When we speak of cyclothymia or say that an individual has cyclothymic personality traitsPerhaps we are falling into frivolity, since cyclothymia, also known as cyclothymic disorder, is a disease. This pathology causes emotional ups and downs with elevated moods (hypomanic symptoms) and mild or moderate depressive symptoms. This ’emotional roller coaster’ is similar to that which occurs in bipolar disorder but less severe. In general, people who suffer from cyclothymia can lead a more or less normal life. However, it is important to ask for help, because it can get worse.
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What is cyclothymia?
As Alba Sanz, a psychologist at MundoPsicólogos, explains, cyclothymia is a disorder characterized by periodic and cyclical changes in our mood, thus making it very unstable. In it we go from a mild state of euphoria, hypomania or hyperthymia, to a mild state of dysthymia or depression, without knowing how long each of them will last.
The most depressive phase is characterized by low energy to do daily activities, recurrent thoughts of self-criticism, feelings of hopelessness, feelings of guilt and worthlessness, fatigue, pain in different parts of the body, and, during this state, they can reach generate suicidal ideas.
On the contrary, continues Alba Sanz, the euphoria phase is characterized by great impulsiveness, an exaltation of sexuality, a feeling of excessive self-esteem, irritability, reduced attention and inability to concentrate, a feeling of having many ideas in a very short time, or reduced sleep. This disorder, according to the Diagnostic Manual of Mental Illnesses, has a prevalence in 1% of the population, is rare and usually develops in adolescence and early adulthood.
Changes in mood vs. cyclothymia
As explained by Dr. José Manuel Montes, head of the Psychiatry Section of the Ramón y Cajal Hospital and psychiatrist of the Mind Area of Blue Healthcare. “We all have mood variations depending on external circumstances. However, when these occur independently of what happens in the environment, and in a cyclical and repeated way, we are faced with a disorder “. Thus, people who have cyclothymia experience changes in your mood that may not affect your life or cause changes noticeable to othersBut these individuals do perceive, notice, and eventually fluctuate. On many occasions, these changes can be associated with the change of season.
As the specialist in psychiatry insists, people around the cyclothymic person may not perceive these changes in mood. “It is the patient who notices it, but is capable of modulating these variations, for example, he can manage this increase or decrease in vitality and energy, so that it does not affect his life situation or others”.
Therefore, it is incorrect to think that cyclothymia is common in people, since it is an ailment. On the other hand, variations in mood due to external circumstances (a move, more stress, a work problem, a conflict with a partner, etc.) can be something habitual and normal, since “it is an understandable situation of adaptation and of emotional response to a vital situation. As long as it is not maintained for a long time ”, recalls Dr. José Manuel Montes.
The psychologist Alba Sanz adds that our life is a sway of emotions, we feel emotions at every moment, these emotions are necessary for our survival and allow us to adapt to different situations that arise, this means that any experience or context can generate certain emotions, in order to know how we can react or which it would be the most effective response at that time and change as soon as a new situation arises. In addition, there are emotions that prevail longer because we have a tendency to leave difficulties behind by feeling that we do not have the tools to face them, or by not giving ourselves that space to do it, which makes the situation not solved, an emotion that is in our lifetime. These emotional changes tell us that we are alive and in a constantly changing context to which we are simply adapting.
We notice the difference between cyclothymia and the emotional changes that come from the examples above, first of all, because the emotions, without this disorder, are not so intense in both poles, We can be sad for a long time, stressed, irritable, but we do not usually go from excessive self-esteem, impulsivity and sexual hyperactivity to a depressed state. Second, it does not usually occur in a cyclical and recurring way. To get an idea of how it is diagnosed, we would need to be observed for at least one or two years, to clarify whether it is this disorder or not.
