Cyclothymia is one of the permanent affective disorders. Those affected suffer from instability in their mood and drive.
What is cyclothymia?
Cyclothymia is a mental disorder. More specifically, it represents a persistent mood disorder. It manifests itself as a chronic instability in the patient’s mood. In the course of cyclothymia, which is also called cyclothymic personality or cyclothymic temperament, depressive, manic and hypomanic episodes alternate.
However, those affected do not perceive the mental disorder as extreme, so that treatment only takes place in rare cases. The lifetime prevalence of cyclothymia varies between 0.5 and 1 percent. It is particularly common in people whose loved ones have bipolar affective disorder. For cbavd definition and meaning, please visit howsmb.com.
In some individuals, cyclothymic disorder eventually progresses into bipolar affective disorder itself. The symptoms of cyclothymia are significantly less than those of bipolar affective disorder. In the German-speaking world, the terms cyclothymia and cyclothymia are often used synonymously. However, the term cyclothymia has undergone a change in meaning over time.
It was coined in 1880 by the German psychiatrist Karl Ludwig Kahlbaum (1828-1899). It served as a term for today’s bipolar affective disorder and captured its cyclical nature. In later years, the term was then used to describe the clinical picture of the cyclothymic disorder.
Causes
The exact causes of cyclothymia are not known. It is believed that genetic dispositions or traumatic events lead to their formation. The disorder can occur regardless of the age of the person affected. Stressful experiences or other illnesses are usually responsible for them.
Typical of the cyclothymic disorder is the alternation between hypomanic (slightly elevated basic mood) and depressive episodes. The dynamic fluctuations are either spontaneous or reactive, triggered by specific events. Cyclothymia usually presents itself in late childhood or early adulthood. In some cases, it can last a lifetime. Mood and drive often remain unremarkable for months.
Symptoms, Ailments & Signs
If a depressive phase occurs during cyclothymia, the patient lacks drive. They also suffer from problems falling asleep or staying asleep and problems concentrating. The self-confidence of the affected persons is reduced. They have fewer conversations than they normally do.
In addition, other typical symptoms of depression are noted, such as loss of interest, feelings of guilt, brooding, pessimism about the future and social withdrawal. If a period of high mood occurs, the drive is stronger and the need for sleep decreases. It is not uncommon for the patient’s self-esteem to be more pronounced. You have more conversations than usual and are proving to be unusually creative in your thinking. Some people experience increased sexual desire during the hypomanic episode.
Diagnosis & course of disease
The diagnosis of cyclothymia can only be made when the affected person has had alternating hypomanic and depressive episodes for at least two years. In addition, the symptom-free intervals must not last longer than two months. The hypomanic periods do not result in severe occupational or social impairments.
There is also no hospital stay. Likewise, no psychotic symptoms may occur, because otherwise the conditions for a mixed or manic episode would be present. In such cases, the doctor cannot identify a cyclothymic disorder. The same applies if major depression occurs during the first two years of illness. Delusional or psychotic disorders should also be ruled out.
The symptoms must not be caused by taking medication or drugs. Another important clue is bipolar affective disorders that occur within the patient’s family. An important diagnostic criterion for the doctor is that the mood swings of cyclotyhmia are not usually caused by specific events in the patient’s life.
They usually show up spontaneously. In the differential diagnosis, attention should be paid to adjustment disorders with depressed mood, bipolar disorder, and depressive or dysthymic disorders. Cyclothymia often lasts for several years.
Because patients often mistake them for ordinary mood swings or unchangeable character traits because of their mild manifestation, they rarely consult a doctor. In some cases, cyclothymia is also associated with addictions such as drug or alcohol abuse. A negative course that leads to a bipolar disorder is rather rare.
When should you go to the doctor?
Behavioral problems or sudden changes in the nature of a person indicate a health disorder. The changes should be discussed with a doctor so that the symptoms can be clarified. If you have trouble concentrating, have trouble sleeping or have mood swings, you should consult a doctor. If there is a depressed mood, heavy brooding and a fundamentally negative attitude towards yourself and life, the person concerned needs help. If phases of heightened euphoria and high spirits occur parallel to this in the course of further development, a doctor’s visit is necessary.
If the need for sleep falls to a minimum during these phases, if the self-esteem is greatly increased and if the person concerned shows a very carefree attitude towards life during this time, this indicates the presence of a mental disorder. If those affected experience times of sexual aversion and a few weeks or months later a very intense sexual desire, there is a need for action. Characteristic of cyclothymia is, on the one hand, an apathetic appearance and, on the other hand, behavior that is very risky and irresponsible. If everyday obligations cannot be fulfilled sufficiently, if there is a lack of interest or if there is a strong withdrawal from social life, this is a cause for concern and must be investigated.
Treatment & Therapy
The doctor determines which treatment takes place in the case of cyclothymia individually for the patient. For example, the administration of medication such as antidepressants is possible. However, taking antidepressants is viewed critically. When used alone, it can cause hypomanic or manic symptoms in around 50 percent of all patients. The administration of carbamazepine, valproic acid and lithium is therefore considered a suitable alternative.
In addition, psychotherapy such as talk therapy or behavioral therapy can also be carried out. Another sensible treatment option is awake therapy. In contrast, the use of electroconvulsive therapy to treat the cyclothymic disorder proved to be ineffective. It is important to begin treatment as soon as the diagnosis is made in order to prevent the disease from getting worse.
Prevention
Preventive measures against cyclothymia are not known. The triggering causes of the affective disorder have not yet been fully researched.
Aftercare
The aftercare of cyclothymia is usually carried out by the patient’s family doctor or therapist. Regular discussions between doctor and patient are an important part of aftercare. It is important to determine the causes of the mood swings. For this purpose, it can be useful to look at the patient’s immediate physical relatives, since cases of bipolar disorders occur excessively often in the immediate vicinity of those affected.
The physical and mental state of the patient can sometimes change very quickly, which means that the medication must be adjusted accordingly. Medication discontinuation is an essential part of follow-up care. It is up to the doctor to treat the dissociative disorder with antidepressants or to suggest other therapy methods to the patient.
Since the disorder often lasts for a lifetime, constant observation of the patient is important. In this context, occupational therapies and causal treatment of cyclothymia are also possible. Which follow-up measures are useful and necessary in detail depends on the severity of the cyclothymia and, in particular, on the individual depressive and hypomanic phases. In any case, the patients must be monitored regularly in order to be able to react quickly to changes in behavior.
You can do that yourself
Cyclothymia usually affects those affected for life. For this reason, the patient must know how to deal with the disease in everyday life. The possibilities for this are very individual. There is no general method. The person affected has to find out for himself how he can best cope with his psychological limitations.
Appointments to talk to the treating psychotherapist should definitely be kept. During the sessions, the patient has the opportunity to discuss his or her feelings or experiences with a professional advisor. However, some sufferers find it easier to talk about the disease in an informal environment. In this case, self-help groups are suitable alternatives. A combination of psychotherapeutic approaches and visiting a self-help group is possible. Discussion groups for relatives of those affected are also offered.
The patient needs something in their everyday life that ‘gives them support’ and has a beneficial effect on their illness. Here, too, he must decide for himself what he has personally gained the better experience with. Note for relatives: Some of those affected change social relationships in favor of their own quality of life. This is not a fundamental cause for concern. A temporary distance from the circle of friends is appropriate as long as the person concerned decides to do so voluntarily and perceives the step as a positive change.
