Anyone who's ever suffered from mood swings knows how disruptive they can be. One minute you're going about your day, lively and productive—the next, your mom says that thing to you again and you’ve fallen into a pit of melancholy so intense, it makes Morrissey look positively sanguine.
But after a friend of a friend was diagnosed with a mood disorder called cyclothymia, a mild form of bipolar, we wondered: When are mood swings more than mood swings? When do they point to a more serious condition?
We spoke with mental health professionals about cyclothymia, which affects at least one percent of the population (though probably more, since cases go undiagnosed). Here’s what we learned.
What is cyclothymia?
Cyclothymia is a mild mood disorder that causes emotional ups and downs. One minute you feel on top of the world, the next you’re struggling to make it through the day. The Mayo Clinic offers a detailed list of cyclothymic symptoms.
And that’s about as straightforward as it gets. Seriously, it only gets more complicated from there.
How is it different from bipolar disorder?
Cyclothymia is in the same family as bipolar disorder, but the symptoms don't always meet the criteria for full-blown hypomania or depression—in other words, the highs aren’t always as high and the lows as low. The fluctuations are also more frequent than bipolar fluctuations: lots of little mood swings.
Cyclothymia can develop into bipolar disorder over time. The earlier you seek help for the condition, the better you can manage its trajectory.
How is it different from a personality disorder?
While cyclothymia is a mood disorder, some people simply have a “cyclothymic personality”—putting it on the spectrum of personality disorders.
Igor Galynker, director of the Family Center for Bipolar Disorder at Mount Sinai Beth Israel in New York, told Fusion that he finds referring to the condition as a “cyclothymic temperament” useful. The line between personality and mood disorder is often blurred, he said, and it takes some finesse to recognize the difference between the two.
“Some people are just upbeat.” Galynker says, “Some are more dysphoric and withdrawn. And some are cycling. It’s hard to tell if a person has cyclothymic personality disorder, which is entirely reactive, or if it’s more related to mood swings, which is not related to what is happening in life.”
Who does the disorder affect?
As we mentioned, about one percent of the population lives with cyclothymia, and it usually develops in the teens or early-to-mid twenties. Men and women are equally affected.
Is cyclothymia underdiagnosed?
Yes, the experts we spoke with said cyclothymia is vastly underdiagnosed. One reason? There simply isn’t much research on cyclothymia. And part of why there isn’t much research is because cyclothymia isn’t considered as disabling as more severe forms of bipolar disorder. On top of that, recognizing any mood disorder isn’t always a piece of cake.
With cyclothymia—and even bipolar—most patients tend to seek help in treating the depressive symptoms. As Scott Woodruff, a postdoctoral fellow at the American Institute for Cognitive Therapy, explained: “You’re less likely to go when you’re actually finding yourself to be unusually productive or unusually energetic.” In other words: You seek help when you’re feeling depressed, so that’s what’s treated.
What does treatment look like?
Treatment generally involves psychotherapy, medication, and regular follow-up visits with a doctor.
How do you recognize a mood disorder in yourself?
Recognizing mood disorders is all about objectivity—something that is easily compromised when you have a mood disorder. Bit of a catch 22, no? Welcome to mood disorders.
A big hurdle is being able to distinguish what is clinical and what is situational. Andrew Solomon, who chronicled his struggles with depression in the New York Times bestseller The Noonday Demon, explained to Fusion that “the natural tendency is to presume that your moods are responsive to situations—and of course, to some degree, they are responsive to situations. When things are going really well, you’re in a better mood than when things are going really badly.”
He continued: “But your ability to determine objectively the relationship between what is happening in your life and what you feel is a skill that anyone who has cyclothymia or bipolar disorder and unipolar depression has to work really hard on. There is a constant self-monitoring going on.”
Both Solomon and Galynker also recommend listening to friends and family. They are invested in your well-being and can honestly and objectively identify shifts in your behavior. So if a friend tells you you’ve been unusually downhearted or even unusually upbeat lately, hear him or her out.