cyclothymic disorder

Cyclothymic Disorder is defined by the ongoing presence of hypomania and depressive symptoms that do not meet full criteria for hypomania or depression episodes.  In Australia, a diagnosis is usually made by a psychiatrist using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) criteria.

An abbreviated list of the Cyclothymic Disorder criteria according to the DSM-5-TR is below:

A.  For at least 2 years (or 1 year for children/adolescents) there are numerous periods of hypomania symptoms and depressive symptoms that do not meet full criteria for an episode.

B.  During the 2 year period the symptoms have been present for at least half of the time and the individual has not been without symptoms for more than 2 months at a time.

C.  Criteria of a major depressive, manic or hypomanic episode have not been met.

Additional criteria include that the symptoms are not better explained by another condition such as schizophrenia and that they are not attributable to a substance. 

The symptoms, although not meeting criteria for a full episode, must also cause clinically significant distress or impairment.

Examples of hypomania symptoms include: elevated mood, increased self-esteem, more talkative or energetic, racing thoughts, distractability, increase in goal directed activity, decreased need for sleep.

Examples of depression symptoms include: depressed mood, loss of interest in activities, changes in appetite, insomnia, fatigue, low energy, feeling worthless or guilty, difficulty thinking, recurrent thoughts of death or dying.

Difference between Cyclothymic Disorder, Bipolar I and Bipolar II disorder

The key difference is that Cyclothymic disorder symptoms do not meet full criteria for an episode, unlike Bipolar I and II disorder.  People living with Bipolar I and II may also have periods of cyclothymia.  Cyclothymic Disorder may progress to Bipolar I or II disorder over time.

Diagnosis

This condition may be harder to detect given that the symptoms do not meet full threshold for a hypomania or depression episode.  Diagnosis is recommended by a psychiatrist due to the nature of this condition to ensure that the full criteria are met and that the disorder is not better explained by another health or mental health condition.

Treatment

Guidelines for the treatment of Cyclothymic Disorder are published by the Royal Australians and New Zealand College of Psychiatrists (https://www.ranzcp.org/clinical-guidelines-publications/clinical-guidelines-publications-library/mood-disorders-cpg).

These guidelines cover a range of areas and treatment types but updated advice is required from your medical practitioner. 

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

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