Cyclothymic disorder (CD), also termed cyclothymia, is a mental disorder with mild but long-lasting and severely impairing mood swings. Characteristic mood changes include periods of euphoria which are abruptly followed by depressive episodes.
CD is part of the spectrum of bipolar disorders and can progress to bipolar disorder type 1 or 2. Onset usually occurs in adolescence and affects both genders equally. Prevalence is estimated to be up to 1/100. Progression to bipolar disorder occurs in up to 50% of cases.
CD may only be diagnosed if the specific mood swings persist for two years in adults or one year in adolescents.
Presentation
Expert consensus defines cyclothymic disorder (CD) as a subclinical variant of bipolar disorder, which is characterized by chronic mood swings alternating between hypomanic and depressive periods. Due to the subclinical nature of CD, it has also been incorrectly assessed as a character trait in the past [1] [2] [3].
A cardinal feature of all types of bipolar disorders is perturbed sleeping, which also applies to CD [4] [5]. Long-term studies have shown that CD is as debilitating as other disorders of the bipolar spectrum [6] [7].
Hypomanic episodes may manifest with general euphoria, exaggerated self-esteem, logorrhea, impaired risk assessment, distractability, lack of concentration, racing thoughts, no need for sleep and marked irritability [1] [3].
CD patients have described their depressive periods with a feeling of fatigue, demoralization, persistent irritability, restlessness, guilt, low self-esteem and sleep disturbances together with weight changes and even suicidal thoughts [1] [8].
CD shows significant clinical overlap with major depressive episodes and bipolar disorders type 1 and 2 and can progress to the latter [9]. The exact etiology of CD remains unknown.
Entire Body System
- Fatigue
When in the low mood the person experiences common symptoms of depression...sadness, emptiness, loss of interest and pleasure, irritability, anger, changes in appetite, sleep problems, restlessness, slow movement and thinking, fatigue, worthlessness and [depression-help-for-you.com]
[…] excessive involvement in pleasurable activities that have high potential for painful consequences During depressive periods Edit The following symptoms (at least 2 or more) are persistent: poor appetite or overeating insomnia or hypersomnia low energy or fatigue [depression.wikia.com]
CD patients have described their depressive periods with a feeling of fatigue, demoralization, persistent irritability, restlessness, guilt, low self-esteem and sleep disturbances together with weight changes and even suicidal thoughts. [symptoma.com]
[…] hypomania: Exaggerated feeling of happiness Extreme optimism Racing thoughts Excessive physical activity Easily distracted Inability to concentrate …and for depressive symptoms: Feeling sad or hopeless Guilt and feelings of worthlessness Restlessness Fatigue [lifelenscounseling.com]
TC Tamar Chetty Aug 15, 2018 "For a while I thought that perhaps I was just fatigued and stressed. Then my coworker told me to check for cyclothymia, so I got an evaluation from a therapist. [wikihow.com]
- Hypersomnia
[…] goal-directed activity excessive involvement in pleasurable activities that have high potential for painful consequences During depressive periods Edit The following symptoms (at least 2 or more) are persistent: poor appetite or overeating insomnia or hypersomnia [depression.wikia.com]
Depressive symptoms of cyclothymia may include: irritability aggressiveness insomnia or hypersomnia (sleeping too much) changes in appetite weight loss or gain fatigue or low energy low sexual desire and function feelings of hopelessness, worthlessness [healthline.com]
[…] toward future or brooding about past events social situations to be good, and to work out well more talkative than usual with inappropriate laughing, joking, and punning to be able to go without sleep has a decreased need for sleep alternating with hypersomnia [ptypes.com]
- Weakness
Google Search: cyclothymic behavior.therapy Google Search: comorbidity cyclothymic personality The Life Story Perspective Childhood Strong, aggressive mother; weak, passive father. [ptypes.com]
Admitting your vulnerability doesn’t make you weak. Choosing to become aware of who we are and then to make ourselves better, after all, is one of the best choices we get to make for ourselves—if only we will. [promises.com]
In the depressive state, people with cyclothymia also experience physical complaints including frequent headaches, tightness in the head and chest, an empty sensation in the head, weakness, weight loss, and hair loss.The distinguishing factor between [en.wikipedia.org]
