Mental health disorders are often complex and difficult to understand, but understanding them can go a long way in providing the support and care individuals need. One such disorder is cyclothymic, a mood disorder that is often overlooked or misunderstood due to its subtler symptoms compared to more severe mood disorders like bipolar I or II. However, despite its mild nature, cyclothymic disorder can still significantly impact a person’s daily life, relationships, and overall well-being. In this blog, we will delve into the symptoms, causes, and treatments for cyclothymic disorder, and how seeking professional help can make a world of difference.

What is Cyclothymic Disorder?

Cyclothymic disorder, also called cyclothymia, is a mood disorder that lasts for at least two years in adults or one year in children and adolescents. It is characterised by periods of hypomanic symptoms (high mood, increased energy) and periods of depressive symptoms (low mood, lethargy). Cyclothymic disorder is characterised by less severe but disruptive mood swings, in contrast to bipolar disorder, which has more significant mood swings.

The symptoms of cyclothymic disorder often go unnoticed because they may not be as noticeable or intense as those seen in full-blown bipolar disorder. However, they can cause significant emotional distress and impair daily functioning. If left untreated, cyclothymia can evolve into a more severe mood disorder, such as bipolar I or bipolar II disorder.

Symptoms of Cyclothymic Disorder

1.  Hypomanic Episodes

Hypomania refers to a period of elevated mood, increased energy, and impulsive behaviour. Though not as severe, it is comparable to mania. In cyclothymic disorder, hypomania symptoms can include:

• Increased energy and activity: A person may feel unusually energetic, restless, and active.
• Elevated or irritable mood: They may experience an overly optimistic or easily irritable mood that seems out of proportion to the situation.
• Decreased need for sleep: Individuals may feel energised and may need less sleep than usual (e.g., only needing a few hours).
• Racing thoughts: There may be an accelerated thought process, making it difficult to concentrate or stay focused.
• Impulsivity: Impulsive behaviours, such as spending money recklessly or engaging in risky behaviours, may be evident.

While hypomanic episodes may seem enjoyable for a time, they can cause problems in relationships and work environments due to impulsive behaviour, irritability, and difficulty focusing.

2. Depressive Episodes

Depressive symptoms in cyclothymic disorder are less intense than those found in major depressive disorder, but can still significantly impact an individual’s well-being. Symptoms of depressive episodes may include:

• Low mood: Persistent feelings of sadness, hopelessness, or lack of motivation.
• Fatigue: An overwhelming sense of tiredness or exhaustion, even with adequate sleep.
• Social withdrawal: A tendency to isolate oneself from friends, family, or activities that were once enjoyable.
• Feelings of worthlessness or guilt: A negative self-view and excessive guilt about things outside one's control.
• Difficulty concentrating: Impaired concentration or memory, making it hard to complete tasks or make decisions.

During depressive episodes, people may feel unproductive and struggle with even the simplest of daily activities. These periods can last for days, weeks, or even months, contributing to feelings of frustration.

3.  Frequent Mood Swings

Cyclothymic disorder is characterized by frequent mood swings that move between episodes of hypomania and depression, often interrupted by periods of stable mood. These unpredictable emotional changes can lead to significant stress, making it difficult for individuals to feel emotionally balanced. Over time, the ongoing struggle with mood instability can provoke intense feelings of anger and persistent anxiety, affecting both personal relationships and professional responsibilities. The rapid cycling of emotions often disrupts daily life, making academic, social, and work-related tasks harder to manage.

Causes of Cyclothymic Disorder

Although the precise causation of cyclothymic disorder is unknown, it is thought to be a result of a confluence of biological, environmental, and genetic variables, much like many other mental health diseases.

• Genetics: A family history of mood disorders, particularly bipolar disorder, can increase the likelihood of developing cyclothymic disorder. Studies have shown that individuals with a first-degree relative (parent or sibling) with bipolar disorder are at a higher risk of cyclothymia.
• Biological Factors: Neurobiological factors, such as imbalances in neurotransmitters like serotonin, dopamine, and norepinephrine, can contribute to the mood swings associated with cyclothymic disorder. Hormonal changes or irregularities in the circadian rhythm (internal body clock) may also play a role.
• Environmental Factors: Stressful life events, trauma, or ongoing interpersonal conflicts can exacerbate symptoms or trigger the onset of the disorder. Chronic pain can also affect mood regulation, making individuals more vulnerable to emotional dysregulation.

