Cyclothymia

Cyclothymia is a rare condition affecting the mood of sufferers. Read and learn all about the causes, symptoms, diagnosis and treatment of this mental ailment.

What is Cyclothymia?

Doctors and medical researchers define this as a comparatively mild type of Bipolar disorder. Like Bipolar, this is a chronic mental condition that results in emotional swings.

It is also referred to as Cyclothymic disorder. The disease is reported to affect approximately similar number of men and women.

Cyclothymia Etymology

The disorder gets its name from a fusion of two Greek terms, “kyklos” meaning “circle” and “thymos” standing for “anger”. Simply put, it means a “cycle of anger” referring to the sudden aggressive behavior shown by a sufferer.

Cyclothymia Incidence

The condition is reported to affect 0.4 to 1% of the entire U.S population. The disease commonly arises during the teenage years or in the early twenties of the life of an individual.

Cyclothymia Episodes

This condition is marked by two episodes or phases, which are characterized by diametrically opposite moods of the same patient. These are:

Picture 1 – Cyclothymia

Depressive Episodes

As the name indicates, it is marked by depressive mood and behavior. These include:

• Concentration problems
• Difficulties in decision-making
• Poor remembrance
• Low confidence
• Self-criticism
• Absence of sexual urge
• Fatigue
• Self-neglect
• Irritability
• Helplessness

The list of symptoms is by no means comprehensive and includes more problems. Discuss with your doctor about the possible problems of this phase in case you have such an individual in your family.

Hypomanic Episodes

It is characterized by abnormal cheerfulness in the patient. The person is shown to exhibit extremely optimistic behavior, very high self-confidence, increased sexual urge and very fast pace of talking. However, he or she may also show agitation, very aggressive behavior, reduced need for sleep, difficulties in concentration and a slew of other problems.

Cyclothymia Causes

This condition, similar to Bipolar disorder, is supposed to arise as a result of genetic factors. However, several other possible causes are:

• Suicidal tendency
• Dependence on drugs or alcohol
• Family history of major depression
• Family history of bipolar disorder

That said, the exact cause of the disease is unknown as yet. As per medical research, however, the condition arises due to a combination of various factors (just like many other mental conditions). Cyclothymia is supposed to develop due to a combination of:

• Heredity
• Environment
• Biochemical processes of the body, such as alterations in brain chemistry

Cyclothymia Symptoms

The disorder is primarily characterized by:

• Mood swings, which are less intense than in mania, major depression or bipolar disorder
• Hypomania episodes
• Episodes of mild depression, which may develop for at least 2 years

Although the signs resemble those of Bipolar disorder, they are less severe in nature. People suffering from this condition can perform their daily activities, although with some difficulty.

Some of the other prominent signs of this condition include:

• Inability to maintain enthusiasm for new activities
• Abrupt changes in mood from happiness to gloom
• Self-medication, with illegal drugs and alcohol
• Difficulties in sleeping, with little sleep during hypomanic phase and inability to wake up on time during depressive stage

Affected individuals also have difficulties in maintaining personal relationships. Their emotions quickly change from intimacy to aloofness. Even on a general level, they feel at the top of the world at one moment and highly despaired at the other instant. They only feel stable during the “in-between” periods.

Cyclothymia Diagnosis

The condition is generally diagnosed once patients, or their family members, describe the history of their mood. Physicians and healthcare providers may advise carrying out urine and blood tests to eliminate medical causes of alterations in moods.

Diagnosis usually includes:

Physical tests

Such examinations may involve

• Checking vital signs like body temperature, blood pressure and heart rate
• Abdominal testing
• Measuring height and weight
• Listening to the sounds of the heart and the lungs

Laboratory tests

These may involve:

• Thyroid tests
• Blood tests
• Complete Blood Count (CBC)
• Urinalysis
• Tests for alcohol and drugs

Psychological evaluation

This includes discussion of patients about their feelings, thoughts and behavior with their mental healthcare providers. Sufferers may be asked about alcohol or substance abuse. They may have to fill out questionnaires and go through psychological self-assessment tests.

Cyclothymia Diagnostic Criteria

The diagnosis of the disorder is based on certain factors like:

• Whether the person has suffered from periods of both depression and hypomania for a minimum period of two years
• Whether he or she has not had any normal mood during the last two months or longer
• Whether the individual has not suffered from manic or mixed episode of major depression during the first two years after the onset of mental changes
• Whether or not the symptoms can be attributed to either Psychotic Disorder or Schizophrenia
• Whether or not the symptoms are a result of any medical condition, illegal drugs or medication
• Whether or not the patient suffers from severe mental impairment or distress in his/her daily life

Cyclothymia Differential Diagnosis

The diagnosis of this disorder is difficult, owing to its similarity with various other mental ailments. These include:

• Psychotic disorders
• Personality disorders
• Adjustment disorders
• Mood disorders
• Bipolar disorder

The differential diagnosis of the condition aims at distinguishing it from the abovementioned disorders.

Cyclothymia Treatment

This is usually a chronic condition that needs lifelong cure, even during those phases when patients feel better. The treatment is generally conducted by a mental healthcare provider experienced in handling such cases.

Timely and effective treatment is essential for curing this condition, as patients are at a high risk of developing Bipolar Disorder. Treatment is also necessary for decreasing the severity and frequency of the Hypomanic and Depressive phases of this condition. Medical cure also helps reduce problems arising from alcohol or any other substance abuse which may worsen the symptoms of Cyclothymia.

