Cyclothymia
A chronic bipolar disorder consisting of short periods of mild depression and short periods of hypomania (lasting a few days to a few weeks), separated by short periods of normal mood. Individuals with cyclothymia (thymia: from the Greek word for the mind) are never free of symptoms of either depression or hypomania for more than two months at a time. In 1980 the classification of cyclothymia was changed in the DSM-IV from Personality Disorder to Mood Disorder.
Though the above description portrays cyclothymia as a mild disorder, it is so only relative to the severity of Bipolar I and Bipolar II disorders. Cyclothymia can completely disrupt the life of an individual and create personal chaos. In their continual oscillation of mood, they never know from one day to the next what to expect.
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Dysthymic phase
Difficulty making decisions; problems concentrating; poor memory recall; guilt; self-criticism; low self-esteem; pessimism; self-destructive thinking; continuously feeling sad; apathy; hopelessness; helplessness; irritability; quick temper; lack of motivation; social withdrawal; appetite change; lack of sexual desire; self-neglect; fatigue or insomnia
Euphoric phase
Unusually good mood or cheerfulness (euphoria); Extreme optimism; Inflated self-esteem; Poor judgment; Rapid speech; Racing thoughts; Aggressive or hostile behavior; Being inconsiderate of others; Agitation; Increased physical activity; Risky behavior; Spending sprees; Increased drive to perform or achieve goals; Increased sexual drive; Decreased need for sleep; Tendency to be easily distracted; Inability to concentrate
In a word cyclothymia seems to sabotage a person's opportunity for a stable life.
This so-called mild form of bipolar is no laughing matter.
Living With Cyclothymia
Cyclothymia may wreak havoc on the personal lives of people with the disorder. Unstable moods frequently disrupt personal and work relationships. People may have difficulty finding a life partner, instead moving through a series of passionate, short-lived romances. Impulsive behavior can be self-destructive and lead to legal problems.People with cyclothymic disorder are also more likely to abuse drugs and alcohol. As many as 50% of people with cyclothymia may also have a problem with substance abuse.
Over time, people with cyclothymia are at increased risk of developing full-blown bipolar disorder. Limited data suggests they are at higher risk of suicide. Treatment with mood stabilizers reduces this risk.
Cyclothymic Personality Disorder as a pervasive pattern of pronounced periodic changes in mood, behavior, thinking, sleep, and energy levels, beginning by early adulthood and present in a variety of contexts, as indicated by seven (or more) of the following:
- has depressive periods: depressed mood or loss of interest or pleasure in all, or almost all, activities and pastimes alternating with hypomanic periods: elevated, expansive, or irritable mood
- becomes excessively involved in pleasurable activities with lack of concern for the high potential of painful consequences alternating with restriction of involvement in pleasurable activities and guilt over past activities
- alternates between over-optimism or exaggeration of past achievement and a pessimistic attitude toward the future, or brooding about past events
- is more talkative than usual, with inappropriate laughing, joking, and punning: and, then, less talkative, with tearfulness or crying
- has a decreased need for sleep alternating with hypersomnia
- has shaky self-esteem: naive grandiose overconfidence alternating with lack of self-confidence
- has periods of sharpened and creative thinking alternating with periods of mental confusion and apathy; displays marked unevenness in the quantity and quality of productivity, often associated with unusual working hours
- engages in uninhibited people-seeking (that may lead to hyper-sexuality) alternating with introverted self-absorption
- frequently shifts line of work, study, interest, or future plans
- engages in occasional financial extravagance
- has a tendency toward promiscuity, with repeated conjugal or romantic failure
- has irritable-angry-explosive outbursts that alienate loved ones ;
- makes frequent changes in residence or geographical location.
High Neuroticism
Chronic negative affects, including anxiety, fearfulness, tension, irritability, anger, dejection, hopelessness, guilt, shame; difficulty in inhibiting impulses: for example, to eat, drink, or spend money; irrational beliefs: for example, unrealistic expectations, perfectionistic demands on self, unwarranted pessimism; unfounded somatic concerns; helplessness and dependence on others for emotional support and decision making.
Low Extraversion
Social isolation, interpersonal detachment, and lack of support networks; flattened affect; lack of joy and zest for life; reluctance to assert self or assume leadership roles, even when qualified; social inhibition and shyness.
Low Openness
Difficulty adapting to social or personal change; low tolerance or understanding of different points of view or lifestyles; emotional blandness and inability to understand and verbalize own feelings; alexythymia; constricted range of interests; insensitivity to art and beauty; excessive conformity to authority.
High Agreeableness
Gullibility: indiscriminate trust of others; excessive candor and generosity, to detriment of self-interest; inability to stand up to others and fight back; easily taken advantage of.
Low Conscientiousness
Underachievement: not fulfilling intellectual or artistic potential; poor academic performance relative to ability; disregard of rules and responsibilities can lead to trouble with the law; unable to discipline self (e.g., stick to diet, exercise plan) even when required for medical reasons; personal and occupational aimlessness.
Motivations
Want to be free to pursue creative, artistic, and other individualistic pleasurable activities while still getting dependency needs satisfied.
