Cyclothymia (Cyclothymic Disorder)

What Is Cyclothymia?

Cyclothymia (cyclothymic disorder) is a relatively mild mood disorder. In cyclothymic disorder, moods swing between short periods of mild depression and hypomania (elevated mood). The low and high mood swings never reach the severity of major depression or mania. Cyclothymia is a "bipolar-like" illness. People with cyclothymic disorder have milder symptoms than in full-blown bipolar disorder.

Who Gets Cyclothymic Disorder?

From 0.4% to 1% of the U.S. population has cyclothymia. Equal numbers of men and women are affected. Symptoms usually begin in adolescence or young adulthood. The onset of cyclothymia is frequently hard to identify.

What Are the Symptoms of Cyclothymia?

In cyclothymic disorder, moods fluctuate from mild depression to hypomania and back again. In most people, the pattern is irregular and unpredictable. Hypomania or depression can last for days or weeks. In between up and down moods, a person might have normal moods for more than a month -- or may cycle continuously from hypomanic to depressed, with no normal period in between.

Compared to more serious mood disorders, the mood symptoms are mild. Depressive symptoms in cyclothymic disorder never reach the criteria for major depression. Elevated mood never reaches the definition for mania.

Cyclothymia can straddle the line between mental illness and normal variations in mood and personality. Some people with mild symptoms are highly successful in life, driven by their hypomania to express individual talents. On the other hand, chronic depression and irritability can ruin marriages and professional relationships.

What Causes Cyclothymic Disorder?

Many experts believe cyclothymic disorder is a very mild form of bipolar disorder. No one is sure what causes cyclothymia or bipolar disorder. Genetics play a role in the development of both these disorders. People with cyclothymia are more likely to have relatives with bipolar disorder and vice versa.

What Are the Treatments for Cyclothymia?

Cyclothymia frequently goes undiagnosed and untreated. Most people's symptoms are mild enough that they do not seek mental health treatment. In fact, some people resist the idea of treatment, which reduces their "up" episodes as well as "down."

The depressive symptoms of cyclothymic disorder are typically more frequent, unpleasant, and disabling than the hypomanic symptoms. Feelings of depression or instability are usually what cause people with cyclothymia to seek help.

Mood stabilizers, such as lithium or Depakene are the preferred treatments for cyclothymia. Antidepressants like Prozac, Paxil, or Zoloft can trigger mania and should be avoided, unless a mood stabilizer is also taken.

Technically speaking, when elevated or depressed moods become severe, a person no longer has cyclothymia, but rather has bipolar disorder. This progression to more severe symptoms can happen, and this is when many people first receive treatment.

Living With Cyclothymia

Cyclothymia may wreak havoc on the personal lives of people with the disorder. Unstable moods frequently disrupt personal and work relationships. People may have difficulty finding a life partner, instead moving through a series of passionate, short-lived romances. Impulsive behavior can be self-destructive and lead to legal problems.

People with cyclothymic disorder are also more likely to abuse drugs and alcohol. As many as 50% of people with cyclothymia may also have a problem with substance abuse.

Over time, people with cyclothymia are at increased risk of developing full-blown bipolar disorder. Limited data suggests they are at higher risk of suicide. Treatment with mood stabilizers reduces this risk.