Cyclothymic disorder (or cyclothymia) is a mild mood disorder defined by swings of hypomania and mild depression. Since it’s so similar to bipolar disorder, the two conditions are sometimes confused. However, cyclothymic disorder is not nearly as severe as bipolar disorder. ¹

As a type of bipolar disorder, cyclothymia is defined by low and high mood swings which are often categorized by depressive or manic episodes. While this condition isn’t as well-known as bipolar, it remains common with 0.4% to 1% struggling with the condition. ²

Cyclothymic Disorder Symptoms

People who struggle with cyclothymic disorder will experience two sets of symptoms: emotional highs and emotional lows. While these symptoms completely contrast, they’re integrated by the condition. Not to mention, while these symptoms are similar to bipolar I and bipolar II disorder, they aren’t nearly as severe.

Hypomanic Symptoms

• Agitation
• Difficulty concentrating
• Easily distracted
• Extreme optimism
• Euphoria (exaggerated feeling of happiness)
• Heightened self-esteem
• Increased physical activity
• Inflated drive to complete goals (possibly related to work, school, social, sex)
• Irritability
• Lack of sleep (may lead to insomnia)
• Poor judgment (can lead to risky behavior or bad decisions)

Depressive Symptoms

• Difficulty concentrating
• Fatigue
• Feelings of sadness, hopelessness, and emptiness
• Irritability
• Loss of interest in activities you once enjoyed
• Problems with sleep (lack of or too much sleep)
• Restlessness
• Tearfulness
• Suicidal ideation (thoughts of death)
• Weight fluctuations (loss of or gain of weight)
• Worthlessness and/or guilt

What Causes Cyclothymic Disorder?

Scientists aren’t 100% certain what causes cyclothymia. However, there are a few indicators:

• Genetics – Does cyclothymia run in your family? If so, research has found you’re at an increased risk of developing it. ³

• Changes in the Brain – Brain scans may be able to pick up differences in the brain (such as neurobiology) directly caused by cyclothymia. ⁴

• Environmental – While it’s not completely understood, scientists are aware that certain aspects of your environment can trigger mental health conditions. For example, traumatic experiences or long periods of stress may lead to cyclothymia. ⁵

If you haven’t experienced any of the causes mentioned above, but still have cyclothymia symptoms, we highly suggest you consult your healthcare provider. Again, scientists still haven’t figured out all the direct causes of this condition.

Risk Factors of Cyclothymic Disorder

Cyclothymia is fairly rare compared to other mental health conditions, including bipolar disorder. With that, it’s difficult to understand all the risk factors associated with the illness. However, as with symptoms, there are some similarities found in other mood disorders.

Most notably, cyclothymia commonly begins in teenager or young adult years. ⁶ Those with the condition are also at risk of:

• Anxiety disorders
• Bipolar I or II disorder
• Emotional difficulties that affect various aspects of your life
• Substance use disorder
• Suicidal ideation

Risk of Suicide

If you or someone you love struggles with cyclothymic disorder and has shown signs of suicidal ideation, it’s important to seek out help immediately. In cases of emergency (i.e. posing a risk to yourself or others), it’s vital to call 911 or go to your local emergency room. In all other cases, you can reach out to the 988 Suicide & Crisis Lifeline.

Cyclothymic Disorder Diagnosis

When you go to see a mental health professional, they will likely consider the following conditions for a diagnosis:

• Bipolar I disorder
• Bipolar II disorder
• Cyclothymic disorder
• Depression

While there is no official test that can pinpoint whether or not you struggle with these conditions, a doctor will go through the following to rule out other conditions:

• Psychological Evaluation – You’ll be interviewed by a mental health professional to get a sense of your thoughts, feelings, and behaviors. During this segment, you’ll want to discuss all the symptoms you have experienced. You may be asked to fill out a self-assessment for professionals to further get an idea of your situation. Not to mention, family members and friends may also be asked to discuss your condition.

• Physical Exam – To rule out other medical issues that provide similar symptoms, a doctor may perform a physical exam along with lab tests.

• Mood Charting – While this isn’t required for everyone, some doctors may ask you to keep a daily record of your moods to further help with your diagnosis.

What are the Criteria for Diagnosis?

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there are several points an individual must meet to be diagnosed with cyclothymia. These include: ⁷

• An individual experiences periods of elevated mood (hypomanic symptoms) along with periods of depressive symptoms for at least two years (one year in children and teenagers). During those years, these high and low mood fluctuations must last for at least half the time.

• If an individual experiences periods of stable moods, these periods must last less than two months.

• Symptoms of the condition must have a significant effect on important areas of an individual’s life (i.e. work, school, social).

• The symptoms an individual experiences don’t meet the criteria for bipolar disorder, major depression, or any other mental health condition.

• The symptoms an individual experiences don’t meet the criteria for a substance use disorder or any other medical condition.

