cyclothymic

Cyclothymic disorder, also called cyclothymia, is a chronic mood disorder characterized by numerous periods of hypomanic symptoms and periods of depressive symptoms that do not meet the full criteria for a hypomanic/manic episode or a major depressive episode. The symptoms endure for at least two years in adults (one year in children or adolescents) with numerous periods of symptoms and only brief, rare symptom-free intervals.

During hypomanic periods, individuals may experience elevated or irritable mood, increased energy, decreased need for sleep, rapid speaking, and racing thoughts. During depressive periods, they may have persistent low mood, fatigue, changes in sleep or appetite, poor concentration, and feelings of hopelessness. The mood fluctuations are chronic, can impair functioning, and tend to wax and wane over time, but they do not reach the severity of bipolar I or II episodes.

Diagnosis is based on clinical evaluation and history, distinguishing cyclothymic disorder from bipolar disorders by the absence of meeting full criteria for manic, hypomanic, or major depressive episodes. Differential diagnoses include bipolar II disorder, major depressive disorder with atypical features, borderline personality disorder, and attention-deficit/hyperactivity disorder.

Prevalence estimates for cyclothymic disorder range around 0.4% to 1% of the population, with onset typically in adolescence or early adulthood. Risk factors include family history of bipolar disorder and exposure to significant stress; comorbidity with anxiety disorders and substance use disorders is common.

Treatment aims to stabilize mood and improve functioning and often combines psychotherapy—such as cognitive-behavioral therapy or interpersonal and social rhythm therapy—with pharmacologic mood stabilization (for example, lithium or lamotrigine). Antidepressants are used cautiously due to the risk of mood destabilization. Psychoeducation and sleep regulation are important components of care.