Cyclothymia

What is cyclothymia?

Cyclothymia is like a mild form of bipolar disorder. You have weeks of low level depression and episodes of mild mania.

Children may have cyclothymia, but it usually starts during young adult years. Men and women are about equally likely to have cyclothymia. Less than 1% of the population has it.

What is the cause?

The exact cause of the disorder is not known. However, it does run in families. If you have relatives with bipolar disorder or cyclothymia, you are more likely to have it.

Parts of the brain may not work normally during manic and depressive episodes. But exactly what triggers these switches is unclear.

What are the symptoms?

During the manic periods you have several days when you may:

• Have a very high self-worth and feel "on top of the world."
• Be very talkative and talk fast, maybe so fast that others have trouble following what you are saying.
• Have racing thoughts and ideas to the point of being disorganized and muddled.
• Have trouble concentrating and find yourself jumping between different ideas.
• Be very restless and hyperactive.
• Have more anxiety and panic.
• Go for days with little or no sleep without feeling tired.
• Be very irritable and get into fights with others.
• Have bursts of high interest in sex and sexual activity.
• Be too active and act recklessly. For example, you might spend too much money or take sudden trips.

The symptoms of depression last a few weeks. Besides feeling somewhat sad and uninterested in things, you may also:

• Be irritable and aggressive.
• Have trouble falling asleep, wake up very early, or sleep too much.
• Have little or excessive appetite.
• Be easily tired and low in energy.
• Have low sexual desire and function.
• Feel worthless and guilty.
• Not be able to concentrate or remember things.
• Feel hopeless or just not care about anything.
• Have unexplained physical symptoms.

You may also have mixed periods when you feel a combination of both manic and depressed phases.

One phase may be followed immediately by the other. Often there is a period of feeling good between the two. If feeling good lasts more than 2 months, then you do not have cyclothymia.

How is it diagnosed?

Your healthcare provider or a mental health therapist will ask about your symptoms and any drug or alcohol use. You may have lab tests to rule out medical problems such as hormone imbalances.

The pattern in adults must last for at least 2 years to be called cyclothymia. For children and adolescents, symptoms that last for a year may be cyclothymia.

How is it treated?

Psychotherapy, medicines, or both, are the best treatment.

Medicines

Several types of medicines can help treat cyclothymia. Your healthcare provider will work with you to carefully select the best one for you.

Psychotherapy

Seeing a mental health therapist is helpful. Therapy may be needed for many months. Cognitive behavioral therapy (CBT) is a form of psychotherapy that is especially helpful. CBT is a way to help you identify and change thought processes that lead to depression. Replacing negative thoughts with more positive ones can help your depression.

Natural Remedies and Alternative Treatments

Omega-3 fatty acids may help to reduce cyclothymia symptoms. No herbal or natural remedies are effective in treating bipolar disorder.

Controlling stress, keeping to a regular sleep schedule, having friends or family to support you, and being more relaxed may help manage manic or depressive episodes.

How long will the effects last?

Cyclothymia often lasts for many years. You may need treatment throughout your life. It is important to follow your prescribed treatment every day.

How can I take care of myself?

• Take your medicine daily, even if you are feeling well. Stopping your medicine when you feel well may cause symptoms to return.
• Get support. Talk with family and friends. Consider joining a support group in your area.
• Watch yourself for the beginning signs of either an over-excitement or depressive phase. Ask others around you to also watch closely.
• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax, for example take up a hobby, listen to music, watch movies, take walks. Try deep breathing exercises when you feel stressed.
• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, quit. Avoid alcohol and drugs, because they can make your symptoms worse. Exercise according to your healthcare provider's instructions.
• Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all the medicines, natural remedies, vitamins, and other supplements that you take.
• Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.

When should I seek help?

If you are showing the signs of either a manic or depressive phase, seek professional help. Most of the time, you will feel much better after a few weeks of treatment.

Get emergency care if you or a loved one has serious thoughts of suicide or harming others. Also get emergency help if manic behavior becomes so wild that it endangers you or others.