Cyclothymic Disorder

Cyclothymic Disorder is a symptomatically mild form of bipolar II disorder, involves mood swings and it is characterized by frequent Hypomanic Episodes and several periods of depressive symptoms for atleast a period of 2 years. These symptoms continue for a few days to a number of weeks. The inception is separated by short episodes of normal mood. Any symptom-free intervals should not last more than 2 months during this 2-year period. Persons affected with cyclothymia are never totally free of symptoms of either depression or hypomania.

The possibility of cyclothymia to go undiagnosed is more due to the fact that the mood swings are considered to be normal by the sufferers and they are unaware that they have a treatable disease. Persons with cyclothymia may experience incidences of low-level depression, known as dysthymia; short periods of energy bursts, resourcefulness, and petulance, known as hypomania; or they may oscillate between both mood states.

The Hypomanic Episodes and depressive symptoms are not directly caused by a general medical condition or the use of any prescription medications, illegal drugs, or Psychotic Disorder. If the Hypomanic Episodes step up to meet the full criterion for a Manic Episode; the conclusion would be changed to Bipolar I Disorder. Alternatively if the depressive symptoms intensify, the diagnosis would be changed to Bipolar II Disorder.

Demographics

The frequency for this disorder in the general population is nearly 0.4% to 1% and the disorder is more common in women. Cyclothymic disorder often co-exist with borderline personality disorder, which is a persistent lifelong illness distinguished by emotional volatility and relationship issues. The female-to-male ratio in cyclothymic disorder affected patients is approximately 3:2. It is found that nearly 75% of all patients develop the disorder between the ages of 15-25

Associated Features:

• Ecstatic Mood
• Depressed Mood
• Irregular and abrupt mood changes
• Hyperactivity
• Sexual Dysfunction
• Weird or unconventional or Suspicious Personality
• Theatrical or inconsistent or unfriendly Personality

Causes:

Most psychodynamic theorists consider that the psychosocial origins of cyclothymia tilt back to the early ordeals, traumas and unmet desires of the initial stages of childhood development. Generally it is accepted that this disorder has an insidious onset in adolescence or early adulthood. It often develops with extended periods of recurring, often erratic mood changes (e.g., the individual may be regarded as unpredictable, morose, impulsive, incompatible or undependable). This disorder typically has a 15%-50% risk that the person will ultimately develop Bipolar I or II Disorder.

Familial Pattern:

Cyclothymic disorder has a strong genetic component. Clinical studies have proved that Cyclothymia is more common in the first-degree biological relations of patients with Bipolar I Disorder. Many of those affected Cyclothymics have a familial record of major depression, bipolar disorder and alcohol/drug dependence. At present, there are no known successful protective measures that can decrease the threat of developing cyclothymic disorder.

Treatment:

Psychotherapy and counseling:

The most successful treatment for individuals diagnosed with cyclothymic disorder is a combination of medication, psychotherapy or counseling to gain knowledge of coping skills for mood swings and adaptive behaviors. Psychotherapy is useful in progressively helping people to improve relationships, to gain better self-esteem, to cope with distress and wipe out other negative feelings.

Pharmacotherapy:

Biomedical treatment is an important component in treating of cyclothymic disorder. Antimanic medications is typically the first line of treatment . Antidepressant medications should be used with concern, because these patients are extremely vulnerable to full-scale manic episodes provoked by antidepressants. These drugs have been reported to be effective.

• Antimanic Drugs
• Carbamazepine (Tegretol)
• Verapamil
• Valproic Acid (Depakene, Depakote)
• Lithium Carbonate

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