Cyclothymic disorder

Definition

Cyclothymic disorder is a mild form of bipolar disorder (manic depressive illness) in which a person has mood swings over a period of years that go from mild depression to euphoria and excitement.

Alternative Names

Cyclothymia

Causes, incidence, and risk factors

The causes of cyclothymic disorder are unknown. Major depression, bipolar disorder, and cyclothymia often occur together in families. This suggests that these mood disorders share similar causes.

Cyclothymia usually begins early in life. It appears to be equally common in men and women.

Symptoms

• Episodes of hypomania (see: Bipolar disorder) and mild depression occur for at least 2 years (1 or more years in children and adolescents)
• Mood swings are less severe than in bipolar disorder, major depression, or mania
• Symptoms are persistent, with no more than 2 symptom-free months in a row

Signs and tests

Your description of your mood history usually leads to diagnosis of the disorder. Your health care providers may order blood and urine tests to rule out medical causes of mood swings.

Treatment

Mood stabilizing medication, antidepressants, talk therapy, or some combination of these three therapies may be used to treat cyclothymic disorder.

Some of the more commonly used mood stabilizers are:

• Lithium. Lithium has been used for years in patients with bipolar disorder, and it may also help patients with cyclothymic disorder.
• Antiseizure drugs. Valproic acid (Depakote), carbamazepine (Tegretol), oxcarbazepine (Trileptal), and lamotrigine (Lamictal) are the most established mood stabilizing antiseizure drugs.

People with cyclothymia may not respond to medications as strongly as patients with bipolar disorder.

Support Groups

As with other illnesses, you can ease the stress of living with cyclothymia by joining a support group whose members share common experiences and problems.

Expectations (prognosis)

Less than half of people with cyclothymic disorder will eventually develop bipolar disorder. In other people, cyclothymia will continue as a chronic condition or disappear with time.

Complications

The condition can progress to bipolar disorder.

Calling your health care provider

Call a mental health professional if you or a loved one has persistent alternating periods of depression and excitement that negatively affect work, school, or social life. Seek immediate help if you or a loved one is having thoughts of suicide.

Prevention

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References

McClellan J, Kowatch R, Findling RL; Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2007;46:107-125.

Tress AV, Smetana GW. Medical evaluation of patients undergoing electroconvulsive therapy. N Engl J Med. 2009;360:1437-1444.