Reaching out is not a sign of weakness and it won’t mean you’re a burden to others. In fact, most friends will be flattered that you trust them enough to confide in them, and it will only strengthen your relationship. [helpguide.org]
- Anorexia
Also of note are other complications such as substance abuse and associated mental disorders such as, Anorexia Nervosa, Bulimia Nervosa, Attention-Deficit/ Hyperactivity Disorder, Panic Disorder, Social Phobia, and Borderline Personality Disorder. [mentalhelp.net]
Gastrointestinal
- Overeating
Based on research in psychology and my personal experiences, here is my advice for how to stop over-thinking and find peace in the present moment: 1) Accept that You Have a Problem with Over-Thinking. [mindslikeours.org]
Abstract The authors identified 46 cyclothymic probands from a random pool of 500 psychiatric outpatients and prospectively followed them over a 2-3 year period. [ncbi.nlm.nih.gov]
[…] spending, fast reckless driving, wild business schemes, overeating, drinking too much, irritability, anger, and aggitation. [depression-help-for-you.com]
THE RESULTS In this way, the researchers discovered that patients treated with ten, 45 minute sessions at fortnightly intervals, not only recovered, but maintained that recovery for over two years. [counselling-directory.org.uk]
- Nausea
Signs and symptoms of the condition are related to the presence of stones and may include nausea, hematuria, flank pain, and/or frequent urinary tract infections. [rarediseases.info.nih.gov]
Psychiatrical
- Mood Swings
Because the mood swings are relatively mild and the periods of mood elevation may be enjoyable, cyclothymia frequently fails to come to medical attention. [web.archive.org]
Moreover, cases should keep track of their mood swings with a mood chart and record their sleeping hours. [symptoma.com]
These mood swings are less severe than with bipolar disorder or major depression. Ongoing symptoms, with no more than 2 symptom-free months in a row. The diagnosis is usually based on your mood history. [nlm.nih.gov]
Although both cyclothymia and bipolar disorder have mood swings between highs and lows, the bipolar mood swings are more extreme. [allaboutdepression.com]
These mood swings, either elation or depression, can last for several months and become a stable mood then the mood can change. Due to the mildness of the mood changes the person suffering from Cycloythmia will rarely bring it to medical attention. [dnet.org.au]
- Euphoria
Characteristic mood changes include periods of euphoria which are abruptly followed by depressive episodes. CD is part of the spectrum of bipolar disorders and can progress to bipolar disorder type 1 or 2. [symptoma.com]
Also known as: Description Cyclothymia is a mood disorder in which the client displays the characteristic ups and downs (depressions and euphorias) of Bipolar Disorder, to a much lower extent, and does not qualify for a diagnosis of Bipolar Disorder. [web.archive.org]
[…] disorder characterized by the following symptoms: extremely high energy or surges of energy pleasure seeking and risk taking behaviors impulsiveness reduced need for sleep rapid thought and speech irritability talkativeness inappropriate elation or euphoria [study.com]
- Fidgeting
You Feel Like You're Moving Through Molasses In the same way that manic episodes are characterized by fidgeting and restlessness, depression may cause "psychomotor retardation," aka physically moving slower. 8. [bustle.com]
Neurologic
- Irritability
Measures of irritability and IA were correlated, but represented distinct constructs. [ncbi.nlm.nih.gov]
Hypomanic episodes may manifest with general euphoria, exaggerated self-esteem, logorrhea, impaired risk assessment, distractability, lack of concentration, racing thoughts, no need for sleep and marked irritability. [symptoma.com]
When in the low mood the person experiences common symptoms of depression...sadness, emptiness, loss of interest and pleasure, irritability, anger, changes in appetite, sleep problems, restlessness, slow movement and thinking, fatigue, worthlessness and [depression-help-for-you.com]
Most individuals who seek help for the disorder alternate between feelings of mild depression and intense irritability. [minddisorders.com]
- Hyperactivity
A person with Cyclothymic Disorder has a history of at least two years of mood swings from mild depression to slight mania or hyperactivity. [alleydog.com]
Manic symptoms include: racing thoughts, a lack of good judgment, irritability, and hyperactivity. Depressive symptoms include: feelings of sadness or hopelessness, weight fluctuation, and suicidal thoughts or ideation. [thriveworks.com]
