CBT for bipolar disorder, which may help someone with cyclothymia.
• Dialectical Behavioral Therapy (DBT): DBT is an approach similar to CBT that works with both behaviors and thoughts. DBT differs from CBT in that it has a self-regulation emphasis, which can be quite helpful for someone in the middle of a Cyclothymic episode with mood swings.
• Gestalt Therapy: Gestalt therapy is an approach that emphasizes the “here-and-now” present moment. Though the history of the person is important, the Gestalt approach is that history shows up in the present moment. This allows the therapist and client to look at what feelings and thoughts come up during the session and how to relate to them.
• Group Therapy: Group therapy can be so helpful for people struggling with Cyclothymia because it the participants get feedback from the other participants about how their experience affects them. This can be quite powerful because often, people with Cyclothymia don’t know how they affect others.

When to Seek Professional Help for Cyclothymia

If you are feeling more depressed or more activated than usual, and it is starting to disrupt your daily life and functioning, it is likely time to seek professional help. Finding a therapist can be overwhelming. You can use particular searches such as  find a therapist. If you are looking for a new therapist, there is also an online therapist directory that can be a helpful resource because you can search for your specific needs.