Bipolar disorders are mental health conditions characterized by significant shifts in mood, from elated and energized to depressed and indifferent. There are three bipolar disorders. The mildest one is known as cyclothymic disorder or cyclothymia.
Distinguishing among the different types of bipolar disorders helps people know what to expect and helps doctors identify the best treatment options. An accurate diagnosis of cyclothymia can help you access treatment that may prevent your condition from progressing to a more severe type of bipolar disorder.
The more you understand the nature of these mood disorders, the more confident you’ll feel in dealing with your own mental health symptoms and the more empathetic you’ll be in dealing with someone you know who has these symptoms.
Bipolar disorderwhich used to be called manic depression, is a condition in which moods shift dramatically and unpredictably. These mood changes are more intense than typical day-to-day mood fluctuations.
Episodes of mania, hypomaniaand depression can significantly interfere with your relationships, your work, and your quality of life.
Bipolar disorders are typically diagnosed in late adolescence or young adulthood.
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- Bipolar I disorder. A condition in which people experience manic episodes lasting at least 1 week or manic episodes so severe that they require hospitalization. People usually experience depressive episodes, which typically last for at least 2 weeks, and sometimes episodes with mixed features of both mania and depression.
- Bipolar II disorder. A condition in which people experience patterns of hypomanic episodes, which are briefer and less severe than full manic episodes, along with depressive episodes.
- Cyclothymia. A condition in which people experience patterns of hypomanic and depressive symptoms for at least 2 years but in which episodes are brief and not severe enough to be classified as hypomanic or depressive episodes.
The main differences between cyclothymia and other bipolar disorders is the severity of symptoms and the pattern of mood shifts. Cyclothymia is distinguished by chronic symptoms of hypomania and depression that aren’t as severe as the symptoms required for a diagnosis of major depression or bipolar disorder.
With bipolar I and II disorders, hypomanic, manic, and depressive episodes often last for
Unlike bipolar I and II disorders, cyclothymia typically causes symptoms on more days than not, with few periods of neutral mood in between.
Bipolar I and II disorders can also cause significant and alarming symptoms, such as delusional thinking or suicidal thoughts, which lead people to look for help. But cyclothymia can be more subtle, tending to result in more interpersonal problems.
Because the manic symptoms of cyclothymia are milder than they are in other bipolar disorders, the condition is often mistaken for general moodiness. It may also be mistaken for a personality disorder, such as borderline personality disorderor a neurodevelopmental disorder such as attention deficit hyperactivity disorder (ADHD).
This type of bipolar disorder causes significant highs and lows. But the high episodes aren’t severe enough to meet the criteria for hypomanic episodes (which themselves are less severe than classic manic episodes). Depressive symptoms are also of decreased severity, but they can last a long time.
Symptoms of cyclothymia can include the following:
- frequent shifts in mood
- significant changes in energy levels
- increased sensitivity to stimuli
- a tendency to overreact
- trouble maintaining personal relationships
- difficulties at school and at work
- behavioral symptoms
- high levels of self-esteem
- racing thoughts
- talking too fast
- agitation or irritability
- not needing as much sleep on some days
- getting easily distracted
- increased focus on goals relating school, work, social life, or sex
- impulsivity or risky behavior
- depressed mood
- social withdrawal or isolation
- low self-worth
- trouble concentrating
- trouble falling asleep at night
- trouble staying awake during the day
- thoughts of self-harm or suicide
Bipolar I disorder involves both manic and depressive episodes. Some people with this type of bipolar disorder have periods of “mixed features,” meaning they have depressive and manic symptoms simultaneously.
Bipolar II disorder also involves depressive episodes, but they may be shorter and a little less severe. It also involves hypomanic episodes, which are shorter and less intense than classic manic episodes.
Symptoms of manic and hypomanic episodes include:
- feeling very happy (euphoria)
- less need for sleep or not sleeping at all
- high energy levels
- high activity levels (fidgeting, moving around)
- feeling irritable or agitated
- high self-esteem or overconfidence
- trouble focusing
- racing thoughts
- risky behavior
- thoughts of suicide or self-harm
- being more sociable, flirtatious, or sexually active
- talking faster and more than usual
- psychosis (manic episodes only)
- delusions or grandiose beliefs (manic episodes only)
- hallucinations (manic episodes only)
Symptoms of depressive episodes can include:
- feeling very depressed, hopeless, or worthless
- low energy or extreme fatigue
- withdrawal or isolation
- talking slowly, softly, or having little to say
- difficulty or inability to do simple tasks
- trouble staying awake during the day or falling asleep at night
- eating too much or too little
- lack of interest in activities you usually enjoy
- thinking about self-harm, death, or suicide
Cyclothymia and other bipolar disorders are usually treated with a combination of medications and psychotherapy, sometimes called talk therapy.
Commonly used medications to treat cyclothymia and bipolar disorders include:
Two widely used forms of psychotherapy include cognitive behavioral therapy (CBT) and family-focused therapy.
People with a bipolar disorder also benefit from learning how to recognize the onset of an episode and apply strategies that may help reduce its intensity. Mood regulation strategies may be particularly helpful for people with bipolar II and cyclothymia.
While psychotherapy and medications can be an effective treatment for bipolar disorders, these conditions continue to present challenges for healthcare professionals.
In particular, treating the depression component of bipolar disorders is particularly challenging.
A healthy lifestyle featuring regular aerobic exercise and a balanced diet may be helpful too. Meditation, prayer, and spiritual practices may complement other treatments, but they can’t take the place of established treatments.
It isn’t currently possible to prevent bipolar disorders because scientists still don’t fully understand their origins. But the effective management of cyclothymia may keep it from progressing into a more severe type of bipolar disorder.
While there are no guarantees that cyclothymia can be treated sufficiently to prevent its progression, being proactive with the management of your condition may at least improve your quality of life and perhaps lessen the frequency and intensity of future shifts in mood.
Cyclothymia is a milder type of bipolar disorder. All bipolar disorders are characterized by drastic mood shifts, but the severity and duration of the highs and lows can vary considerably.
Bipolar I and bipolar II disorder often interfere with relationships, work, and daily responsibilities. Cyclothymia can present difficulties in these areas too, but symptoms tend to be less severe. This allows many people with cyclothymia to work, go to school, and care for themselves with fewer challenges than people with other types of bipolar disorder.