Hypomanic CD symptoms in children are hard to distinguish from characteristic attention deficit hyperactivity disorder (ADHD) signs making CD a non-trivial diagnosis. Manic episodes never occur in CD. [symptoma.com]
- Insomnia
[…] increase in goal-directed activity excessive involvement in pleasurable activities that have high potential for painful consequences During depressive periods Edit The following symptoms (at least 2 or more) are persistent: poor appetite or overeating insomnia [depression.wikia.com]
Common Symptoms of Cyclothymic Disorder: Pessimism Difficulty concentrating Poor memory Irritability Insomnia Lack of motivation These depressive symptoms contrast with such euphoric symptoms as: Extreme optimism Exaggerated self-esteem Poor judgement [allaboutcounseling.com]
For example, the hypomanic or “high” phase of cyclothymic disorder can be characterized by: Extreme cheerfulness and optimism Exaggerated self-esteem Risk-taking behavior and bad decisions Irritability, hostility or aggression Insomnia High energy and [luxury.rehabs.com]
- Agitation
Thanks Agitated Depression Test Before Staring This Test: To get accurate results for the agitated depression test, we recommend taking this general bipolar test … Read More Suicidal Test Are You Suicidal This test will try to measure your depression [illnessquiz.com]
[…] motivation; accomplishing tasks is an effort Sleeping too much or too little; difficulty falling asleep or staying asleep Problems with concentrating, thinking, or making decisions Changes in appetite; marked weight loss or gain Feeling slowed down or agitated [allaboutdepression.com]
Then after only a short while her agitation or depression would return and rather than acknowledge its perennial nature, she’d assume the problem was with her lover—everything was going badly because of him, not her mercurial moods. [promises.com]
You Get Inexplicably Irritable Both depression and hypomania are known to cause irritability and agitation. 5. [bustle.com]
You're constantly annoyed, agitated, irritated and restless. And that's just if you're in a hypomanic period. Once you've finished the hypomanic period, you go right into a depressive period. [yourtango.com]
- Excitement
Does your mood sometimes swing from mildly depressed to boisterously excited? If so, you may be suffering from Cyclothymia, a type of mood disorder often described as a milder form of Bipolar Disorder. [lifelenscounseling.com]
Call a mental health professional if you or a loved one has alternating periods of depression and excitement that do not go away and that affect work, school, or social life. Seek help right away if you or a loved one is having thoughts of suicide. [nlm.nih.gov]
Calling your health care provider Call a mental health professional if you or a loved one has persistent alternating periods of depression and excitement that negatively affect work, school, or social life. [coordinatedhealth.com]
If a person is more dark and unhappy than happy and excited most of the time, it may be a sign. If these symptoms appear frequently over a two month time period, it may also be a sign of cyclothymic disorder. [gomentor.com]
When to Contact a Medical Professional Call a mental health professional if you or a loved one has alternating periods of depression and excitement that do not go away and that affect work, school, or social life. [baptistjax.com]
Workup
Diagnosing cyclothymic disorder requires a physical examination to check for potential causes of mood swings, a psychological evaluation to analyze the patient's mood swings with questionnaires and professional interviews. The patient's family and close friends may be included in this psychological analysis to obtain a complete picture of the mood swings and their frequency. Moreover, cases should keep track of their mood swings with a mood chart and record their sleeping hours.
Clinical criteria for CD are persistent episodes of hypomania and depression for at least one year in adolescents and two years in adults with intermittently stable mood periods shorter than two months. Characteristic findings cannot be traced back to other causes like substance abuse, and significantly affect the patient's social interactions [1].
Hypomanic CD symptoms in children are hard to distinguish from characteristic attention deficit hyperactivity disorder (ADHD) signs making CD a non-trivial diagnosis. Manic episodes never occur in CD [3] [10].
Progression of CD to bipolar disorder type 1 and 2 can be prevented with professional treatment. A late onset of CD hints towards substance abuse.