Behaviors
Decreased effectiveness or productivity at school, work or home; increased productivity, often associated with unusual and self-imposed working hours; Social withdrawal; uninhibited people-seeking (extreme gregariousness); hypersexuality without recognition of possibility of painful consequences; loss of interest in or enjoyment of sex; tearfulness or crying; inappropriate laughing, joking, punning; Excessive involvement in pleasurable activities with lack of concern for the high potential for painful consequences, e.g., buying sprees, foolish business investments, reckless driving. Irritable-angry-explosive outbursts that alienate loved ones; episodic promiscuity; repeated conjugal or romantic failure; frequent shift in line of work, study, interest or future plans; resort to alcohol and drug abuse as a means for self-treatment or augmenting excitement; occasional financial extravagance
Cognitive Effects
Periods of low self-esteem alternating with periods of inflated self-esteem; pessimistic attitude toward the future or brooding about past events alternating with over-optimism or exaggeration of past achievements; decreased attention, concentration, or ability to think clearly alternating with periods of sharpened and unusually creative thinking. Brooding or obsessive rumination
Cyclothymic Personality: "Such individuals are characterized by an extratensive and outgoing adjustment to life situations; and apparent personal warmth, friendliness, and superficial generosity; an emotional reaching out to the environment; and a ready enthusiasm for competition. Characteristic are frequently alternating moods of elation and sadness, stimulated apparently by internal factors rather than by external events. The individual may occasionally be either persistently euphoric or depressed, without falsification or distortion of reality."
The cyclothymic person functions according to an all-or-none principle. His elation and sadness are related to anticipatory states. When positive anticipation prevails, the laws of probability are discarded, and he acts as if failure or disappointment were not among the possible outcomes of an enterprise or a hope. Suggestions of risk and pleas for caution are good-naturedly rejected. As the dangers of disappointment become more apparent there is often a further elevation of mood as if to deny the danger.
The total positive anticipation turns to total negative anticipation when an obstacle is encountered or a disappointment is experienced. In the negative anticipation phase, obstacles are overemphasized, disappointment appears inevitable, and a sense of impotence and doom prevails.
When gross falsification or distortion of reality attends the extremes of elation or sadness, the cyclothymic label is no longer applied, and the term manic-depressive psychosis is used to describe the current state and its development. The patient can be helped by a psychotherapeutic approach in which he is encouraged to explore dangers, obstacles, and potential disappointment, and to learn new responses to them.
"Cyclothymic personality is defined here in terms of the basic response characteristics of low novelty seeking, low harm avoidance, and high reward dependence, which are associated with the second order traits of being scrupulous and usually hyperthymic but gullible and vulnerable to frustration and rejection. Such individuals are warm and socially sympathetic but highly self-confident authoritarians. Although they are usually cheerful and optimistic, they are also moody or dysphoric in response to being cheated or rejected. This corresponds closely to classical descriptions of cyclothymic personality.
"However current criteria in the DSM-III and ICD do not strictly distinguish between such a stable temperamental variant and mild endogenous mood disorder without the associated temperamental variant. In fact, in the DSM-III, cyclothymic disorder is listed only with affective disorders, not personality disorders. Reliable methods are available for identifying a broadly defined group of individuals with subclinical affective disorders. However, it should be possible to distinguish between personality disorder defined here and mild affective disorders without the associated personality variant. Individuals with the personality variant should have other personality traits that are not necessarily associated with mood disturbances. For example, the cyclothymic personality should be associated with being frugal (low novelty seeking) and persistent (high reward dependence), with the dysphoric states being reactive to frustrative loss or expected rewards, rather than autonomous."
Cyclothymia
Cyclothymia is a Greek word which means cycles of mood. In this condition, mood goes up and down throughout a person’s life. Cyclothymia can occur alone or with other mood disorders.
When it occurs alone, cyclothymia causes people to have brief mood swings that last days to weeks. The moods they can cycle through include:
Depression: feeling down, sad, unmotivated, fatigued, self-critical, hopeless. In this state people usually want to be alone, stay in bed, and may crave carbohydrates.
Dark Hypomania: irritable, edgy, impulsive, anxious, distracted, dissatisfied, trouble sleeping. In this state people may act recklessly or self-medicate with drugs, alcohol or nicotine.
Bright Hypomania: energized, happy or euphoric, filled with plans or creative ideas, talkative and outgoing, not needing much sleep. In this state people may be very productive and charismatic, spreading their excitement to others. Many things about bright hypomania are desirable. On the negative side, its overconfidence may lead to unwise decisions and the hyper-energized state may cause conflict with others.
Cyclothymia also known as cychlothymic disorder and chronic bipolar disorder is a persistent instability of mood characterized with frequent periods of mild elation (hypomania) and mild depression.
Hypomania also known as a hypomanic state is the mildest degree of mania characterized with optimism, euphoria and tireless activity and uninhibited behavior. There are two sides to hypomania. One is exiting and can be positive (bright side) and the other can be exiting but it is usually negative (dark side) "Bright side" of hypomania: When in this state a person has a lot of energy, many ideas and is able to work without taking a break.
This is why hypomania is sometimes called "an artistic disorder". Aside from being a hard worker a person can also be very charming and entertaining, which makes him or her a perfect date.
"Dark side" of hypomania: Due to the uninhibited behavior, a person in this state can act in impropriate and embarrassing way. They can be mean and offensive to people around them. In addition, a person can be preoccupied with unrealistic schemes and solutions to problems which result is ignoring anything else including job, spouse or children.
