What is Cyclothymia? Symptoms. Diagnosis, and Treatment plan in 2021

Cyclothymia, or cyclothymic disorder, is a mild mood disorder with symptoms similar to bipolar II disorder. Both cyclothymia and bipolar disorder cause emotional ups and downs, from manic highs to depressive lows. 

Cyclothymia is characterized by fluctuating low-level depressive symptoms along with periods of mild mania (hypomania). Symptoms must be present for at least two years before a diagnosis of cyclothymia may be made (one year in children). These changes in mood tend to occur in cycles, reaching highs and lows. In between these highs and lows, you may feel like your mood is stable. 

The main difference between the two disorders is intensity. The mood swings associated with cyclothymia are not as extreme as those that come with bipolar disorder: Those with bipolar disorder experience intense symptoms that meet clinical criteria for the diagnoses of mania and major depression, while those with cyclothymia experience milder “ups and downs,” described as hypomania and mild depression. If left untreated, cyclothymia can increase your risk of developing bipolar disorder. 

The condition usually develops in adolescence. People with the disease often appear to function normally, although they may seem “moody” or “difficult” to others. People will often not seek treatment because the mood swings do not seem severe. People with cyclothymia may occasionally even be hyper-productive. 

According to the most recent Diagnostic and Statistical Manual of Mental Disorders (DSM-V), cyclothymia is distinguished from bipolar disorder because it lacks the full criteria of major depression, mania, or a mixed episode disorder. However, some people with cyclothymia will develop bipolar I or bipolar II disorder later in life. 

Symptoms of Cyclothymia? 

People with cyclothymia usually experience many weeks of low-level depression followed by an episode of mild mania that lasts several days. 

Depressive symptoms of cyclothymia may include: 

1. Irritated behavior
2. Aggressive behavior 
3. Insomnia(lack of sleep) or Hypersomnia (sleeping too much) 
4. Lessor increased appetite
5. Weight gain or loss 
6. Fatigue or low energy level 
7. Less sexual desire and function
8. Feelings of hopelessness, worthlessness, or guilt
9. Lack of attentiveness in academics or job, lack of concentration, or forgetfulness
10. Physical distress with no reason 

If they tend to show maniac attacks, they may show the following symptoms:

1. Very high self-esteem 
2. Excessive talking or speaking very quickly, sometimes so fast others can't understand what the person is saying 
3. Muddled and disorganized thoughts
4. lack of focusing power
5.  The feeling of restlessness and hyperactivity
6. Increased anxiety level
7. Insomnia or Hypersomnia (without feeling tired)
8. Arguing all the time
9. Hypersexuality
10. The feeling of recklessness or impulsive behavior 

Some patients tend to show mixed behavior and symptoms with depressive symptoms as well as maniac symptoms. 

Diagnosis of Cyclothymia: 

The exact cause of Cyclothymia is still unknown but the research says that it is hereditary and tends to exist in families and succeeding generations. If the person doesn't experience mood swings for around two months then it is pretty sure for them to have mood swings and elevations only and nothing else. 

To ensure whether it is Cyclothymia or just mood elevations, your psychologist may compare the following symptoms with yours: 

1. Hypomania i.e. an extended period of elevated mood and depression from at least two years in adults and one year in children and teenagers.
2. Occurrence for at least half of the time
3. Stability of mood swings that last for less than two months
4. Symptoms that affect your daily life — at school, job, etc.
5. Showing symptoms that don’t meet the criteria set for bipolar disorder, major depression(MDD), or another mental disorder
6. Showing symptoms that are not caused by substance abuse or another physical health condition. 

Your doctor may compare your symptoms with the above-stated symptoms and ensure whether it is major depression, Cyclothymia, or just mood swings. They can also perform some lab tests like TSH (thyroid test), CBC, or some other test to ensure if there is any physical condition that is triggering Cyclothymia or mental illness in the patient. 

The treatment plan for Cyclothymia: 

Cyclothymia is considered a chronic mental health condition and requires lifelong treatment. Stopping treatment will seem tempting for the patient, but if he stops taking the treatment, the symptom may get worse and can lead to major depression or bipolar disorder. Alcohol and drug usage may also make symptoms worse. 

The treatment plan for Cyclothymia includes: 

Medication

Patients with Cyclothymia are most often prescribed antidepressant medicines and mood stabilizers. The antidepressant medicines often trigger he stress and anxiety by reducing depression level in the mind and increase the level of feel-good hormones in the brain. 

Talk therapy or psychotherapy

Cyclothymia is often treated with talk therapy which includes cognitive behavior therapy (CBT) and well-being therapy. 

Cognitive Behavioral Therapy (CBT)

 Focuses on identifying negative thoughts and behavior and replacing it with positive and healthy thoughts. 

Well-being Therapy

Focuses on improving the overall quality of life rather than focussing on single and particular mental problems. When both of these therapies are used in combination then it will help to maintain significant changes in the patient for the long term.