# What is cyclothymia?



## David Baxter PhD (Aug 13, 2006)

*301.13 Cyclothymic Disorder*

A. For at least 2 years, the presence of numerous periods with hypomanic symptoms (see p. 338) 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.


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## foghlaim (Aug 13, 2006)

I must be really "slow" this evening.. 

can someone explain the above in "English" for me. sme i can understand but well para A just confuses the life outta me!!!

thanks..
nsa


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## David Baxter PhD (Aug 13, 2006)

Cyclothymia is basically a milder or less severe version of bipolar disorder, where the modd swings are not quite as extreme;

http://en.wikipedia.org/wiki/Cyclothymia

*Cyclothymia is a mild mood disorder which is sometimes seen as more of a personality trait than an illness. Cyclothymia is characterised by repetitive periods of mild depression followed by periods of normal or slightly elevated mood. A percentage of cyclothymics go on to develop full-blown bipolar disorder (normally bipolar II type) at some stage in their lives, while others suffer from forms of depression or other more severe mood disorders. *

http://wordnet.princeton.edu/perl/webwn

_*a mild bipolar disorder that persists over a long time*_


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## foghlaim (Aug 13, 2006)

My thanks David..

Now i can understand it.. 


nsa


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## Vinton (Nov 7, 2007)

I was diagnosed in 73 with cyclothemia..but I'm depressed more than hyper. I've been taking effexor for 4 years and to be honest it has not done a thing for me except lower my anxiety

I've been retired since 95 and I realize that I've been like that for as long as I remember and even had suicidal thoughts  but 20 years ago I did not know what I do now.

I dont feel like swallowing more AD's and feel numb and  gain to 100 lbs.

The other alternative is electroconvulsive therapy and even better the new therapy I read about in the reader's digest in toronto.

I've got a great family and to stick around so I must find a way to get out of this.


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## Retired (Nov 7, 2007)

> The other alternative is electroconvulsive therapy and even better the new therapy I read about in the reader's digest in Toronto.



Vinton,

It is a big leap from anti depressant medication therapy to ECT.  You may want to discuss the benefits and risks with your doctor before pursuing that idea.

However, it is not unusual that one anti depressant compound may not be effective in one person's therapy, or even lose its effectiveness over time.

The usual process is to change to another compound until the right compound is found that works for you.

There's no need to lose hope in finding a successful treatment; it sometimes takes a little time and plenty of patience.


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## Into The Light (Nov 7, 2007)

also there may be the option of combining two anti-depressants; i don't have a direct link but i remember seeing a post on the forum about this a while ago that a combination can be helpful to those with difficult-to-treat depression. i would ask your doctor about this.

edit: i found the link, here it is: Treatment-resistant depression: Options when depression won't go away - Psychlinks Psychology and Self-Help Forum


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## Vinton (Nov 7, 2007)

I will tell you what happened:


In 1973 I woke up with my right side partially paralized.The local GP told me that it could me a tumor or menengistist .I ended up  800 KM away in the hopital for a bunch of test and when I got out they told me it was just a virus but they told my wife that it was MS and I would find out soon enough.
Out of the hopital I went into depression so bad that I could not walk. No therapy, no medication and no one told me what it was and had to wait till 1982 for a diagnosis.Those years were hell.
After that  depression hit me again and I was put on lithium for 4 years. After the psychiatrist changed it to clonazepam (2.5 mgs) . From the on I've  spent so much money and time on  therapies. In 2000 I decided to get off the clonazepam and I did my last cut 6 months ago but the price was way too much. I cannot describe what I went through and during that period and up to today I rarely talk about it in my house and keep it in.

So 2 weeks ago I started another  therapy.

I have a great family .We have two daughters and 5 grandchildren and there are no problems ..

Epival: 750Mg
effexor:150 mgs
Straterra: 100Mg (ADHD)
Also have tourettes.
We are 6 in the family suffering with 2 or 3 of the
 above..


Honestly it is a blessing to have this site...


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## David Baxter PhD (Nov 8, 2007)

Vinton said:


> I dont feel like swallowing more AD's and feel numb and  gain to 100 lbs.





TSOW said:


> it is not unusual that one anti depressant compound may not be effective in one person's therapy, or even lose its effectiveness over time. The usual process is to change to another compound until the right compound is found that works for you. There's no need to lose hope in finding a successful treatment; it sometimes takes a little time and plenty of patience.



As Steve notes, sometimes it takes trial and error to find the best medication or mix of medications. You are not "doomed" to gain 100 pounds on antidepressants. Talk to your doctors about both your sense that the Effexor isn't working very well for you and your concern about gaining weight. Most people are able to find medication which works for them without inbtolerable side-effects.


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## Vinton (Nov 11, 2007)

For me the worse part of cyclothemia is when:

A close relative tells me: 

I told you not to say this..
You always talk too much..
I've told me many time..

After having a group conversation:

What did I say?
Did I say to much..
Heck! I should'nt have said that..


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## David Baxter PhD (Nov 11, 2007)

Vinton said:


> For me the worse part of cyclothemia is when:
> 
> A close relative tells me:
> 
> ...



Maybe that indicates a problem with the close relative, rather than with you.



Vinton said:


> After having a group conversation:
> 
> What did I say?
> Did I say to much..
> Heck! I should'nt have said that..



This is where cognitive behavior therapy (cognitive restructuring) can be particularly helpful - to get you out of the negative cycle and help you with reality checking.


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## Vinton (Nov 11, 2007)

Well!! I never look at it this way..


