Cyclothymic disorder is an illness that takes a person from mild depressions to elated states, called hypomania. It is a treatable and manageable condition that is vastly underdiagnosed.
Some people refer to cyclothymic disorder as a milder form of bipolar or manic-depressive disorder. Indeed, it is a closely related illness, having a genetic component just as bipolar does. Both disorders tend to run in families, along with alcoholism and suicidal behaviors.
However there are differences between cyclothymia and its more well-known counterpart, bipolar disorder. Both are described as mood disorders, characterized by patterns of highs and lows. However, in cyclothymia the depressions are mild and the ups are not full-blown manias, but rather hypomanic in nature. In fact, many people with the disorder will never be diagnosed, as their behavior will be written off as moodiness, or a flaky personality. Their lives are typified by interruption, many job changes, broken relationships and often substance abuse, which is used by the person as a means of self-medicating the symptoms.
To meet the criteria for a diagnosis of cyclothymic disorder, a person must have these patterns of highs and lows, not enough to qualify as bipolar, but still characterized as an unevenness in mood. Persons with cyclothymia will not have a relief of these symptoms for longer than two months straight.
The ties to bipolar disorder are obvious in research. Between 20-50% of persons with cyclothymia will eventually develop bipolar disorder in their lives. An estimated 80% of bipolar patients first experienced cyclothymic disorder.
Since the illnesses are so similar, treatments are as well. The difference is that bipolar patients almost always need medication to treat and prevent future episodes, whereas cyclothymic patients may not require medication at all. Many patients with cyclothymic disorder are able to manage their illness with psychotherapy alone. For those who have problems that disrupt their lives, jobs and or relationships, medication may be prescribed. The usual medications are standard mood stabilizers that are used in bipolar illness, such as Depakote and lithium.
Psychotherapy will address ways the patient can better manage their illness and their lives. The therapist will help the patient recognize warning signs that they are heading into a hypomanic or depressive state and take precautions. Some patients only take antidepressants on an as needed basis, and knowing when they are approaching a depression will signal the time to begin such medication. However, any usage of antidepressants must be monitored closely, as antidepressants can bring on manic states. The therapist will work closely with the patient to discover their mood patterns, often using a mood chart. Also subjects for therapy include maintaining a regular sleep pattern, eating well, and avoiding alcohol and illegal drugs, as these have a strong impact on cyclothymia. The therapist’s role is to help the patient deal more effectively with the illness, and perhaps to help inform and educate family members.
Since many patients have addiction problems, usually as a result of trying to treat the symptoms themselves with alcohol or drugs, counseling may be needed to address this as well. Ideally, a therapist should be knowledgeable about both addictions and cyclothymic disorder.
Not just any therapist will do. One needs to find out about the therapist’s practice. How many patients does he/she see with bipolar or cyclothymia? What are their standard treatments for these illnesses? Where does the therapist have hospital privileges? Are the office hours and location convenient? Will a patient see only one therapist or others in the practice? No one should assume that any psychologist or counselor is equipped to handle all illnesses.
Cyclothymic disorder is definitely a manageable illness, with education, support and proper treatment. The sooner treatment begins, the better the chances of success.
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