Varda Imtiaz

Introduction

 Cyclothymia is derived from the Greek word

κυκλοθυμία (from κῦκλος kyklos, "circle" and

θυμός thymos, "mood, emotion").

 It means "to cycle or circle between moods or

emotions
 In cyclothymic disorder, moods swing

between short periods of mild depression

and hypomania, an elevated mood.

 The low and high mood swings never reach

the severity of major depression or full mania

 History

 In 1883, Karl Ludwig Kahlbaum identified a

disorder characterized by recurring mood cycles.

 The disorder contained both melancholic and

manic episodes that occurred in a milder

form than in bipolar disorder

 Term "cyclothymia“ was introduced by

Kahlbaum and his student Ewald Hecker

Prevalence

 Lifetime prevalence 0.4 – 1.0 %

 More common in females then male

 Age of onset usually in adolescence or early

adulthood
Symptoms

Hypomanic symptoms

 An exaggerated feeling of happiness or well-

being (euphoria)

 Extreme optimism

 Inflated self-esteem

 Talking more than usual

 Poor judgment that can result in risky

behavior or unwise choices

 Racing thoughts

 Irritable or agitated behavior

 Excessive physical activity

 Increased drive to perform or achieve goals

(sexual, work related or social)

 Decreased need for sleep

 Tendency to be easily distracted

 Inability to concentrate
Depressive symptoms

 Feeling sad, hopeless or empty

 Tearfulness

 Irritability, especially in children and

teenagers

 Loss of interest in activities once considered

enjoyable
 Changes in weight
 Feelings of worthlessness or guilt

 Sleep problems

 Restlessness

 Fatigue or feeling slowed down

 Problems concentrating

 Thinking of death or suicide

Causes of Cyclothymia

 The causes of Cyclothymia are not known

 Genetic link because Cyclothymia,

depression tend to run in families.

 Traumatic events or experiences may act as a

trigger for the condition, such as severe

illness or long periods of stress.

Diagnosis:

Cyclothymia is classified in DSM-5 as a subtype of

bipolar disorder.
The criteria are:
A.
For at least 2 years (at least 1 year in children
and adolescents) there have been numerous
periods with hypomanic symptoms that do
not meet criteria for a hypomanic episode and
numerous periods with depressive symptoms
that do not meet criteria for a major
depressive episode
B.
During the above 2-year period (1 year in children

and adolescents), the hypomanic and depressive

periods have been present for at least half the
time and the individual has not been without the
symptoms for more than 2 months at a time.
C.
Criteria for a major depressive, manic, or
hypomanic episode have never been met.

D.
The symptoms in criterion A are not better
explained by schizoaffective disorder,
schizophrenia, schizophreniform disorder,
delusional disorder, or other specified or
unspecified schizophrenia spectrum and
other psychotic disorder.
E.
The symptoms are not attributable to the
physiological effects of a substance (e.g., a
drug of abuse, a medication) or another
medical condition (e.g., hyperthyroidism)
Comorbidities

 Cyclothymia commonly occurs in conjunction

with other disorders.

 20-50 percent of people with depression

anxiety, and related disorders also have

cyclothymia.
Other co morbidites

 Impulse control issues

 Eating disorders

 ADHD

 Atypical depression

 Separation anxiety
 Differential diagnosis
 Dysthymic disorder

 Bipolar disorder

 Bipolar NOS disorder

 Borderline personality

 ADHD
Diagnosis

 Physical exam.
A physical exam and lab tests may be done to

help identify any medical problems that

could be causing your symptoms.

Psychological evaluation

 A doctor may ask about thoughts, feelings

and behavior patterns.

 Fill out self-assessment or questionnaire.

 Ask family members or close friends may be

to provide information about symptoms,

such as possible hypomanic or depressive

symptoms
Mood charting

 Keep a daily record of moods

 Sleep patterns or

 Other factors that could help with diagnosis

and finding the right treatment.

Treatment

The aim is to:

 Stop the cyclothymia developing into Bipolar

disorder

 Reduce symptoms
 Stop symptoms coming back

 Treat alcohol or other substance use problems

Psychotherapy
 Psychotherapy, such as cognitive behavioural

therapy (CBT), can help with cyclothymia.

 Identify unhealthy, negative beliefs and

behaviors and replace them with healthy,

positive ones
 CBT can help identify what trigger
symptoms.

 Teach effective strategies to manage stress

and cope with upsetting situations.

Interpersonal and social rhythm
therapy (IPSRT)
 IPSRT focuses on the stabilization of daily

rhythms, such as

Sleeping

Waking

Meal times

Exercise
Medications

 Mood stabilisers

 Antidepressants
 Mood stabilisers include:

Lithium – commonly used to treat bipolar

disorder

 Anti-epileptic drugs – such as

Carbamazepine, Oxcarbazepine Or Sodium

valproate
Complications
 A high risk of later developing bipolar I or II

disorder

 Substance misuse is common

 May also have an anxiety disorder

 Increased risk of suicidal thoughts and

suicide
Prevention

 There's no way to prevent cyclothymia.

However, treatment at the earliest indication

of a mental health disorder can help prevent

cyclothymia from worsening.

 Long-term preventive treatment can help

prevent minor symptoms from becoming full-

blown episodes of hypomania, mania or

major depression
Society & culture

 Actor Stephen Fryhas spoken about his

experience with cyclothymia, which was
depicted in the documentary Stephen Fry:

The Secret Life of the Manic Depressive

 Singer Charlene Soraia had cyclothymia and

wrote a song about her experiences with the
disorder.
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