Cyclothymic Disorder: Symptoms, Causes & Management

Definition

A chronic mood disorder with numerous periods of hypomanic symptoms and depressive symptoms that do not meet full criteria for bipolar I/II or major depression. Symptoms persist for ≥2 years (1 year in adolescents).

Symptom Clusters

Hypomania (≥2 days)

  • Elevated/expansive mood
  • Increased energy/activity
  • Pressured speech, racing thoughts
  • Decreased need for sleep
  • Impulsivity, risk-taking
  • Inflated self-esteem

Depression (≥2 days)

  • Sadness, hopelessness
  • Anhedonia
  • Appetite/sleep changes
  • Fatigue, poor concentration
  • Worthlessness, guilt
  • Suicidal ideation

Treatment

  • Psychotherapy (CBT, interpersonal, psychoeducation).
  • Mood stabilizers (lithium, lamotrigine, valproate) or atypical antipsychotics.
  • Antidepressants used cautiously (risk of switching).

Outlook

With treatment, many achieve symptom control and functional improvement. Ongoing monitoring is essential.

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