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## BluMac81 (Jul 14, 2008)

My question is, is cyclothymia the version of bipolar disorder where the mood swings happen fairly rapidly several times throughout the day?


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## braveheart (Jul 14, 2008)

No, it's where both the depression and mania are mild. Think dysthymia and hypomania.


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## stargazer (Jul 14, 2008)

It's possible, BlueMac, that you were thinking of the term "rapid cycling."


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## lil freckle (May 9, 2009)

What I got from it was it's not as severe as bipolar disorder. and you must have had the described symptoms for one year of ur adolecent/childhood and 1 year as an adult...


...I could be completely off though!


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## David Baxter PhD (May 9, 2009)

lil freckle said:


> What I got from it was it's not as severe as bipolar disorder. and you must have had the described symptoms for one year of ur adolecent/childhood and 1 year as an adult...
> 
> ...I could be completely off though!


 
No, you're not off. That's pretty much it.


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## lil freckle (May 12, 2009)

Is it easily confused with bipolar?

I have already been diagnosed with bi polar. type one i think. I'm rapid cycle. I was diagnosed at 15. But taking divalproex sodium makes the swings take longer to hit the manic or depressive state and last much longer. When I was on lithium i was still rapid cycle still, just not as harsh.


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## Sara-Bella (Nov 29, 2009)

Is it possible for adolescents to be diagnosed with Cyclothymia, or for it to be 'official' in teens, does it have to be severe? Also, does having an anxiety disorder improve the likelihood of having bipolar, warning symptoms in effect, or developing it later?


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## David Baxter PhD (Nov 29, 2009)

Sara-Bella said:


> Is it possible for adolescents to be diagnosed with Cyclothymia



Yes.



Sara-Bella said:


> for it to be 'official' in teens, does it have to be severe?



Not any more severe than adults. The difficulty with teens is that their emotional reactions tend to be relatively intense which interferes with the caveat for any diagnosis of "rule out other causes of the symptoms".



Sara-Bella said:


> Also, does having an anxiety disorder improve the likelihood of having bipolar, warning symptoms in effect, or developing it later?



No. Although individuals with bipolar disorder do often experience anxiety, having an anxiety does not necessarily predispose you to bipolar disorder or cyclothymia. The majority of people with anxiety disorders do not develop bipolar symptoms.


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## panpan (Apr 15, 2011)

How does this differ from dysthymia?


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## David Baxter PhD (Apr 15, 2011)

Dysthymia is chronic mild depression, sort of Major Depression Jr.

Cyclothymia is like Bipolar Disorder Jr., with the highs not so high and the lows not so low.


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## Laj (Apr 16, 2013)

Can this condition be entwined with locus of control behavior - depression?


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## David Baxter PhD (Apr 16, 2013)

Laj said:


> Can this condition be entwined with locus of control behavior - depression?



I'm not certain what you're asking here, Laj. Typically, someone with cyclothymia will certainly go through periods of depression and some have theorized that depression itself may sometimes be linked to locus of control issues or perceptions (e.g., helplessness, powerlessness).


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## Laj (May 5, 2013)

Hi David,

Thank you for your reply. It's difficult to find any privacy here to respond sooner. Yes, I guess my question was a bit confused...my thought pattern lately.  My husband seems to have this type of behavior i.e. locus of control. He actually frets thinking things out - so much so that it disturbs his sleep. He's fanatical if there is even one spot on his shirt, pants -that you can hardly see if there was one.   Also, I feel because of this trait, whenever we have a disagreement, it is the "end of the marriage. I'm warning you, I can only take so much and that is it!!"  he says. So it is very frustrating for me. I have to watch what I'm saying as he also cannot take criticism.  He writes everything down. His personal area is strewn with all types of pieces of paper with notes on them. What to do, errands to run, thoughts he has on certain topics, things to look up, people to talk to etc. Little pieces of paper, very neat, tiny writing. He loves to play jokes on and teases people, he looks at old (80's - 90's years of age) as so adorable. He tells one lady every chance he gets "Love you" when they see each other and over the phone, etc.  Is this an Oedipus (sp) thing.  He has a high i.q. (130 or close) ...I don't know if that has anything to do with it but it seems he doesn't have any common sense especially while driving. He prides himself on his looks no, he is obsessed with the way he looks- when he was younger he was indeed quite breathtaking as the girls would say.  They would stop him on the streets and tell him how handsome or cute he was. Sorry, David, I know I am rambling. I just need to get this out when I am able to have time away from him.

I know I need direction on how to cope with this. When it comes to his relationships with other people, I have to concur with his feelings about them or he labels me jealous and will not tolerate any other opinion.  I've seen his rage and it does not fit the situation.  He explodes for minor things.


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## David Baxter PhD (May 6, 2013)

I think you are confusing locus of control (general orientation or belief that things that happen to you are not within your own control vs. things that happen to you are entirely within your control) with controlling personality or the need to control that occurs with OCD.

Certainly, it's hard to see this relationship as healthy for you in any way. What you describe does suggest elements of OCPD (Obsessive-Compulsive Personality Disorder) and/or Narcissistic Personality Disorder - I am not attempting to diagnose him here but simply describing the described behaviors and personality traits in the context of your question.

There are also similarities to The Abusive Personality as described and documented by Dr. Don Dutton at the University of British Columbia.

Either way, the behaviors and traits you describe are generally highly resistant to change, in part because the individual himself sees little reason to change (i.e., in his view, it is you that needs to change, not him).


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