What is Cyclothymic Disorder?
People with cyclothymia tend to transition rapidly between episodes of mild depression and hypomania. Hypomanic symptoms resemble those of manic states in bipolar, but are less severe. In each phase of the disorder symptoms might last a few days, or several weeks. The periods of depression and hypomania are sometimes sandwiched between shorter periods of relatively normal mood state.
This disorder occurs in women and men in equal frequency, but women are more likely than men to seek diagnosis and treatment. In most cases, people with this mood disorder seek help during depressive phases. This is one reason why misdiagnosis is common, as not all people with the disorder realize that hypomanic phases are part of the disorder, and might not report these symptoms. Correct diagnosis is particularly important because up to 40% of people with cyclothymic mood disorder will eventually develop bipolar disorder.
Causes of Cyclothymia
Several different factors are implicated in the development of cyclothymia. These include social, psychological, and biological causes.
- Social factors are thought to be involved in up to 80% of cases, but it is not clear how strong an influence these are. An example of a social factor is the parenting style of the cyclothymic person’s mum and dad.
- Psychological factors include stressful triggering events such as the failure of a relationship, loss of a job, or living through a traumatic event. Negative thinking patterns, and learned feelings of hopelessness and helplessness, are also contributing factors.
- The risk of developing cyclothymia is up to three times higher for someone with a family history of cyclothymia or bipolar disorder. Other influential biological factors include reduced serotonin and high cortisol levels.
One of the defining characteristics of cyclothymia is a pattern of alternating periods of depression and hypomania. People with this mood disorder are generally able to function from day to day, but go through periods in which their ability to function is reduced. The unpredictability of shifts between depression and hypomania is another defining feature of the disorder.
- Feelings of sadness, hopelessness, anxiety, guilt
- Suicidal thoughts or behavior
- Lack of interest in life, daily activities
- Lack of appetite
- Reduced sex drive
- Reduced ability to concentrate
Someone in a depressive phase might also experience chronic pain of unknown origin. The pain is generally not present during hypomanic phases.
- Mild euphoria, which might include unusual cheerfulness, good mood, high level of optimism, and higher self-esteem
- Aggressive behavior or hostility, being inconsiderate to other people, agitation
- Poor judgment
- Unusually rapid thoughts and speech
- Higher level of physical activity
- Tendency towards riskier behavior and impulse behavior
- Increased level of motivation
- Higher sex drive
- Reduced sleep and need for sleep
- Easily distracted with difficulty concentrating
The diagnostic criteria for cyclothymic mood disorder must be met for this condition to be diagnosed in a person. Criteria include:
- Symptoms must have been present for two years or longer (or one year in a child).
- The person has not been symptom-free for a period longer than two months.
- The symptoms do not fulfill criteria for major depressive disorder, schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder (not otherwise specified).
- Symptoms are not the direct result of prescription medications or substance abuse, or another medical condition.
- The symptoms cause distress or impair the person’s ability to function in social, personal, or work settings.
In making a diagnosis of cyclothymic mood disorder, a doctor must rule out symptoms caused by drug use, other psychiatric disorders, and medical conditions such as epilepsy, hyperthyroidism, and Huntington’s disease.
National Institute of Health MedlinePlus: Cyclothymic Disorder
The Mayo Clinic: Cyclothymia
UK PsychNet: Cyclothymic Disorder Information Sheet