Cyclothymic Disorder Treatment

Like many mental health conditions, cyclothymic disorder requires lifelong treatment as symptoms can relapse. Not to mention, cyclothymia can lead to bipolar I or II disorder and it’s vital to prevent this from happening. There are two main forms of cyclothymia treatment:

1.) Medication

Currently, the Food and Drug Administration (FDA) doesn’t approve any medication for cyclothymia. However, your doctor may prescribe similar medications used in bipolar disorder to reduce symptoms. These include mood stabilizers, such as lithium (Lithobid), valproic acid (Depakene), and divalproex sodium (Depakote). ⁸

2.) Psychotherapies

People with cyclothymia tend to do much better under psychological counseling. These talk therapies can happen in an individual, family, or group setting. Currently, two different types of psychotherapies have been found to help with cyclothymic disorder:

• Cognitive Behavioral Therapy (CBT) – Focuses on identifying negative thought and behavior patterns and replacing them with positive ones. Many use CBT as a way to identify symptoms and triggers. From there, the goal is to develop effective strategies for managing and coping with these symptoms. ⁹

• Interpersonal and Social Rhythm Therapy (IPSRT) – Focuses on maintaining healthy daily rhythms. These include your wake/sleep cycle, when you eat, and other regular activities you perform. It’s been found that those with a mood disorder tend to do better when they’re on a consistent daily routine for various aspects of their life. ¹⁰

What Can You Do About Cyclothymia?

Since cyclothymic disorder is a lifelong condition, it’s in your best interest to follow certain self-care steps to ensure the prevention of symptoms. These may include:

• Understand Your Warning Signs – If you’ve lived with cyclothymia for a while, you likely understand the pattern of your symptoms and what triggers them. Be sure to address these warning signs early to prevent them from worsening.

• Take Medication As Told – If you were given medication for cyclothymia, it’s important to take it exactly as your doctor recommends. Even if you don’t feel symptoms, your medication may prevent symptoms from returning.

• Avoid Drugs and Alcohol – It’s important to stay away from drugs and alcohol as these tend to exasperate mood disorders. If you currently struggle with addiction, you’ll want to consult your doctor about treatment for that.

• Journal Your Moods – Keep a record of your moods, daily routines, and significant events. This will allow you and your doctor to understand your thought patterns and develop an effective treatment plan.

• Stay Physically Active – Even moderate exercise can help steady your mood. It’s important to keep active as this releases endorphins (feel-good chemicals) in your brain. Endorphins can help with other aspects of your daily life. ¹¹

• Sleep Regularly – You need the right amount of sleep since your wake/sleep cycle plays a major role in your mood. If you have difficulty with sleep, you should consult your doctor.

Final Word

While cyclothymia is a lifelong condition, you can manage and prevent symptoms from flaring up. With the right kind of treatment plan and effective coping mechanisms, you can overcome this condition and move on to living a fulfilling life.

References

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² Bielecki JE, Gupta V. Cyclothymic Disorder. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557877/

³ Barnett JH, Smoller JW. The genetics of bipolar disorder. Neuroscience. 2009 Nov 24;164(1):331-43. doi: 10.1016/j.neuroscience.2009.03.080. Epub 2009 Apr 7. PMID: 19358880; PMCID: PMC3637882.

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⁷ Perugi G, Hantouche E, Vannucchi G. Diagnosis and Treatment of Cyclothymia: The “Primacy” of Temperament. Curr Neuropharmacol. 2017 Apr;15(3):372-379. doi: 10.2174/1570159X14666160616120157. PMID: 28503108; PMCID: PMC5405616.

⁸ Kishi T, Ikuta T, Matsuda Y, Sakuma K, Okuya M, Mishima K, Iwata N. Mood stabilizers and/or antipsychotics for bipolar disorder in the maintenance phase: a systematic review and network meta-analysis of randomized controlled trials. Mol Psychiatry. 2021 Aug;26(8):4146-4157. doi: 10.1038/s41380-020-00946-6. Epub 2020 Nov 11. PMID: 33177610; PMCID: PMC8550938.

⁹ Totterdell P, Kellett S, Mansell W. Cognitive behavioural therapy for cyclothymia: cognitive regulatory control as a mediator of mood change. Behav Cogn Psychother. 2012 Jul;40(4):412-24. doi: 10.1017/S1352465812000070. Epub 2012 Feb 22. PMID: 22353188.

¹⁰ Frank E, Swartz HA, Boland E. Interpersonal and social rhythm therapy: an intervention addressing rhythm dysregulation in bipolar disorder. Dialogues Clin Neurosci. 2007;9(3):325-32. doi: 10.31887/DCNS.2007.9.3/efrank. PMID: 17969869; PMCID: PMC3202498.

¹¹ Basso JC, Suzuki WA. The Effects of Acute Exercise on Mood, Cognition, Neurophysiology, and Neurochemical Pathways: A Review. Brain Plast. 2017 Mar 28;2(2):127-152. doi: 10.3233/BPL-160040. PMID: 29765853; PMCID: PMC5928534.