Cyclothymic Disorder

Cyclothymic disorder is a mental disorder characterized by mood problems as patients have emotional ups and downs but their symptoms fall short to be considered bipolar type I or II. ^[1]

Epidemiology

Studies show that 0.4 to 1% of Americans have the disorder. Both genders are equally affected. The onset is typically hard to determine but most symptoms are initially noted during adolescence or early adulthood. ^[2]

Causes

The exact cause is unknown. Most are linked to genetics. As with other mood disorders like major depression and bipolar disorder, patients with cyclothymic disorder often have a relative who is diagnosed with mental disease. The patients also frequently have history of major depression, suicide or dependence to a substance like alcohol or illicit drugs. ^{[2] [3]}

Signs and Symptoms

Patients experience mood shifting in an irregular and unpredictable pattern. When the person has a high mood or in the hypomanic phase, symptoms include extreme optimism, rapid speech, inflated happiness, too much spending, aggression towards others, difficulty concentrating, increased sexual drive, decreased sleep hours and excessive physical activity. When the person has a low mood or in the depressive phase, symptoms include hopelessness, suicidal thoughts, fatigue, decreased libido, sleep and appetite problems, apprehension and loss of interest in activities considered enjoyable before. The manifestations are less severe than in bipolar disorder. Patients experience the symptoms for at least two years with no 2 symptom free months. Pediatric patients may have different diagnostic criteria. ^{[4] [5]}

Diagnosis

The symptoms especially the mood patterns are reviewed by getting the patient’s history. Physical examination and laboratory tests like blood and urine exams may be requested to rule out other possible medical causes. ^[5]

Treatment

Most symptoms are mild therefore patients do not seek medical advice and thus the disorder is frequently undiagnosed. In diagnosed cases, mood stabilizing medications like lithium may be given. Antidepressants are not commonly prescribed unless the patient develops a full major depression. Some may benefit with talk therapy or combination of different treatment modalities. In some cases, cyclothymic disorder disappears with time while in some, it progresses to bipolar disorder. ^{[2] [5]}

References:

1.      http://www.mayoclinic.com/health/cyclothymia/DS00729

2.      http://www.webmd.com/bipolar-disorder/guide/cyclothymia-cyclothymic-disorder

3.      http://bodyandhealth.canada.com/channel_condition_info_details.asp?disease_id=271&channel_id=1053&relation_id=28250

4.      http://www.mayoclinic.com/health/cyclothymia/DS00729/DSECTION=symptoms

5.      http://www.nlm.nih.gov/medlineplus/ency/article/001550.htm