To
elaborate a bit, cyclothymia is basically what you call people who have mild
bipolar symptoms. It first appeared in the
DSM-IV as a
Axis I mood disorder, after much research had indicated that there is a lot more to
Bipolar Disorder than previously thought. The basic symptom is a chronic
instability of moods with alternating mild depressive episodes and periods of mild
elation. It is difficult to really diagnose this because the elation is typically so mild that it cannot be considered a
manic episode, more a period of happiness in the persons life. The key to the diagnosis is the instability of the
mood, that is the depressive episodes are not long term nor are they
severe enough to be considered a major depressive episode. It is also fairly common in persons with a family history of bipolar disorder and may co-exist with
personality disorders.
Treatment of cyclothymia rarely resorts to medication as the symptoms are generally not severe enough to impair functioning (else they would be diagnosed with full blown bipolar disorder), however during more severe episodes a mood stabilizing drug such as lithium or valproate may be prescribed. Psychotherapy is the main treatment, however most people with this disorder never seek out treatment because it may not have enough of an impact outside of times of stress. A number of researchers feel that cyclothymia is actually due to identity issues and negative personality traits (such as borderline personality disorder traits that are not severe enough to warrant the diagnosis of a personality disorder), and as such therapy focusing on raising self esteem, regulation of emotions, and interpersonal relationships may be beneficial. Some research has indicated that cyclothymia occurs more frequently in patients with borderline personality disorder than other personality disorders.
Unfortunately, this is a disorder that has only recently begun to be recognized as something seperate from bipolar disorder, and even the experts don't all agree that it is. In the past 10 years we have gone from recognizing manic depression as an all encompassing illness to categorizing it as 3 different disorders (bipolar I, II, and III) and cyclothymia. What the cause of cyclothymia is and how it relates to personality disorders and other mood disorders is not really known. On the bright side, the outcome is quite good for patients, with therapy they can learn to cope with the symtpoms.
DSM -IV Criteria
A) For at least 2 years, the presence of numerous periods with hypomanic symptoms
and numerous periods with depressive symptoms that do not meet criteria for a
Major Depressive Episode. Note: In children and adolescents, the duration must be at
least 1 year.
B) During the above 2-year period (1 year in children and adolescents), the person
has not been without the symptoms in Criterion A for more than 2 months at a time.
C.) No Major Depressive Episode, Manic Episode, or Mixed Episode has been present
during the first 2 years of the disturbance.
Note: After the initial 2 years (1 year in children and adolescents) of Cyclothymic
Disorder, there may be superimposed Manic or Mixed Episodes (in which case both
Bipolar I Disorder and Cyclothymic Disorder may be diagnosed) or Major Depressive
Episodes (in which case both Bipolar II Disorder and Cyclothymic Disorder may be
diagnosed).
D) The symptoms in Criterion A are not better accounted for by Schizoaffective
Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder,
Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.
E) The symptoms are not due to the direct physiological effects of a substance (e.g.,
a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism).
F) The symptoms cause clinically significant distress or impairment in social,
occupational, or other important areas of functioning.