Cyclothymia - Case of Mild Mood Disorder

The sun is shining but I am in the dark. Didn't want to get out of bed this morning struggled to get out of bed this morning. I want to cry I feel like I need to but I can't. People annoy me just their voices. Have no energy just want to curl up go to sleep and not wake up. - Madge2015

For as long as i can remember I have suffered from severe mood swing, almost two years ago the doc diagnosed me as depressed and have been on antidepressants since. I feel I have been mis-diagnosed and after many nights of researching, I came across cyclothymic disorder. My symptoms match exact. Today was a very bad day, I am sick of fighting this and trying to understand what goes on in my head. It consumes me to the point I just want someone to come and take me away and bring me back to my family when I am fixed. - Deby26

Probably many of us have such thoughts when one feels they have experienced something similar to a depressive episode and after some days, experience a mania episode which lasts for many days. But dont know whats exactly going on? You are not alone who experiencing this.

In fact, I was going through forums and found that many of our members shared their experiences and stories on it. You could check them here, or here and here as well.

Are you also experiencing such thoughts and emotions? And unable to recognize what exactly it is? Then, perhaps this is what you need to see and read:

Introduction to Cyclothymia

It is a mild mood disorder with characteristics similar to Bipolar disorder because both cyclothymia and bipolar cause emotional fluctuations, from depressive lows to mania highs. It means cyclothymia patients usually experience some weeks of low depressive episodes followed by mild mania episode that exist for many days. They then find stable mood for few days, later again experience low level depression, and cyclic process continues with the intervals.

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Many think that bipolar and cyclothymic are same. But the level of intensity differentiates the two. In bipolar, one can experience an extreme level of mood swings. While, in cyclothymia, it's not extreme ones. They are of moderated levels. However, if cyclothymia is not recognized and treated at initial stages, it could lead to the risk of developing bipolar disorder.

As per DSM-V (Diagnostic and Statistical Manual of Mental Disorders), Cyclothymia is different from bipolar because it does not have all the characteristics of depression, mania, or mixed of both. Some suffering from Cyclothymia could develop Bipolar-I or II at the later stages of their lives because they do not seek treatment, considering their mood swings do not seem as severe as bipolar or depression.

Symptoms

It could be considered as a lite version of bipolar where sufferer may not be experiencing high and low but not as extreme as of depression or bipolar; the mood swings could destabilize and able to pose issues and concerns for the sufferer. Sometimes, one suffering from cyclothymia can be misdiagnosed as Bipolar or BPD (Borderline personality disorder). It is different. As it includes the characteristics of Hypomania and Depression, so lets know its symptoms from both aspects.

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Symptoms of Cyclothymia (Depressive symptoms)

Experience aggressiveness in the behavior.

Either lack of sleep or sleeping too much.

Fluctuations in appetite.

Feeling low or less energetic

Highly distracted and less focused.

Feeling irritated quite often.

Feeling hopeless, highly demotivated. Finding themselves useless.

(Hypomania symptoms)

Spendthrifts.

Hyperproductive in doing whatever they do.

Optimistic approach

Feeling too happy

Restless, feeling anxious

Insomnia for days without feeling tired.

Thoughts rushing in mind.

As it is a mild mood disorder, they usually experience the symptoms of both depression and hypomania. Starting with some weeks of low-level depression followed by next some days of moderated mania.

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Diagnosis of Cyclothymia

Many people suffering from it find it difficult to recognize, accept they have the issue, or even if some do, they do not reach out to seek treatment. To diagnose it, physicians will discuss medical history and symptoms. To differentiate the cyclothymia from the normal level of mood swings, they compare symptoms one experience with the symptoms of cyclothymia to figure out if you are one suffering from it. The criteria they use are as below:

Symptoms of low depression to the high mania for a period of at least two years. For teens and children, this period is at least one year.

The period should be of stable mood for less than a couple of months.

