Cyclothymic disorder is a mild form of bipolar disorder (manic depressive illness) in which a person has mood swings over a period of years that go from mild depression to euphoria and excitement.
Causes, incidence, and risk factors
The causes of cyclothymic disorder are unknown. Major depression, bipolar disorder, and cyclothymia often occur together in families. This suggests that these mood disorders share similar causes.
Cyclothymia usually begins early in life. It appears to be equally common in men and women.
Symptoms
- Episodes of hypomania (see: Bipolar disorder) and mild depression occur for at least 2 years (1 or more years in children and adolescents)
- Mood swings are less severe than in bipolar disorder, major depression, or mania
- Symptoms are persistent, with no more than 2 symptom-free months in a row
Signs and tests
Your description of your mood history usually leads to diagnosis of the disorder. Your health care providers may order blood and urine tests to rule out medical causes of mood swings.
Treatment
Mood stabilizing medication, antidepressants, talk therapy, or some combination of these three therapies may be used to treat cyclothymic disorder.
Some of the more commonly used mood stabilizers are:
- Antiseizure drugs. Valproic acid (Depakote), carbamazepine (Tegretol), oxcarbazepine (Trileptal), and lamotrigine (Lamictal) are the most established mood stabilizing antiseizure drugs.
People with cyclothymia may not respond to medications as strongly as patients with bipolar disorder.
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Bipolar disorder involves periods of elevated or irritable mood (mania), alternating with periods of depression. The "mood swings" between mania and depression can be very abrupt.
Causes, incidence, and risk factors
Bipolar disorder affects men and women equally. It usually appears between ages 15 - 25. The exact cause is unknown, but it occurs more often in relatives of people with bipolar disorder.
Types of bipolar disorder:
- People with bipolar disorder type I have had at least one fully manic episode with periods of major depression. In the past, bipolar disorder type I was called manic depression.
- People with bipolar disorder type II have never experienced full-fledged mania. Instead they experience periods of hypomania (elevated levels of energy and impulsiveness that are not as extreme as the symptoms of mania). These hypomanic periods alternate with episodes of depression.
- A mild form of bipolar disorder called cyclothymia involves less severe mood swings with alternating periods of hypomania and mild depression. People with bipolar disorder type II or cyclothymia may be misdiagnosed as having depression alone.
In most people with bipolar disorder, there is no clear cause for the manic or depressive episodes. The following may trigger a manic episode in people who are vulnerable to the illness:
- Life changes such as childbirth
- Medications such as antidepressants or steroids
- Periods of sleeplessness
- Recreational drug use
Symptoms
The manic phase may last from days to months and can include the following symptoms:
- Agitation or irritation
- Inflated self-esteem (delusions of grandeur, false beliefs in special abilities)
- Little need for sleep
- Noticeably elevated mood
- Hyperactivity
- Increased energy
- Lack of self-control
- Racing thoughts
- Over-involvement in activities
- Poor temper control
- Reckless behavior
- Binge eating, drinking, and/or drug use
- Impaired judgment
- Sexual promiscuity
- Spending sprees
- Tendency to be easily distracted
These symptoms of mania are seen with bipolar disorder I. In people with bipolar disorder II, hypomanic episodes involve similar symptoms that are less intense.
The depressed phase of both types of bipolar disorder includes the following symptoms:
- Daily low mood
- Difficulty concentrating, remembering, or making decisions
- Eating disturbances
- Loss of appetite and weight loss
- Overeating and weight gain
- Fatigue or listlessness
- Feelings of worthlessness, hopelessness and/or guilt
- Loss of self-esteem
- Persistent sadness
- Persistent thoughts of death
- Sleep disturbances
- Excessive sleepiness
- Inability to sleep
- Suicidal thoughts
- Withdrawal from activities that were once enjoyed
- Withdrawal from friends
There is a high risk of suicide with bipolar disorder. While in either phase, patients may abuse alcohol or other substances, which can make the symptoms worse.
Sometimes there is an overlap between the two phases. Manic and depressive symptoms may occur together or quickly one after the other in what is called a mixed state.
