According to statistics, cyclothymia disorder is very rare and its prevalence in the world population is close to 1%. The DSM-IV (Diagnostic and Statistical Manual of Mental Disorders), tells us that Cyclothymia is characterized by mild episodes of depression and hypomania (elevated or irritable mood and reduced need for sleep for at least 4 days). Adults are diagnosed after symptoms persist for two years. Children and adolescents are diagnosed after 1 year.
According to Dr. Stepehn Stökl B., Chief of Psychiatry at the Regional Health Center in Ontario, Canada:
“Cyclothymia disorder has an onset in late adolescence and early adulthood and is chronic in nature; it is the midpoint between bipolar I and bipolar II disorder.”
The main problem is that most people who suffer from cyclothymia never receive treatment, said John Preston, Ph.D., professor at Allian International University and author of 3 books on bipolar disorder, including “Taking Charge of Bipolar Disorder” ( ). This is because depression is not disabling, and people feel well for periods of time, but these periods do not last more than two months, as stipulated by the DSM-IV diagnosis. In other words, because the symptoms are less disabling, people simply don’t realize they have this disorder, said Sheri Van Dijk, psychotherapist and author of the book Skills for Bipolar Disorder (). Usually family members and loved ones are the ones who realize the problem, since they suffer from the difficulties of living with someone with very unstable moods.
“Cyclothymia has a high morbidity, related to the breakdown of personal and work relationships, and if subjects are not treated, the consequences can be even worse and they can develop severe changes in mood,” said Stokl, “which “which can lead to being diagnosed with bipolar disorder,” Preston explained.
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Diagnosing cyclothymia
Making an accurate diagnosis of Cyclothymia is a bit difficult, since it can be confused with bipolar II disorder or borderline personality disorder (but subjects with bipolar II disorder tend to struggle with more severe depression). There are also important differences between cyclothymia and borderline personality disorder. A person with borderline disorder may experience hypomanic episodes, acting very cheerful, but their elevated mood does not last long and always happens after falling in love with someone new. Once the infatuation fades, the person feels despondent again.
Related to this, Preston said:
“The significant sign of hypomania is a decreased need for sleep. People with hypomania only sleep for 3 or 4 hours, they do not feel fatigue, while people with borderline disorder feel exhausted. Additionally, people with borderline personality disorder are “exquisitely sensitive to feelings of rejection and abandonment.”
According to Preston, the best way to diagnose cyclothymia disorder comes from:
“Obtaining a comprehensive history of the person’s state of mind, which requires conducting interviews with the subject and loved ones who know them very well. “Usually, loved ones are best able to detect changes in mood.”
Cyclothymia disorder is due to biological changes in the nervous system. But fortunately, the treatment is highly effective in reducing symptoms and helping the patient improve their health and lead a full life.
How to deal with Cyclothymia
If you have been diagnosed with cyclothymia, learn as much as you can about this disorder. As Van Dikj says “To do something effective, you need to know what you are dealing with.”
Talk to a psychologist or psychiatrist about symptoms, causes, triggers, and treatment options.
Preston assures that “many experts are against pharmacological treatment for cyclothymia.” One reason is that mood stabilizers have many side effects and antidepressants are well known to worsen the symptoms of cyclothymia in the long term (they can trigger hypomanic episodes).
Preston emphasized the importance of two fundamental strategies:
- Maintain healthy sleep patterns, since few hours of sleep activate mood episodes. Avoiding coffee after midday can dramatically improve sleep. If you feel very tired in the afternoon, take 10 minutes to walk, as it offers the same amount of energy as a cup of coffee.
- The second strategy is to avoid drug and alcohol consumption.. Alcohol abuse is commonly related to cyclothymia. When people are depressed, they seek the help of a few drinks to get relief. But alcohol exacerbates mood disorders and sabotages the hours of sleep (even if you fall asleep quickly after consuming alcohol, it disrupts the quality of sleep. Alcohol in conjunction with caffeine does not allow you to achieve the deep and regenerative stages of the dream).
Psychotherapy is highly effective. Research has found that cognitive behavioral therapy and interpersonal social rhythm therapy (IPSRT) are helpful in the treatment of bipolar disorders. Van Dijk and Stokl have also noted that dialectical behavior therapy is valuable for the treatment of these disorders.
Social rhythmic interpersonal therapy focuses on two goals: improving interpersonal relationships and creating healthy routines. According to Preston, relationships can be a significant source of stress for people with Cyclothymia and can contribute to changes in their moods. This therapy is similar to family or couples therapy in that it helps individuals learn better communication skills and resolve their problems, and it also helps loved ones understand that cyclothymia is a neurochemical disorder and is not the individual’s fault. .
Related to psychotherapies, Van Dijk said: All of these psychotherapies can help subjects learn effective coping skills, for example, an individual can learn assertive skills to help improve their relationship and strategies to process and manage their emotions to prevent turn into problem behaviors, such as substance abuse.
Preston assures:
“Routine is the key to stabilizing moods, and people with bipolar disorder are especially sensitive to change. “Any modification in your eating, sleeping or exercise patterns can interfere with your circadian rhythms and can trigger an episode.”
That is why it is important that the changes are made under the same terms. For example, experts suggest that going to bed at the same time and waking up at the same time may be very tedious, but it can be very helpful in regulating your mood.
As psychotherapists, I would like to know your opinions and what strategies you have found to be most effective for the treatment of this disorder.
Fountain: Image: on Flickr