- Cyclothymia involves frequent shifts between hypomania and depression, aka high and low mood states.
- These symptoms are milder than bipolar disorder mood episodes, but it’s essential to get support.
- Treatment options may include therapy, medication, and lifestyle changes like sticking to a routine.
It’s natural to experience mood shifts throughout the day in response to different situations.
But if you have cyclothymic disorder, aka cyclothymia, you’ll experience frequent changes in your mood that may happen for no apparent reason. You might feel excited and optimistic in the morning, then low and hopeless just a few hours later, even if nothing happened to upset you.
Cyclothymia can resemble other mood disorders like major depressive disorder and bipolar I disorder because it involves both agitation and sadness. In fact, it’s considered a milder form of bipolar disorder.
The biggest difference between cyclothymia and other mood disorders, however, is that you won’t experience a full episode of major depression, mania, or hypomania, according to Bonita Sur, a clinical psychologist and assistant professor of psychiatry at Baylor College of Medicine. That means you’ll experience fewer symptoms than you would with other mood disorders, and the ones you do notice may be milder.
Although the mood shifts that happen with cyclothymia may be less severe, they tend to last longer — and they can still throw your life off-balance, disrupting your work, relationships, and personal life.
Read on to learn the main signs of cyclothymia, how to care for yourself during fluctuating moods, and what doctors recommend for treatment.
You may have cyclothymia if you experience unpredictable shifts between “up” — aka hypomanic — and “down” — aka depressive — mood states.
Here’s a list of characteristic signs that can help you recognize those mood states:
With cyclothymia, you may have some symptom-free periods, but these won’t last any longer than two months at a time.
In short, you’ll experience symptoms of either depression or hypomania for at least half the time of a two-year period, or a one-year period for kids and teens under the age of 18.
Cyclothymia vs. bipolar disorder
If you have bipolar I or II disorder, your moods typically shift less often than they do with cyclothymia.
Your symptoms will also meet the criteria for a full episode of depression, mania, or hypomania, as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).
Unlike cyclothymia, bipolar I and II disorder often require temporary inpatient treatment to manage symptoms, since they can become severe — and in some cases, life-threatening — without treatment.
Here are some examples of these more severe symptoms to help you determine if you could have bipolar disorder, or another condition — like cyclothymia:
Causes and risk factors
- Family history: Studies suggest having a close relative with bipolar disorder can raise your chances of developing a mood disorder like cyclothymia. If you have cyclothymia, there’s a 15%-50% chance of it eventually developing into bipolar I disorder or bipolar II disorder. Research on twins estimates a 70%-80% chance that cyclothymia is inherited.
- Genetics: Specific genes like CLOCK and TIMELESS may also increase your chances of developing cyclothymia.
- Trauma: Traumatic experiences like serious illness or chronic stress can trigger cyclothymia in some people. Childhood trauma, in particular, significantly increases your risk of developing any bipolar disorder.
While mood shifts don’t always have a specific trigger, you may find that certain things trigger changes in mood, such as:
- Not getting enough sleep: A lack of sleep may increase your risk of experiencing mood symptoms, since sleep affects your brain chemistry, mood, and ability to cope with stress.
- Drug or alcohol use: Certain medications, recreational drugs, and alcohol may make you more vulnerable to mood symptoms if you have a mood disorder, though experts have yet to study this specifically for cyclothymia. One study of 120 students did find, however, that inconsistent drinking patterns and binge drinking increased risk of hypomania associated with bipolar I and II disorders and cyclothymia.
- Major life changes: While losing a loved one or moving away for college can leave you more vulnerable to depression, significant events you’re excited about, like getting married, can also trigger mood symptoms.
Getting a diagnosis
Tell your mental health clinician or primary care doctor if you’ve been experiencing hypomanic and depressive symptoms for several years, says GinaMarie Guarino, a licensed mental health counselor at PsychPoint.
Medical practitioners widely consider cyclothymia a mood disorder. However, some researchers think the emotional reactivity and mood swings from cyclothymia relate to temperament, not a mental health condition.
To date, not much research has explored the nuances of cyclothymia — perhaps in part because it’s fairly rare. And this limited information can make it more complicated to get a diagnosis.
Since cyclothymia is a lifelong condition, charting your mood can help you track fluctuations over time to see how often you experience symptoms. Your care team can use this information to make a more accurate diagnosis.
They may also ask other questions before making a diagnosis, such as:
- If you’re over 18: Have you noticed your mood symptoms for at least two years?
- If you’re under 18: Have you noticed your mood changing a lot for at least one year?
- Have you ever had complete relief from mood symptoms for more than two months at a time?
- How often does your mood tend to shift?
- Do your symptoms make it tough to work, take care of your basic needs, or maintain relationships?
- Do you take any medications?
Treatment and coping tips
Since cyclothymia is lifelong, developing a treatment plan with your therapist or doctor can help you manage mood shifts and reduce the chances of your symptoms getting worse.
Your clinician might recommend a few different treatments, including:
Certain lifestyle changes could also make a difference in your symptoms. Examples include:
- Developing a daily routine: Setting up a consistent schedule can ease mood symptoms by minimizing mood triggers like poor sleep and forgetting to take your medication. These are core components of interpersonal and social rhythm therapy (IPSRT), which experts consider very effective at treating mood disorders and reducing your risk of developing another bipolar disorder.
- Aerobic exercise: 20 minutes of aerobic exercise may help improve symptoms of cyclothymia and other bipolar disorders by encouraging your body to release endorphins and dopamine, two of the so-called “happy hormones.”
- Boost your self-esteem: Building self-esteem can help you cope with symptoms, Guarino says. One study of 40 people with bipolar disorders found that low levels of self-esteem may increase your risk of depression. You can boost your self-esteem by celebrating small wins, like taking time to practice deep breathing when you’re feeling overwhelmed, and surrounding yourself with supportive, caring friends.
If your mood fluctuates between highs and lows that last for a day or more and these shifts complicate your daily life and relationships, Guarino recommends talking to a healthcare professional about cyclothymia.
These mood shifts can be difficult to navigate, but treatment can make a big difference.
A therapist or other mental health professional can help you understand your mood triggers and take steps to minimize disruptive changes in your mood.