Cyclothymic Disorder

Cyclothymic Disorder

Cyclothymic disorder, also known as cyclothymia, is a relatively mild form of bipolar II disorder characterized by mood swings that may appear to be almost within the normal range of emotions. These mood swings range from mild depression, or dysthymia, to mania of low intensity, or hypomania. It is possible for cyclothymia to go undiagnosed, and for individuals with the disorder to be unaware that they have a treatable disease. Individuals with cyclothymia may experience episodes of low-level depression, known as dysthymia; periods of intense energy, creativity, and/or irritability, known as hypomania; or they may alternate between both mood states. Like other bipolar disorders, cyclothymia is a chronic illness characterized by mood swings that can occur as often as every day and last for several days, weeks, months, or as long as two years. Individuals with this disorder are never free of symptoms of either hypomania or mild depression for more than two months at a time (Encyclopedia of Mental Disorders).

The German psychiatrist Ewald Hecker introduced the concept of cyclothymia in 1877, but its definition has evolved from a mild problem with mood to its current status, in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), as a mood disorder alongside bipolar disorder and major depression. Cyclothymic disorder also appears in the International Classification of Diseases (ICD-10), published by the World Health Organization. Those who have this disorder usually fail to recognize it as well as doctors who treat them due to the fine line between pathological and normal mood swings (Colino, 2005).

Cyclothymic Disorder often begins early in life and is sometimes considered to reflect a temperamental predisposition to other Mood Disorders (especially Bipolar Disorders). In community samples, Cyclothymic Disorder is apparently equally common in men and in women. In clinical settings, women with Cyclothymic Disorder may be more likely to present for treatment than men (Mental Health Today). The hypomanic, or upbeat, phase features symptoms such as elevated mood, increased self-esteem, decreased need for sleep, racing thoughts, an increase in goal-directed activity and excessive involvement in pleasurable activities. These symptoms might last for four or more days, and then alternate with periods of mildly depressive symptoms such as sadness, pessimism, fatigue, feeling guilty, trouble concentrating and changes in sleep or appetite. For a person to be diagnosed with the disorder, this alternation persists for at least two years (Colino, 2005). Although cyclothymic and chronic hypomanic dispositions contribute to success in business, leadership, achievement, and artistic creativity in some persons, they more often have serious detrimental interpersonal and social sequelae. Cyclothymic instability is particularly likely to be manifested in an uneven work and schooling history; impulsive, frequent changes of residence; repeated romantic or marital breakups; and an episodic pattern of alcohol and drug abuse (Merck.com).

Patients with cyclothymic disorder are estimated to constitute from 3-10% of all psychiatric outpatients. They may be particularly well represented among those with complaints about marital and interpersonal difficulties. In the general population, the lifetime chance of developing cyclothymic disorder is about 1%. The actual percentage of the general population with cyclothymia is probably somewhat higher, however, as many patients may not be aware that they have a treatable disease. Cyclothymic disorder frequently coexists with borderline personality disorder, which is a severe lifelong illness characterized by emotional instability and relationship problems. An estimated 10% of outpatients and 20% of inpatients with borderline personality disorder have a coexisting diagnosis of cyclothymic disorder. The female-to-male ratio in cyclothymic disorder is approximately 3:2. It is estimated that 50%-75% of all patients develop the disorder between the ages of 15 and 25 (Minddisorders.com).

No treatment has been clearly defined but psychotherapy or medication can be tried or they can be used together as part of treatment. Psychotherapy usually takes place as individual psychotherapy but groups have been proven to be helpful. Some clinics have found that helping the client