Mood Swings and Mental Health: Cyclothymia

As celebrities such as Catherine Zeta-Jones and Demi Lovato go public with their bipolar diagnoses, awareness of the issue—and the fact people can be extremely high-functioning if they get proper treatment—is increasing. However, a less severe version of bipolar, cyclothymia, remains unfamiliar to most people.

Cyclothymia is characterized by chronic mood swings that are less severe than those associated with bipolar. Because symptoms are less pronounced than symptoms of traditional bipolar, people may go without treatment for years and frequently don't recognize symptoms until the issue has interfered with a major life activity.

What Are the Symptoms?

Cyclothymia is characterized by persistent swings between depression and an elevated mood. The criteria for diagnosis require that mood swings not be caused by substance use or a medical condition, that symptoms cause clinically significant distress, and that symptoms are not better explained by another mental health diagnosis. Other criteria:

  • Presence of symptoms for at least two years
  • At least one hypomanic episode and at least one depressive episode
  • No major depressive or manic episode, as this better fits a diagnosis of bipolar
  • No longer than two months without symptoms

What Causes It?

Unlike some other mental health conditions, cyclothymia doesn't seem to be caused by life circumstances, and mood swings caused by stress or exciting life events wouldn't qualify a person for diagnosis. Occasional mood swings and simple moodiness are not the same as cyclothymia. Cyclothymia runs in families, indicating that it probably is due at least in part to a genetic predisposition. Variations in brain chemistry—especially an imbalance in neurotransmitters such as norepinephrine—could contribute to the development of the issue. People whose parents have depression or bipolar are also more likely to develop cyclothymia. Unlike some issues, it's equally common in men and women, and symptoms tend to appear fairly early in life.

How Is It Treated?

Because symptoms are less severe than bipolar, some people with cyclothymia are able to receive relief through psychotherapy and lifestyle changes. Mental health professionals commonly prescribe psychoactive medications, however. Mood-stabilizing drugs can be helpful, and many people with the issue take antidepressants; depressive symptoms of cyclothymia are generally more pronounced than the hypomanic symptoms.

Cyclothymia is sometimes more difficult to treat with medication than bipolar. Medications used for bipolar can be too strong and exacerbate, rather than mitigate, mood swings, so people with the issue sometimes have to try several different medications at several different dosages to get relief. However, with the right drug and therapy combination, people with cyclothymia can be cleared of symptoms. While some people with cyclothymia ultimately develop bipolar, most don't, so cyclothymia should not be seen as a precursor to manic depression.


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