Cyclothymia is a form of bipolar disorder. It is treated like bipolar disorder with medications, including mood stabilizers, and psychotherapy.

Definition

Cyclothymia or cyclothymic personality is a (milder) form of bipolar disorder. It corresponds to the existence for at least two years at least half the time of many periods of a few days or weeks during which hypomanic symptoms (excessive mood but attenuated compared to the manic symptoms) are present and many periods during which Depressive symptoms are present in the criteria for major depression. It causes suffering or problems of professional, social or family behavior. 

Namely: 15 to 50% of cyclothymic disorders progress to type I or II bipolar disorders. 

Causes 

The causes of cyclothymia and bipolar disorder in general are not well known. What we do know is that bipolar disorders are due to an interaction between biological factors (abnormalities in the production and transmission of neurotransmitters and hormonal abnormalities) and the environment (trauma in childhood, stress, etc.).

There is a familial predisposition to bipolar disorder. 

Diagnostic

The diagnosis of cyclothymia is made by a psychiatrist if a person has had hypomanic periods and periods of depression for at least two years but without the criteria for bipolar disorder (at least one year in children and adolescents), if these disorders are not due to the taking of a drug (cannabis, ecstasy, cocaine) or a medication or to a disease (hyperthyroidism or nutritional deficiencies for example). 

The people concerned 

Cyclothymic disorders affect 3 to 6% of the population. The onset of cyclothymic disorder is detected in adolescents or young adults. In comparison, type I bipolar disorder affects 1% of the population. 

Risk factors 

Having people with bipolar disorder in your family is a risk factor for developing cyclothymia. The other risk factors for developing bipolar disorders including cyclothymia are drug or alcohol abuse, sad or happy stressful events (divorce, death of a loved one, birth, etc.) or an unbalanced lifestyle ( disturbed sleep, night work …)

Symptoms of cyclothymia are those of bipolar disorder but less severe. The disease is characterized by an alternation of depressive episodes and manic episodes.

Depressive episodes …

The depressive episodes of the cyclothymic person are characterized by a loss of energy, a feeling of worthlessness and a loss of interest in things that normally provide pleasure (cooking, sexuality, work, friends, hobbies). Some people with cyclothymia think about death and suicide.

… alternating with manic episodes

Hypomanic episodes are characterized by an unusual feeling of euphoria, irritability, hyperactivity, talkativeness, racing thoughts, an exaggerated sense of self-worth, lack of introspection, lack of judgment, impulsiveness and the desire to spend extravagantly.

These mood disorders cause discomfort and difficulties in professional and family life.

Cyclothymia, like other bipolar disorders, is treated with medications: mood stabilizers (Lithium), antipsychotics, and anti-convulsants. 

Psychotherapy (psychoanalysis, behavioral and cognitive therapies-CBT, family-centered therapy -TCF, completes the drug management. This aims to help better manage his condition, to react positively to the triggers. , to support the patient.

Psychoeducation sessions aim to make patients better understand and know their disease and treatment (recognize the triggers of manic and depressive episodes, know the medications, how to manage stress, establish a regular lifestyle….) to reduce their symptoms and frequency.

It is possible to optimize the prevention of relapses from manic or depressive episodes. 

It is first of all necessary to avoid stressful situations and to learn to relax (by practicing meditation or yoga for example).

Sleeping well is essential. Not getting enough sleep is indeed a trigger for a manic episode. 

It is advisable to stop drinking or limit alcohol consumption because too much alcohol can be a trigger for manic or depressive episodes. The consumption of drugs is strongly discouraged because any drug can lead to bipolar episodes. 

Keeping a mood diary helps you to warn of an episode of hypomania or depression and to take preventative measures.