Cyclothymia: Types, Symptoms, Causes, Diagnosis, and Treatments

Cyclothymia, one of the three primary kinds of bipolar disorder, is sometimes considered the mildest illness. People with Cyclothymia may alternate between mild to moderate depression and sensations of elation or mild euphoria, as opposed to enduring alternating episodes of significant depression and mania, as is typical in bipolar disorder.

Cyclothymia, commonly known as a cyclothymic disorder, is a type of mental illness. In Cyclothymia, you will experience emotional ups and downs, but they are not as severe as in bipolar I or II. Also, if you have Cyclothymia, you will go through times when your mood changes considerably from its baseline. You might also experience the feeling of being top of the world and then a slump in which you feel slightly down.

Although Cyclothymia's highs and lows are less intense than those of bipolar illness, it's still important to get support for managing these symptoms. This is because they can impair your capacity to function and raise your risk of developing bipolar I or II.

Bipolar disorder is a type of mental health disorder characterised by extreme mood swings, where patients either feel emotionally low and depressed or they feel emotionally high and manic.

Cyclothymia is a less severe type of bipolar disorder, where low degrees of depression and distinct hypomanic episodes are common. Also, long periods of steady moods are standard in people with the cyclothymic disorder, followed by cyclical mood swings of peaks and falls. You might also feel stable and okay between these cyclothymic highs and lows.

Individuals with Cyclothymia generally experience several weeks of less-severe depression followed by mild mania that usually stays for several days.

Depressive symptoms of Cyclothymia

Regardless, the depressive indications of Cyclothymia include -

• Hypersomnia or insomnia.
• Aggressiveness.
• Irritability.
• Alterations in appetite.
• Low energy or fatigue.
• Lack of concentration, Inattentiveness, or forgetfulness.
• Weight gain or loss.
• Feelings of worthlessness, hopelessness, or guilt.
• Awkward physical symptoms.
• Low libido.

Hypomanic Symptoms of Cyclothymia

Some of the symptoms to look for in this condition –

• Very high self-esteem.
• Impulsive or reckless behaviour.
• Argumentative.
• High anxiety.
• Low attentiveness.
• Hyperactivity and restlessness.
• Days with little or zero sleep.
• Extremely high libido.
• Uncontrollable thoughts (disorganised and chaotic).
• Talking excessively or speaking fast, sometimes so quickly that it’s becoming tough to follow.

The exact reason behind Cyclothymia is still not apparent. However, medical professionals think that environmental and biological factors play a significant role in causing Cyclothymia. A few of the potential causes include the following –

• Genetics and heredity.
• Bipolar disorder.
• Major depression.

Cyclothymic disorder has the potential to progress to bipolar disorder, and less than half of those with the illness are believed to experience this. Hence, knowing about the risk factors can help to worsen the situation.

• According to studies, people with cyclothymic disorder are also more prone to alcohol abuse and drug abuse including illicit substances like meth, cocaine, xanax, etc. e. This use of substances results from poor impulse control when feeling good and more intense responses to enjoyable situations.
• Research has also shown that cyclothymic disorder's instability may increase suicide risk. This risk is due to a propensity for intense emotional reactions and moods that can change quickly between being down and feeling energetic.

Before declaring a patient with Cyclothymia, healthcare providers must follow a diagnostic procedure. This generally includes –

• Physical Exam: Your doctor would first examine your physical conditions. Then they may order some specific lab tests to confirm any underlying causes or to understand the symptoms.
• Psychological Exam: Depending on their primary evaluation, your doctor may recommend a psychologist to check your mental health condition. They would talk about your feelings, thoughts and behavioural patterns. In addition, you may also have to fill in a questionnaire for self-assessment.
• Mood Charting: Your doctor may also ask you to track your mood changes, sleep patterns and other relative factors to find an appropriate treatment method.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) issued by the American Psychiatric Association includes the following criteria for diagnosing Cyclothymia. A few of those include the following –

• One must have had frequent episodes of positive moods and depression symptoms for at least two years.
• Most of the time, steady mood phases last shorter than two months.
• The affected person's symptoms are distressing at work, school, or other crucial social settings.
• The signs don't fit the symptoms of severe depression, bipolar disorder, or other mental illnesses.
• The symptoms are not the result of substance abuse or disease.

Prescription Drugs for Cyclothymic Disorder

• Mood stabilisers.
• Anticonvulsants/anti-seizure drugs like Depakote.
• Patients not responding to anti-seizure medications may benefit from atypical antipsychotic drugs like olanzapine (Zyprexa) and risperidone (Risperdal).
• Medications that reduce anxiety, like benzodiazepines.
• Anti-depressants (should only be used with a mood stabiliser because using them alone could result in potentially dangerous manic episodes).

Psychotherapy Treatment for Cyclothymic Disorder

An essential component of treating Cyclothymia is psychotherapy, sometimes known as talk therapy or psychological counselling. Individuals can opt for psychotherapy in individual, family, or group settings. In this regard, different types of psychotherapy can be helpful. This therapies include –

• Cognitive-Behavioural therapy (CBT): It's a typical therapy for cyclothymic disorder. This treatment focuses on identifying unhealthy, unfavourable attitudes and habits and changing them to favourable ones. CBT can also assist in determining the causing factors behind the symptoms.
• Interpersonal and Social Rhythm Therapy (IPSRT): Its main goal is stabilising everyday rhythms, including waking up, sleeping, and eating. Therefore, a regular schedule of IPSRT is always beneficial for improved mood management. Also, following a healthy daily regimen for sleep, meals, and exercise may benefit those suffering from mood problems.
• Other Therapies: Besides these, there are other therapies that have shown effective results in treating Cyclothymic disorder. Since these therapies vary from one person to another, you may ask your healthcare provider if any other therapy would work for your condition.

Despite the mood changes, individuals with bipolar disorder frequently fail to recognise its severity. They also face challenges in figuring out the intensity of disturbance it brings to their lives and those they care about, preventing them from receiving the necessary therapy.

You should note that the symptoms of bipolar disorder do not abate on their own. If you observe shifting moods of hypomania or signs of mild depression, consult your doctor immediately. Seeking treatment for Cyclothymia from a mental health professional can help to cure it quickly.

Along with the treatment methods, one can also make certain lifestyle modifications to manage the condition. Several coping mechanisms and way-of-life adjustments can help with the signs and symptoms of the cyclothymic disorder, some of which are included below –

• Taking your prescribed medications on time.
• Giving up using alcohol or drugs for recreational purposes.
• Observant of warning signals.
• Getting adequate rest.
• Keeping a list of the items that cause cyclothymic disorder to flare up.
• Understanding the condition.
• Joining a group for support.
• Exercising regularly.
• Locating healthy outlets.
• Retaining focus on your objectives.
• Studying and putting into practice relaxation and stress management methods.

Hence, it is evident that cyclothymia causes increased depression and mood episodes. Also, as the symptoms are not as severe as those associated with bipolar disorder, it might be challenging to diagnose. Hence, if you recognise any symptoms, it is best to consult a medical professional who can assist you in curing the disorder.