The defining feature of cyclothymia (also called cyclothymic disorder) is chronic mood swings or changes. You could say it’s the “little brother” of bipolar disorder.
For people with cyclothymia, the mood swings consist of numerous, different periods of hypomanic and depressive symptoms. But the main feature is that the hypomanic symptoms are insufficient in number, severity, extent, or duration to meet the criteria of a manic episode.
The same happens with the depressive symptoms. The depressive symptoms are insufficient in number, severity, extent, or duration to meet the criteria of a major depressive episode. Otherwise we would be discussing bipolar disorder. The similar but less severe symptoms are why some people call cyclothymia the “little brother” of bipolar disorder.
Hypomanic and Depressive Symptoms
Hypomania refers to a state similar to mania, but less intense. Hypomania is a psychiatric episode with transient symptoms of irritability or agitation. It is often described as a less intense or “incomplete” form of a manic episode.
Hypomanic symptoms include euphoria that lasts for several days. It also includes agitation, shortened sleep time, hyperactivity, and exaggerated self-confidence which are all significantly different from the person’s previous emotional state. Unlike mania, hospitalization for hypomania is not normally necessary.
As for the depressive symptoms of cyclothymia, they are usually similar to those of a depressed person. Nevertheless, these symptoms are usually not as noticeable or as intense as in a major depressive episode.
Symptoms of Cyclothymia or Cyclothymic Disorder
In addition, symptoms must be persistent for the first two years of the condition. They must be present most days. For children and adolescents, they should last for one year instead of two.
In addition, the patient should not be symptom-free for more than two months. Symptom-free periods of more than two months mean that the person does not have cyclothymia. They also must not meet the criteria for major depression, mania, or hypomania.
Nor is it cyclothymia if the pattern of the mood swings is better explained by schizoaffective disorder. But also schizophrenia, a schizophrenic episode, a delusional disorder and any schizophrenia spectrum disorder or other psychotic disorder. In short, it should not fit the diagnostic criteria for any other mental condition.
On the other hand, it is important not to confuse cyclothymia with an altered mood caused by a psychoactive drug or other medical condition. This is just as important to get an accurate diagnosis. Some substances (drugs or medicines) can cause similar symptoms.
Like most psychological episodes, the patient must have clinically significant mood swings or disturbances to be diagnosed with cyclothymia. The mood swings can affect or affect social life, work, or other important aspects of their daily lives.
Diagnostic criteria of cyclothymia
According to the DSM-5 (Diagnostic and Statistical Handbook of Mental Disorders, 5th Edition), the following diagnostic criteria must be present for a diagnosis of cyclothymia:
- Periods of hypomanic symptoms that do not meet the criteria of a hypomanic episode, and numerous periods of depressive symptoms that do not meet the criteria of a major depressive episode for at least two years (one year for children and adolescents).
- During the aforementioned two-year period, the hypomanic and depressive episodes must be present more than half the time and for at least six consecutive months.
- The symptoms never met the criteria for a major depressive episode or a manic or hypomanic episode.
- The symptoms are not better explained by schizoaffective disorder, schizophrenia, a schizophrenic episode, a delusional disorder, and any schizophrenia spectrum disorder or other psychotic disorder.
- Symptoms cannot be attributed to the psychological effects of a substance (eg a drug or medication). But also not from another medical condition (for example, hyperthyroidism).
This condition is often difficult to deal with and it is quite chronic. In addition , patients with cyclothymia have a 15-50% chance of developing type 1 or type 2 bipolar disorder later on. As we have seen, cyclothymia or cyclothymic disorder is related to bipolar disorder. The only major difference is that neither the hypomanic symptoms nor the depressive symptoms meet the criteria of a manic or depressive episode.