Treatment
This review will include historical concepts, clinical phenomenology, family history, biological studies, and treatment of cyclothymia. [ncbi.nlm.nih.gov]
Early recognition means avoiding unnecessary complications and establishing specific treatments and clinical management since the beginning. [doi.org]
Read about help in the community and treatments available. [selfcounseling.com]
Treatment Options Medications and psychotherapy are the common treatment options prescribed to patients living with cyclothymia. [psycom.net]
Prognosis
Find information on the symptoms causes, diagnosis and prognosis of this disorder. Read about help in the community and treatments available. [selfcounseling.com]
Prognosis Prognosis is good when the proper combination of medication and therapy are received. [allpsych.com]
The early detection and treatment of cyclothymia can guarantee a significant change in the long-term prognosis, when appropriate mood-stabilizing pharmacotherapy and specific psychological approaches and psychoeducation are adopted. [ncbi.nlm.nih.gov]
Prognosis Prognosis is good but low patient compliance and recurrence of stone formation and subsequent interventions can very rarely induce renal insufficiency. The documents contained in this web site are presented for information purposes only. [orpha.net]
Etiology
[…] or if there is no etiological relationship between the mood symptoms and the general medical condition. [mental-health-today.com]
The exact etiology of CD remains unknown. [symptoma.com]
Etiology Research on this disorder is not nearly as well documented as its counterparts. It is assumed that both biological and environmental factors play a role. [allpsych.com]
Learn about the etiology, symptoms, treatment and prognosis. Behave Net - Cyclothymic disorder - Learn about the diagnostic criteria of Cyclothymic disorder. [selfcounseling.com]
Epidemiology
Results: Current epidemiological and clinical research showed the high prevalence and the validity of cyclothymia as a distinct form of bipolarity, frequently associated with multiple comorbidities with anxiety, impulse control, substance use, and so [doi.org]
Current epidemiological and clinical research showed the high prevalence and the validity of cyclothymia as a distinct form of bipolarity, frequently associated with multiple comorbidities with anxiety, impulse control, substance use, and so called "personality [ncbi.nlm.nih.gov]
According to him, as the complexity and subtyping of mood disorders continue to grow, there is increased challenge to support the concepts epidemiologically and clinically, with a particular need to improve matching of phenotypes with genetic and other [news-medical.net]
Pathophysiology
Paediatrics, Neonatology (347) Internal Medicine (337) Physiology and Pathophysiology (334) Pathology and Forensic Medicine (268) Medical Chemistry and Biochemistry (252) Neurology (246) Genetics (163) Psychiatry, Psychology, Sexology (160) Surgery, Traumatology [portal.mefanet.cz]
Eur Neuropsychopharmacol 15:75–84 PubMed CrossRef Google Scholar Soares J (2003) Contributions from brain imaging to the elucidation of pathophysiology of bipolar disorder. [link.springer.com]
Prevention
Close attention after childbirth is warranted to alleviate and prevent these episodes in such women. [ncbi.nlm.nih.gov]
There's no sure way to prevent cyclothymia. [mayoclinic.org]
Although preventive treatment hasn’t been identified yet, there is some hope among researchers that early treatment for cyclothymia may prevent full-blown bipolar disorder from developing. [everydayhealth.com]
Progression of CD to bipolar disorder type 1 and 2 can be prevented with professional treatment. A late onset of CD hints towards substance abuse. [symptoma.com]
References
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th edition. Washington DC: American Psychiatric Association; 2001.
- Akiskal H, Khani M, Scott-Strauss A. Cyclothymic temperamental disorders. Psychiatr Clin North Am. 1979;2:527–554.
- Van Meter AR, Youngstrom EA. Cyclothymic disorder in youth: why is it overlooked, what do we know and where is the field headed?. Neuropsychiatry (London). 2012; 2(6): 509–519.
- Geller B, Zimmerman B, Williams M, DelBello M, Frazier J, Beringer L. Phenomenology of prepubertal and early adolescent bipolar disorder: examples of elated mood, grandiose behaviors, decreased need for sleep, racing thoughts and hypersexuality. J Child Adolesc Psychopharmacol. 2002;12(1):3–9.
- Harvey A, Mullin B, Hinshaw S. Sleep and circadian rhythms in children and adolescents with bipolar disorder. Dev Psychopathol. 2006;18(4):1147–1168.
- Birmaher B, Axelson D, Goldstein B, et al. Four-year longitudinal course of children and adolescents with bipolar spectrum disorders: the course and outcome of bipolar youth (COBY) study. Am J Psychiatry. 2009;166(7):795–804.
- Kessler R, Avenevoli S, Merikangas K. Mood disorders in children and adolescents: an epidemiologic perspective. Biol Psychiatry. 2001;49(12):1002–1014.
- Tomba E, Rafanelli C, Grandi S, Guidi J, Fava GA. Clinical configuration of cyclothymic disturbances. J Affect Dis. 2012; 139(3):244-249.
- Vieta E, Reinares M, Rosa AR. Staging bipolar disorder. Neurotox Res. 2011;19(2):279–285.
- Van Meter AR, Youngstrom EA, Findling RL. Cyclothymic disorder: A critical review. Clin Psych Rev. 2012; 32(4):229-243.