Cyclothymia


Cyclothymia

Description, Causes and Risk Factors:

ICD-10: F34.0.

Cyclothymia is a chronic bipolar disorder consisting of short periods of mild depression and short periods of hypomania (lasting a few days to a few weeks), separated by short periods of normal mood. The mood instability - mild elation or mild depression - is related to bipolar disorder (manic depression), and is in fact considered to be a milder form of bipolar disorder. Though less severe, cyclothymia can have great impact on a person's life, with unexpected and extreme mood changes disrupting the ability to function normally.

Cyclothymia

Both men and women are equally likely to suffer from cyclothymia, affecting up to 1% of the population. Cyclothymia generally starts appearing during young adulthood, though onset may also occur at a later age.

The exact causes of cyclothymia are not known, but it is often a result of the same genetic factors that cause bipolar disorder. In fact, approximately one in three people with cyclothymia will eventually be diagnosed with bipolar disorder following a full-blown manic episode or major depression. There's usually a family history of major depression, bipolar disorder, suicide, or alcohol/drug dependence.

Cyclothymic disorder frequently coexists with borderline personality disorder (BPD), which is a severe lifelong illness characterized by emotional instability and relationship problems. An estimated 10% of outpatients and 20% of inpatients with borderline personality disorder.

Patients with cyclothymic disorder are estimated to constitute from 3-10% of all psychiatric outpatients. They may be particularly well represented among those with complaints about marital and interpersonal difficulties. In the general population, the lifetime chance of developing cyclothymic disorder is about 1%. The actual percentage of the general population with cyclothymia is probably somewhat higher, however, as many patients may not be aware that they have a treatable disease.

At this time, there are no known effective preventive measures that can reduce the risk of developing cyclothymia. Genetic counseling, which assists a couple in understanding their risk of producing a child with the disorder, may be of some help.

Symptoms:

Symptoms may include:

    Increased energy and activity level.

  • Decreased need for sleep.

  • Tendency to be distracted or to rapidly jump from one idea to the next.

  • Being more talkative than usual.

  • Feelings of high self-esteem, possibly coupled with grand ideas or increased.

  • Goal-oriented activities.

  • People with cyclothymic disorder are also more likely to abuse drugs and alcohol. As many as 50% of people with cyclothymia may also have a problem with substance abuse.

Diagnosis:

According to DSM-IV a diagnosis of cyclothymia is based on the following:

    Individual has had many periods of both hypomania and depression, for a period of at least 2 years.

  • Individual has experienced no periods of normal mood lasting longer than two months.

  • Individual has experienced no major depression, manic or mixed episode during the first two years of symptoms.

  • Symptoms are not attributable to either Schizophrenia or Psychotic Disorder (PD).

  • Symptoms are not due to effects of medication, illicit drugs or medical condition.

  • Individual experiences significant distress or impairment in daily living.

Doctors consider that a diagnosis of cyclothymia can be made if there's a history ofmood instability over a period of at least two years, and symptom-free intervalsnever last more than two months. For children and adolescents, symptoms only needto be present over a one-year period.

If a person has experienced major depressive, manic, or mixed, the diagnosis will likely be changed to bipolar I or IIdisorder. A doctor will usually also need to rule out other conditions, such asschizophrenia, delusional disorder, or a psychotic disorder as being the cause ofsymptoms. As well, it's also possible that the symptoms are caused by substance abuse,physiological effects of certain medications, or an unrelated medical condition.

Treatment:

Pay Attention to Mood: Keep a journal and note down how moods shift on a daily basis. List how the mania or depression affected an ability to function effectively. Pay special attention to how swings negatively affected a job, relationship or health.

Treatment for cyclothymia consists of the use of antiepileptics such as lithium, Depakote, Tegretol, Neurontin, and Lamictal to name a few. Antipsychotics are generally not utilized. Antidepressants are also generally not utilized as they have the potential to make a person manic, and the depression does not last long enough for them to take effect.

Side effects of the medications must be discussed with your PCP.

Psychotherapy is used to help the person understand their disease process, to give them insight into their disease, and to come up with new coping mechanisms. Additionally, it assists them in dealing with daily activities such as social and workplace functioning.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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