Cyclothymia (cyclothymic disorder)

DEFINITION

Cyclothymia (si-klo-THIGH-me-uh), also called cyclothymic disorder, is a mood disorder. Cyclothymia causes emotional ups and downs, but they’re not as extreme as in bipolar disorder type I or II.

With cyclothymia, you experience periods when your mood noticeably shifts up and down from your baseline. You may feel on top of the world for a time, followed by a low period when you feel somewhat blue. Between these cyclothymic highs and lows, you may feel stable and fine.

Compared with bipolar disorder I or II, the highs and lows of cyclothymia are less extreme. Still, it’s critical to seek help managing these symptoms because they increase your risk of bipolar disorder I or II. Treatment options for cyclothymia include talk therapy (psychotherapy), medications and close, ongoing follow-up with your doctor.

CAUSES

It’s not known specifically what causes cyclothymia. As with many mental health disorders, research shows that it may result from a combination of:

  • Heredity — cyclothymia tends to run in families
  • Your body’s biochemical processes, such as changes in brain chemistry
  • Environment

SYMPTOMS

Cyclothymia symptoms alternate between emotional highs and lows. The highs of cyclothymia are characterized by symptoms of an elevated mood (hypomanic symptoms), which resemble those of mania but are less severe. The lows consist of mild or moderate depressive symptoms.

 

Cyclothymia symptoms are similar to those of bipolar disorder I or II, but they’re less severe. When you have cyclothymia, you can typically function in your daily life, though not always well. The unpredictable nature of your mood shifts may significantly disrupt your life because you never know how you’re going to feel.

Hypomanic phase of cyclothymia

The highs (hypomania) of cyclothymia meet the same diagnostic definition of hypomania for type II bipolar disorder. Signs and symptoms may include:

  • An exaggerated feeling of happiness or well-being (euphoria)
  • Extreme optimism
  • Inflated self-esteem
  • Poor judgment
  • Rapid speech
  • Racing thoughts
  • Aggressive or hostile behavior
  • Being inconsiderate of others
  • Agitation
  • Excessive physical activity
  • Risky behavior
  • Spending sprees
  • Increased drive to perform or achieve goals
  • Increased sexual drive
  • Decreased need for sleep
  • Tendency to be easily distracted
  • Inability to concentrate

Depressive phase of cyclothymia

Depressive episodes of cyclothymia may include a combination of these signs and symptoms:

  • Sadness
  • Hopelessness
  • Suicidal thoughts or behavior
  • Anxiety
  • Guilt
  • Sleep problems
  • Appetite problems
  • Fatigue
  • Loss of interest in activities once considered enjoyable
  • Decreased sex drive
  • Problems concentrating
  • Irritability
  • Chronic pain without a known cause

For the first two years after symptoms begin, the highs and lows of cyclothymia are less extreme. After that time, your highs and lows may become more pronounced. You may have depressive episodes that meet the criteria for full-blown major depressive episodes. Or you could experience full manic episodes.

When to see a doctor

  • If you have any symptoms of cyclothymia, seek medical help as soon as possible. Cyclothymia generally doesn’t get better on its own. If you’re reluctant to seek treatment, work up the courage to confide in someone who can help you take the first steps.
  • If a loved one has symptoms of cyclothymia, talk openly and honestly with that person about your concerns. You can’t force someone to seek professional help, but you can offer support and help find a qualified doctor or mental health provider.

Suicidal thoughts

Although suicidal thoughts might occur with cyclothymia, they’re more likely to occur if you have bipolar disorder I or II. If you’re considering suicide right now:

  • Call 911 or your local emergency services number, or go to a hospital emergency department.
  • Call a local crisis center or suicide hotline number — in the United States, you can call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to reach a trained counselor. Use that same number and press 1 to reach the Veterans Crisis Line.
  • If you just can’t make that call, reach out to someone else — immediately — such as your doctor, mental health provider, family member, friend or someone in your faith community.