Treatment Options for Cyclothymic Disorder

The cyclothymic disorder may seem mild, but it can cause significant distress in the long run, and treatment is essential to managing symptoms effectively. Usually, a mix of medication, psychotherapy, and lifestyle modifications is used for treatment.

1. Psychotherapy (Talk Therapy)

Psychotherapy is one of the most effective treatments for mood disorders like cyclothymia. Cognitive Behavioural Therapy (CBT) is a popular approach for helping individuals identify and change negative thought patterns and behaviours that contribute to emotional instability. Through CBT, individuals can learn coping strategies, improve problem-solving skills, and manage the emotional extremes of hypomanic and depressive episodes.

Interpersonal and Social Rhythm Therapy (IPSRT) is another form of therapy that can help regulate the daily routines and sleep-wake cycles that are often disrupted in cyclothymic disorder. IPSRT focuses on improving interpersonal relationships and maintaining a stable routine, which is crucial for managing mood disorders.

2. Medication

While cyclothymic disorder is less severe than full-blown bipolar disorder, mood stabilisers like lithium and antidepressants can be prescribed to manage symptoms. A healthcare provider might also recommend antipsychotic medications if the individual experiences more severe mood swings. It's important to note that medications should be monitored carefully by a healthcare provider to prevent adverse effects or the worsening of symptoms.

3. Lifestyle Changes and Self-Care

Changing one's lifestyle can also be very important for managing cyclothymic disorder. Regular exercise, healthy eating, and a consistent sleep schedule are essential for maintaining stable moods. Avoiding alcohol, drugs, and other mood-altering substances can also help prevent mood swings. Mindfulness and relaxation techniques, such as meditation, yoga, and deep-breathing exercises, can reduce stress and promote emotional stability.

For individuals struggling with cyclothymic disorder, accessing professional support can be an important part of the recovery process. TalktoAngel, an online counselling platform, offers convenient access to licensed therapists who can provide valuable guidance in managing the emotional ups and downs associated with this condition. Through online therapy, individuals can receive counselling from the comfort of their homes, ensuring that help is always within reach, regardless of time or location.

Online therapy can be particularly beneficial for those with busy schedules, those who prefer private, convenient sessions, or those who may feel more comfortable speaking to a counsellor remotely. TalktoAngel offers a range of therapeutic services, including Cognitive Behavioural Therapy and mindfulness-based strategies, that can help individuals with cyclothymic disorder develop effective coping mechanisms, enhance emotional regulation, and ultimately lead a more balanced life.

Conclusion

Cyclothymic disorder may not always be as visible or as severe as bipolar disorder, but it can still cause considerable distress and disrupt a person’s life. Early recognition, appropriate treatment, and support from mental health professionals can make a significant difference in managing symptoms. Whether through psychotherapy, medication, or lifestyle changes, individuals with cyclothymic disorder can achieve a better quality of life. If you or someone you know is struggling with cyclothymic disorder, seeking therapy and professional guidance—whether in-person or through platforms like TalktoAngel—can offer the tools and support needed to improve emotional stability and live a more fulfilling life.

Contributed by: Dr (Prof) R K Suri, Clinical Psychologist & Life Coach &  Ms. Sangeeta Pal, Clinical Psychologist.

References

• Ketter, T. A. (2007). Cyclothymic disorder: An overlooked, but important mood disorder. Psychiatric Clinics of North America, 30(4), 655-664. https://doi.org/10.1016/j.psc.2007.06.003
• Miklowitz, D. J. (2008). The role of family therapy in treating bipolar disorder: Current status and future directions. Journal of Family Therapy, 30(2), 219-240. https://doi.org/10.1111/j.1467-6427.2008.00472.x
• Van Der Gucht, E., & Oldershaw, A. (2016). The impact of psychological treatments in bipolar disorder. Psychological Medicine, 46(7), 1431-1442. https://doi.org/10.1017/S0033291716000125