Symptoms that do not meet the symptoms of low depression to high mania or other mental disorder(s).

Symptoms affecting your work-life balance.

They may perform certain lab tests to figure out if it is due to some other medical condition or not so they get clear and better idea about the symptoms of cyclothymia.

Treatment

Generally, there are no specific medications approved to treat it. However, through workable medications and therapy, it gets treated. It is a chronic disorder that needs lifelong treatment. If one stops taking suggested medications or therapies, it could return and risk development of bipolar.

Medications that are potentially suggested

Medicines for mood stabilizers to minimize mood fluctuations

Medicines that are antidepressants or anti-anxiety

Anti-seizure medications used to treat cyclothymia. It is also known as anticonvulsants)

Generally, antipsychotic medicines also used to treat patients who do not respond to anti-seizure medicines. It means if anti-seizure medicines not effective for patients, then antipsychotic medicines could be prescribed.

To treat it, mainly one can rely on therapy and only in rare cases the medications that are mentioned above are suggested. In therapies include psychotherapy, cognitive behavioral therapy, and family therapy.

Psychotherapy is an essential part of the treatment of it. It further categorized as CBT and Well Being Therapy.

Under CBT, one practices to overcome negative,unhealthy thoughts, and behavior and replace them with positive thoughts and behavior to keep the stress in check and keep the mood swings controlled.

Under Well Being Therapy, one practice to have a better quality of life. Mindfulness practices could help to improve the well being of one and considered as an effective tool.

Under Family Therapy, the focus is on fixing the conflicts with family members, if any and practice effective communication so that undesirable stress could remain checked and controlled.

Generally, the specialists suggests therapies in conjunction with medications to have an effective treatment of it. It helps to improve the lives of the sufferers of cyclothymia.

Where to find Support Groups/ Be part of Support Groups?

Maybe we are not aware about it, but there are many support groups available for those who experiencing cyclothymia where they can share their experiences, stories and learn about others too who experienced same. It helps one to feel that they arent alone and get encouraged to reach out and accept it openly. Few support groups are:

7CupsOfTea

MDJunction

Cyclothymia Support Society

Pysch Forums

Conclusion

It is not easy to accept the vulnerabilities of mental health. Many of us are unable to recognise the issues, and even if somehow we able to recognise, it then becomes difficult to reach out and seek support and treatment due to certain factors like fear of judgment, lack of understanding, or so on.

However, admitting it wont make one weak. It allows one to be mindful of their issues and concerns and accordingly, avoid getting exposed to the stuff that triggers these issues.. Asking for support could help one to be open, courageous to accept and find alternates to deal with it.

Cyclothymia is a rare mild mood disorder and probably not easily traceable. But even if one has a doubt based on the symptoms one can have, better to connect to the physician and specialists to get it diagnosed and reduce chances of developing bipolar in later stages of life. With the help of medications and therapies, it could be treated and improve overall well being.

Discussion

Let us share, discuss and learn about it and spread awareness so we could able to recognize it often and minimize the risk of developing bipolar and support each other better.

How helpful you find this project?

Have you felt you or someone around you could be suffering from it considering those symptoms? Share your thoughts or personal experiences about it with us.

What are your ideas or suggestions to spread awareness about it?

References

Perugi, G., Hantouche, E., & Vannucchi, G. (2017, April). Retrieved March 08, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5405616/

Cyclothymia Personality, Symptoms, Causes, and Treatment. (n.d.). Retrieved March 08, 2018, from https://www.psycom.net/depression.central.cyclothymia.html

Cyclothymia (Cyclothymic Disorder). (n.d.). Retrieved March 08, 2018, from https://www.webmd.com/bipolar-disorder/guide/cyclothymia-cyclothymic-disorder#1

Cyclothymia (Cyclothymic Disorder) (n.d.). Retrieved March 08, 2018, from https://www.nhs.uk/conditions/cyclothymia/