Program & Services

Cyclothmia

Basics

People who have cyclothymia (sigh-clo-thigh-mee-uh), have huge mood swings. They have very high highs and very low lows. There may be calm times in between. People can have these ups and downs on an ongoing basis. They usually don't go for more than two months without a mood swing.

Until 1980, people with were thought of as having an uneven temper. We now know it's a milder form of bipolar disorder. The mood swings are not as wide.

This problem happens to small number of people (about one percent). For these people, life can be hard. It disrupts moods, sleep, work and your health. It makes it hard to deal with others. The high can feel great, but the gloom that follows is a heavy price to pay.

It's almost like the way a toddler acts. Happy, then mad then happy again. But dealing with a grown up toddler can be stressful. The roller coaster of moods can make life hard for everyone.

If you think you or a loved one has cyclothymia, seek help.

Symptoms

• Going to sleep with an almost superhuman feeling of confidence
• Waking up the next morning tired and unable to get going
• Striking out with anger when someone tries to stop a desire or impulse
• Starting a project but not seeing it through.
• Not being there for your child or spouse because you're either too high or too low.

Cyclothymia strikes men and women. It can begin the teens or early 20s. Many can end up with manic-depression (bipolar disorder).

The up feelings can be great. But it takes its toll. The things the person does during this time can bring trouble for loved ones and co-workers. The person may go on careless spending sprees. They may act inappropriately with the opposite sex. Soon though their mood swings to feeling low.

Be ready to spot the signs of a mood upswing:

• A distinct period of elevated or irritable mood
• Inflated sense of self-esteem or grandiosity
• Less need for sleep
• Incessant chatter
• A flight of ideas, racing thoughts
• Distraction and poor judgment
• Increase in goal-directed activity
• Overindulging in pleasurable activities with bad consequences

A mood down swing soon follows for those with cyclothymia. The low isn't bad enough to go to the hospital, but it can cause serious problems. The depressed person is tired, on edge, and very down.

Treatment

People with cyclothymia have problems with their brain chemistry. They need medicine. However, people with cyclothymia may also have other problems. So, don't assume medicine alone will be the only care they need. It may be best include talk therapy. This can teach them problem solving and self-control.

Lithium carbonate is the most common medicine for cyclothymia. Over half of those who take it have reduced symptoms and less frequent mood swings.

Some people taking lithium have side effects like trembling hands, nausea and weight gain. The side effects will decrease as the body gets used to the medicine. And the good effects keep increasing.

Low doses of the anti-convulsants valproate (Depakote) and carbamazepine (Tegretol, Carbatrol) help, too. People are at a higher risk to get depressed with these medicines. But the side effects are usually mild.

Some people may need more than medicine. They may also need help in dealing with others when a mood swing is coming. Such as, if the person is becoming really talkative, he can find something quiet to do. He can take the phone off the hook to keep from calling friends late at night.

It's important for families to be a part of the person's care. Counselors can show family members, partners and friends how to give support. �The person with cyclothymia needs to think of others. He may have pushed them to their limits with his actions. Everyone must know that it's important for the person to keep getting care.

FAQs

I found out I have cyclothymia. My wife was fed up with the way I was acting and said she'd leave me if I don't get help. But I'm worried about the medicines. Do they have serious side effects?

You may not like the possible side effects. But leaving your condition untreated can do far more damage in the long run.

With the help of a counselor and your wife's support, you can find the right medicine and care. But don't stop taking the medicine just because you feel better. Even counseling alone may help keep your marriage from being damaged beyond repair. While you may think your highs are fine, your wife doesn't.

My wife has had cyclothymia since she was 18. She has taken medicine for many years. We are planning our first child. Should she stop her medicine?

Many providers think it may be risky for women to be on certain medicines when they are expecting. But there could be a risk if she stops taking her medicine. This risk can include suicide. There is no simple answer. You need to talk with your wife's doctor.

Women with cyclothymia have a higher risk for mood swings in the first three months after the baby is born. Taking medicine at the time of delivery will reduce this risk. Use caution though when taking medicines while pregnant. There's a much higher rate of birth defects found in babies whose mothers took certain medicines for cyclothymia while pregnant.

You and your wife should talk with her providers to determine the best plan. They may find a way to help her build coping skills. This may include reducing her activities. She may be able to ward off trouble without using medication.

Since starting college several months ago, my daughter has been acting odd. She goes from being full of energy, to being tired and grouchy. Some of the things she says sound strange, too. She says she's not on drugs. But I'm worried. What's wrong with her? What should we do?

Your daughter may be showing the early signs of cyclothymia. Or maybe it could be a more serious bipolar disorder. Stress such as starting college has been known to bring on mood problems. This is even more the case if she has shown signs of mood problems in the past or if there is a family history. �

She may need to see a doctor. If she doesn't want to go, keep trying. Give her time. Help her to accept that she has a problem and not to be embarrassed.

My friend just got out of the hospital. He tried to commit suicide. He says he has cyclothymia. He says it's not serious. Is he right?

No. He is either mistaken or trying to mislead you. A suicide attempt indicates a serious illness. The person needs long-term care including medicine.

Resources

Books

Mondimore, Francis Mark, Bipolar Disorder: A Guide for Patients and Families. Johns Hopkins Press Health Book, 1999.

Whybrow, Peter C., M.D., A Mood Apart: the Thinker's Guide to Emotion and its Disorders. HarperCollins, 1998.

Jamison, Kay Redfield, An Unquiet Mind: A Memoir of Moods and Madness. Random House, 1997.

Agencies

National Mental Health Association
2001 N. Beauregard St., 12th Floor
Alexandria, VA 22311
(703) 684-7722
(800) 969-NMHA (6642) (automated information line)
www.nmha.org

Depression and Bipolar Support Alliance
730 N. Franklin St., Suite 501
Chicago, IL 60610-3526
(800) 826-3632
www.ndmda.org

Web Site

The National Institute of Mental Health offers a useful primer with information about diagnosis, symptoms and treatment of specific disorders at: http://www.nimh.nih.gov/publicat/index.cfm