Cyclone of water glistening in the sunlightCyclothymia, also known as cyclothymic disorder, is one of three main types of bipolar. It is often thought the be the mildest form of the condition.Therapy and other treatment methods can help with mood shifts and other symptoms of cyclothymia.

What Is Cyclothymia?

Cyclothymia is one of three types of bipolar. Rather than experiencing alternating episodes of major depression and mania as is common in other types of bipolar, people experiencing cyclothymia may alternate between feelings of mild or moderate depression and feelings of happiness or mild euphoria. 

According to the Diagnostic and Statistical Manual (DSM), adults must meet the criteria for cyclothymia for at least 2 years in order to be diagnosed with the condition, with relief from symptoms occurring for no more than 2 months. For children to be diagnosed, symptoms must have been present for at least a year.

Other criteria include cycling between feelings of depression and hypomania, without ever meeting the diagnostic criteria for major depression, mania, or hypomania. Symptoms must not be related to or caused by major life events, such as the death of a loved one or the birth of a child. For a diagnosis of cyclothymia, the symptoms must be severe enough to interfere with daily life, but not severe enough to warrant a diagnosis of bipolar.

Cyclothymia Signs and Symptoms

When determining whether an individual has cyclothymia, a mental health professional may use a cyclothymia test or assessment to find out if that person’s symptoms could indicate a diagnosis. 

Common symptoms and behaviors characteristic of cyclothymia include:

  • Periods of isolation, loneliness, and feelings of worthlessness that are not severe enough to completely limit functioning
  • Sudden onset of a happier, elevated mood that may be euphoric and enjoyable
  • Risk-taking and increased activity during periods of euphoria
  • Chronic mood instability
  • Minor episodes of depression and/or low self-esteem
  • Difficulty concentrating

People with cyclothymia may also experience substance abuse issues or problems sleeping, and children who are diagnosed with cyclothymia are more likely to experience ADHD than their peers.

Cyclothymia and Bipolar

Often appearing when an individual enters their teens, cyclothymia is characterized by mood disturbances that generally follow a pattern of fluctuation between symptoms of depression and hypomania, a mild form of mania. These mood shifts also characterize bipolar, but with bipolar, mood swings tend to occur in greater number and with more severity. Cyclothymia appears to occur in about .4% to 1% of the population; bipolar occurs at a slightly higher rate (in about 2.6% of United States residents).

In general, those with cyclothymia may not be as likely to seek treatment as those with bipolar, possibly because the mood swings may not be severe and can potentially be attributed to normal mood shifts or other causes. Although cyclothymia appears to affect men and women equally, women seem to be more likely to seek treatment for symptoms of cyclothymia than men.

Both cyclothymia and bipolar occur with greater frequency when there is a family history of bipolar.

Cyclothymia and Related Conditions

Cyclothymia may co-occur with a variety of other mental health issues. Below are some common mental health issues that may either co-occur with or be mistaken for cyclothymia. 

  • Cyclothymia with anxious distress: As with other types of bipolar, cyclothymia may come with the specifier “anxious distress.” Individuals who experience cyclothymia with anxious distress may feel restless, tense, frequently worried, or have an impending sense of doom. People who have cyclothymia with anxious distress may be at a higher risk for suicidal ideation than those without it, so accurate diagnosis and prompt treatment are often key.
  • Cyclothymia and ADHD: People with cyclothymic disorder may also experience ADHD. One study indicated that individuals with ADHD may be more likely to also experience cyclothymia. Another study revealed youth diagnosed with cyclothymia are likely to have another co-occuring mental health condition, the most common of which was ADHD.
  • Cyclothymia and dysthymia: Dysthymia, or persistent depressive disorder, is characterized by a state of mild to moderate chronic depression. People with cyclothymia may show symptoms of dysthymia, but in addition, they can experience hypomanic moods in which they may have more energy and a euphoric mood.
  • Cyclothymia and borderline personality (BPD): Some research shows that cyclothymia is more common in individuals with borderline personality than in those with other personality disorders. According the the DSM-5, these conditions can co-occur when the diagnostic criteria for both are met.

Cyclothymia and Relationships

As cyclothymia often makes emotional regulation more difficult for those who experience it, the condition may also present challenges in interpersonal relationships. Hypomanic periods may increase a person’s likelihood to overreact to things that happen around them, which may increase tension within a relationship. Couples counseling may help partners of people with cyclothymia to understand and work through their unique challenges. 

A study published in Current Neuropharmacology posits that those with cyclothymia may also find it more difficult to face rejection or criticism from others. This trait may increase an individual’s risk of becoming involved in an abusive relationship, as it can cause them to submit to an abusive partner’s wishes in order to avoid retribution. 

Learn more about therapy and treatment for cyclothymia.

References:

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  2. Bipolar Disorder. (n.d.). Retrieved from http://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml
  3. Calistrogo, D. (2018, August 27). Cyclothymia: Cyclothymic personality symptoms, causes, and treatment. Retrieved from https://www.psycom.net/depression.central.cyclothymia.html 
  4. Cyclothymia (cyclothymic disorder). (2018, May 10). Retrieved from https://www.mayoclinic.org/diseases-conditions/cyclothymia/diagnosis-treatment/drc-20371281 
  5. Key differences between dysthymia and cyclothymia. (2017, December 29). Retrieved from https://www.recoveryranch.com/depression/key-differences-dysthymia-cyclothymia 
  6. Landaas, E. T., Halmøy, A., Oedegaard, K. J., Fasmer, O. B., and Haavik, J. (2012, March 8). The impact of cyclothymic temperament in adult ADHD. Journal of Affective Disorders, 142(1-3), 214-247. Retrieved from https://www.sciencedirect.com/science/article/pii/S0165032712003096 
  7. Levitt, A. J., Joffe, R. T., Ennis, J., MacDonald, C., & Kutcher, S. P. (1990). The prevalence of cyclothymia in borderline personality disorder. The Journal of Clinical Psychiatry, 51(8), 335-339. Retrieved from http://psycnet.apa.org/record/1991-04651-001 
  8. Perugi, G., Hantouche, E., & Vannucci, G. (2017). Diagnosis and treatment of cyclothymia: The “primacy” of temperament. Current Neuropharmacology, 15(3), 372-379. doi: 10.2174/1570159X14666160616120157
  9. Purse, M. (2018, December 9). Bipolar disorder with anxious distress. Retrieved from https://www.verywellmind.com/bipolar-disorder-with-anxious-distress-380590 
  10. Van Meter, A. R., & Youngstrom, E. A. (2012, December 1). Cyclothymic disorder in youth: Why is it overlooked, what do we know and where is the field headed? Neuropsychiatry (London), 2(6), 509-519. doi: 10.2217/npy.12.64