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The prelude to bipolar disorder
Cyclothymia is also the prelude to bipolar disorder. “A very high percentage of patients with bipolar disorder report having suffered these changes, usually since adolescence, before debuting with this pathology”, clarifies the specialist. On the other hand, the psychiatrist warns, these mood swings without just cause can occur in the patient with cyclothymia for many years, even decades. “These cyclothymic people have a high probability of suffering from bipolar disorder, a disease that could appear, in fact, at the age of 70, for example.”
For this reason, the head of the Ramón y Cajal Psychiatry Section recommends that if a person recognizes these symptoms, that is, they have mood swings not related to external circumstances and which may be seasonal, they go to a doctor to comment.
As Alba Sanz explains, cyclothymia has symptoms that can be very similar to those that occur in bipolarity, especially in type II, these being, for example, a feeling of guilt, difficulty concentrating, reduced sleep, passing from states of happiness, depressives, irritability or suicidal thoughts. The difference exists in that in the case of cyclothymia the symptoms are milder, they are not disabling, for this reason, people who experience it do not tend to ask for help, depressive symptoms are not usually perceived as serious, and In moments of mania, when feeling that false sense of well-being, one does not usually go to a professional. Another difference is that in cyclothymia there are usually no hallucinations or psychotic characteristics.
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Diagnostic criteria for cyclothymia
According to DSM-5, the manual for the diagnosis and statistics of mental disorders published by the American Psychiatric Association and which serves as a reference for a medical assessment, these would be the aspects to take into account to suspect that a person suffers from cyclothymia:
- You have suffered periods in which you have had accelerated moods (with a lot of energy and vitality) and others with depressive symptoms. These ups and downs have been going on for at least two years.
- The periods in which your mood has been stable have lasted less than two months.
- The symptoms you refer to do not meet the diagnostic criteria for bipolar disorder, major depression, or mental disorder.
- The symptoms you suffer from are not the product of substance use or another illness.
To confirm the diagnosis, your doctor or other health professional will probably do several tests:
- A physical exam. Examination and clinical analysis.
- A psychological evaluation. To know your feelings, your thoughts and your behavior patterns. It is also possible that, with your consent, they talk with family members or people around you.
- Documentation of your moods. Recording your emotions, how you are feeling, your sleep patterns or other factors can help establish a diagnosis of what is happening to you.
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As Dr. Montes explains, the treatment is aimed at manage these mood swings and prevent the factors that can lead to the onset of bipolar disorder, since, as we said, cyclothymia has a high risk of becoming this mental illness.
It also seeks to reduce the frequency and severity of symptoms so that the person suffering from cyclothymia has a more balanced life.
Likewise, since these mood alterations can favor the consumption of substances or alcohol, treatment also seeks to reduce this risk and, if there is one, to treat an addiction problem, since it can aggravate the symptoms.
“Treatment to avoid these mood swings, which are conditioned by an alteration of the mood regulatory center in the brain, may require the prescription of medicines called mood stabilizers. In addition, psychotherapy, generally based on cognitive behavioral psychology, it can also help to identify the causes that favor these variations in order to introduce strategies to deal with them “, indicates the expert.
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Also, patients can adopt healthy lifestyle habits to improve these ups and downs. Some of them can be:
- Eat a balanced, healthy and varied diet in which fresh foods predominate. Avoid processed and ultra-processed ones, as well as reduce the consumption of salt, sugar or soft drinks.
- Avoid the consumption of alcohol and other toxins such as drugs
- Improve sleep habits, stay up late and take measures to promote deep sleep and restful sleep
- Do moderate and regular physical exercise since physical activity is a good measure to stabilize the mood, because they secrete brain chemicals that help you feel better and sleep well.
- Complete the exercise with relaxing activities. They can be disciplines such as yoga, tai chi or meditation, as well as others such as equine therapy, painting, crafts, etc.
- Keep track of emotional ups and downs. This will help the patient to be more aware of mood swings and the doctor to make a diagnosis.
- Avoid shift jobs and, above all, those that involve working at night.