Cyclothymic disorder, sometimes also called cyclothymia, is a milder form of bipolar disorder and depression. This condition often goes undiagnosed and untreated, because many people who have symptoms do not associate the swings with a problematic condition, and they are more likely to self-medicate with drugs or alcohol when cyclothymic symptoms become hard to manage.
Between 0.4 percent and 1 percent, of the US population is likely to have cyclothymia, with equal numbers of men and women struggling with the condition. Cyclothymia can be disruptive to work and personal relationships, so it is important to understand this condition and get appropriate treatment.
Signs or Symptoms Indicating Cyclothymic Disorder
People who have cyclothymic disorder experience periods of depressed, low mood, followed by elevated mood, high energy, or euphoria. However, the low periods are not intense enough to receive a diagnosis of clinical depression for the most part, although they can interfere with daily functioning. High moods are also not full-blown mania and last less than a week. Symptoms can include the following:
- Restlessness, increased need for activity, and increased physical energy
- Euphoric or overly positive mood
- Extreme irritability or aggressive behavior
- Racing speech and thoughts
- Jumping from one idea to another in conversation
- Difficulty concentrating
- Getting less sleep due to feeling less tired
- Grandiose delusions in one’s abilities
- Poor judgment or impulsivity
- Spending sprees
- Different, active behaviors that diverge from normal energy levels or interests
- Increased sex drive
- Intrusive or provocative thoughts
- Abuse of drugs due to impulse problems or to sustain the experience (e.g., cocaine, sleep aids, and alcohol)
Low mood or depressed state
- Persistent sadness
- Changes in appetite: either reduced appetite or overeating
- Low self-esteem
- Feeling worthless, hopeless, or guilty with no cause
- Trouble concentrating
- Difficulty with memory
- Difficulty making decisions
- Withdrawal from social activities or family obligations
- Not pursuing previously enjoyed activities or hobbies
- Suicidal ideation
Mood swings and persistent depression are also characteristics of cyclothymic disorder, much like bipolar I disorder and bipolar II disorder, although again, not as severe.
Causes of Cyclothymic Disorder
- Genetics: No single gene causes bipolar disorder or cyclothymic disorder, but several genes acting together can be triggered by environmental factors and lead to cyclothymic disorder or bipolar disorder. In fact, people with a genetic predisposition toward these conditions are more likely to receive a diagnosis of bipolar disorder after they have been diagnosed with cyclothymic disorder due to worsening symptoms.
- Environment: People who have family members, especially parents or siblings, with major depression, bipolar disorder, substance abuse problems, or domestic violence problems are more likely to develop cyclothymic disorder. Other traumatic experiences, such as experiencing terrorism or violence, can trigger cyclothymic disorder as well.
- Biochemistry: Changes to the brain’s chemistry can lead to cyclothymic disorder. These changes can be hormonal, due to substance abuse, or due to illness or injury.
Steps to Diagnosis of Cyclothymic Disorder
In order to diagnose cyclothymic disorder, symptoms of hypomania and depression must be regular and persistent. Here are some signs that medical professionals and therapists look for to diagnose cyclothymic disorder:
- Cycles of elevated and depressed mood must be present for two years in adults, and one year in children and adolescents.
- Hypomania and depression must occur at least half the time each year, with no more than two symptom-free months between episodes. Unlike bipolar disorder, however, symptoms of cyclothymic disorder can lead to periods of normal feeling or behavior that last longer.
- Symptoms impact work, school, social life, and family obligations; however, they are not as disruptive as symptoms of bipolar disorder, major depression, or another mental health condition.
- Symptoms are not caused by substance abuse or an underlying medical condition. That being said, people with cyclothymic disorder may increase the severity of their symptoms, or the frequency of hypomanic and depressive cycles, by self-medicating with drugs or alcohol.
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Help for Co-Occurring Cyclothymic Disorder and Substance Abuse
People who struggle with mental health issues, such as cyclothymic disorder, depression, and bipolar disorder, are at a greater risk of also abusing substances in order to moderate manic and depressive states. Unfortunately, this self-medicating tends to lead to worsening symptoms, along with physical side effects.
It is important to get appropriate help to overcome substance abuse and mental health problems together, and this means finding a rehabilitation program that can assist people struggling with co-occurring conditions. One condition will not get better without the other also being treated. Medically supervised detox, psychiatric prescription medication and medical monitoring, and individual and group therapy can all help people struggling with cyclothymic disorder and substance abuse together to get better.