The primary treatment options for this disease include:

Medications

Use of medicines may be useful in controlling symptoms of the disorder and avoiding Hypomanic or Depressive episodes.

Psychotherapy

Also known as talk therapy or counseling, it involves cognitive behavioral therapy, family therapy, group therapy and social rhythm therapy. Psychological therapies are an essential part of the treatment of this disease.

Cyclothymia and Medications

Medications used for treating the condition involve use of:

Mood stabilizers

These are most commonly prescribed for remedying this ailment. They help stabilize and regulate mood of patients. Lithium (Eskalith, Lithobid) is a common mood stabilizer, and is usually the first choice, for curing this Hypomanic phases of this disorder. Doctors may prescribe this drug for life-long prevention and treatment of Hypomanic symptoms.

Anti-seizure drugs

Also referred to as anticonvulsants, these are used to avoid mood swings. Drugs of this type involve Lamotrigine (Lamictal), Divalproex sodium (Depakote) and Valproic acid (Depakene).

Antipsychotic medicines

Patients who do not show any positive response to anti-seizure medications are administered with Risperidone (Risperdal) and Olanzapine (Zyprexa) which may bring some amount of relief.

Anti-anxiety medications

These drugs, such as Benzodiazepines, may be effective in improving the sleep of patients. The Food and Drug Administration has approved the medication Quetiapine (Seroquel) for the treatment of both the depressive and manic phases of bipolar disorder. These may also be effective in curing Cyclothymic disorders.

Antidepressants

Doctors generally do not recommend use of antidepressants for curing Cyclothymic disorder, unless such medications are used along with a mood stabilizer. Taking these drugs alone may trigger potentially serious manic episodes, as in the case of Bipolar disorders. It is essential to consult a doctor and weigh the pros and cons carefully before taking such medications.

Cyclothymia Complications

If not treated in time, this disorder may give rise to severe emotional problems. These may have a negative impact on every aspect of the lives of patients of Cyclothymic disorders. The disease also increases the risk of having Bipolar disorder to a great extent. Approximately half of all such individuals are also likely to take recourse to substance or alcohol abuse. Many of these patients are at a higher risk of committing suicide.

Cyclothymia Risk Factors

The actual risk factors of this mental syndrome have not been fully identified as yet. However, being young or at an adolescent age is supposed to raise susceptibility to this ailment. This is due to the fact that the condition is found to arise particularly in adolescents and young adults.

Cyclothymia Prognosis

Less than half of the population suffering from this condition eventually develops Bipolar disorder. In others, the disease persists as a chronic condition or resolves with the passage of time.

Cyclothymia Management

Patients can reduce the stress of living with this disease by joining any support group that extends assistance to people who suffer from the condition. Support groups put patients in touch with other individuals with similar difficulties. Long-term treatment is also required to manage the disorder.

Picture 2 – Cyclothymia Image

Management also involves:

• Taking medications on time and as directed
• Carefully monitoring the symptoms
• Avoiding alcohol and drugs
• Keeping a daily record of moods and routines

Patients should also consult doctors before taking any medication prescribed by another physician for some other disease. This is necessary as some medicines may interfere with certain drugs prescribed for Cyclothymia or even trigger Bipolar disorder.

Managing this condition can be difficult for sufferers, as several medicines used for its treatment gives rise to side effects. Having a persisting condition that requires life-long cure and management may also cause anger and resentfulness in sufferers. Patients are often tempted to stop medical cure during their Hypomanic episodes.

Love, care and support of family members can help one tide over various mental ailments and Cyclothymia is no exception. Proper care and constant family support can make patients feel loved and looked after. This is sure to have a positive impact on their mind and help them deal with the disorder more easily. The condition may also resolve naturally within a shorter duration.

Cyclothymia Home Remedies

This is a serious mental condition and cannot be cured by home remedies. However, it can be managed with the aid of certain lifestyle modification measures. These involve:

• Staying focused on goals – As this disorder requires prolonged treatment, patients have to find ways to stay focused to achieve a fine balance in their personal and professional life. Constantly reminding the self about possible damage to relationships, social life or career can help a patient stay motivated.
• Engaging in healthy activities and hobbies – Sufferers must busy themselves with healthy and recreational activities that ease their stress and divert their minds to the positive side of life. Regular exercise or sports activities can also help release hormones that regulate stress and soothe the mind.
• Practicing stress management techniques – Learning Yoga, meditation or Tai-chi and practicing them regularly can also have a positive effect on the mind. This can take tension off the mind and make sufferers feel more rejuvenated, both physically and mentally.

Cyclothymia Prevention

As yet, there is no sure way to avoid this disease. However, starting medical treatment at the earliest signs of mental problems can help prevent deterioration of the disorder. Long-term treatment, aimed at prevention, can also help an individual avoid minor episodes of the disease from becoming full-blown cases of depression or mania.

If you or any of your loved ones is having symptoms of this condition, contact a medical professional on an immediate basis. As aforesaid, a delay in treatment can negatively affect the social, personal or professional life of a person. It may also give rise to suicidal tendencies. The disease may also worsen to Bipolar disorder. Treatment, when conducted effectively and in time, can help manage the disease to a great extent and even resolve it after some time.

References:

http://www.mayoclinic.com/health/cyclothymia/DS00729

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002517/

http://www.webmd.com/bipolar-disorder/guide/cyclothymia-cyclothymic-disorder

http://www.mcmanweb.com/cyclothymia.html