Abstract
The Cyclothymic Disorder also known as Cyclothymia is a disorder which has symptoms that resemble a great deal with those of the bipolar disorder except that they are not as extreme. Living with the disorder is not as complicated of a task as it may seem rather in some cases, the patient does not even realize the existence of the disease. It is however not very ideal for the condition to go unnoticed for it has great potential of developing into the most extreme ailment of the Bipolar disorder. The diagnosis could be made simpler by informing the people of symptoms that may suggest bipolar disorder. Therefore, the first step towards identification of the condition starts with the educating of the people. This paper is being written with the same objective in mind.
Introduction
Cyclothymia could be defined as a mental health condition that involves the fluctuation of moods in between depression and ecstasy. These highs and lows are very likely to follow a cycle and in between these two extreme states of mood, the individual may feel very stable and optimistic about his/her condition. The symptoms of the condition are very much similar to that of bipolar disorder. The main difference between the two is that of intensity. The mood swings that relate to cyclothymia are not as extreme as the symptoms of bipolar disorder. Because of the same relationship, cyclothymia if left untreated bumps up the risks of the condition maturing into the bipolar disorder.
Cyclothymia usually develops during the adolescence, but the symptoms are in a number of cases ignored because they do not seem severe enough to take action. Another reason for this ignorance is that the people who actually have the disease function a lot like normal individuals apart from a few mood swings which could be attributed to a number of events in the individual’s life. The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) distinguishes cyclothymia from Bipolar Disorder due to the lack of its full criteria of depression and mania. Our observations also lead us to believe that people who have cyclothymia, later on, develop bipolar I and bipolar II disorders towards the later part of their lives.
Causes
We have not been able to complete plentiful research on the Cyclothymic disorder to know for sure that factors and environmental conditions could lead to the development of the disorder in people. What little research we do however have does suggest a few reasons why this disease surfaces. One of the causes of cyclothymia is genetics. In many families, the disturbance is part of the family genes and in families such as these; the members are at higher risks to develop the mental ailment. The condition could also in a few cases result from the individual’s biochemical process that takes place in the body. From what little we know about the causes of the Cyclothymic Disorder, the mental health professional is also of the opinion that environment conditions like trauma or prolonged periods of stress in an individual could further the development of the disorder.
Symptoms
People who have the cyclothymic disorder usually go through weeks of mild depression which is followed by an episode of manic which more often than not stretches over the course of several days. The depressive symptoms of the disorder present themselves in the form of irritability, aggression, either of the two extremes being insomnia or hypersomnia, weight fluctuation, lack of sexual desire or inability to function sexually, feelings of hopelessness and physical symptoms that cannot usually be explained.
In the condition, depression is followed by prolonged episodes of mania and the symptoms of the mania include unusually high self-esteem, excessive talking or the practice of speaking very quickly, restlessness or hyperactivity, increase in anxiety, going days without sleep without feeling tired, state of increased sexual desire and ability, reckless and impulsive attitude, racing thoughts that are not very organized and the lack of focus. In a few patients, there have also been complaints of the expression of depression as well as maniac symptoms within a very short time of one another.
Diagnosing Cyclothymic Disorder
Since the symptoms of the condition resemble a great deal with a number of mental health tribulations including Bipolar Disorder I, Bipolar Disorder II, depression and a few others, the diagnosis of the condition require the medical professional to see if the symptoms are results of any of these conditions or the Cyclothymic Disorder itself. The diagnosis of the condition involves a number of tests and exams, and the process takes off with a physical exam. This physical exam is carried out in order to determine if there are any medical problems that the patient may be suffering through which might be causing the symptoms.
The physical exam in most cases is followed by a psychological evaluation. In this step of the diagnostic procedure, the psychologist has a discussion with the patient and asks about the patient’s moods, feelings thoughts and the patterns of action. The process may even involve a self-evaluation questioner who has to be completed by the person who is under diagnosis. The process could also be made more efficient by talking to the patient’s friends and family members about his/her moods, feeling, and behaviors. This is a step however which is only taken after the medical practitioner has received permission from the patient for such evaluation. All through the diagnosis, the doctor may keep that patient’s moods chart where his/her actions, responses, moods, and feeling are kept track of by the doctor.
For the purpose of reaching a conclusion on a diagnosis with the Cyclothymic disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) which is published by the American Psychiatric Association provides that psychologists with the following points which if present diagnose a patient with cyclothymia. The first of these five requirements is that the
patient has been through periods of elevated mood as well as periods of depression for at least two years where these mood highs and lows have been occurring, at least, half the time over the course of the two years. The manual also states that the periods of stable mood under the disorder do not usually last for more than two months. So if a patient goes through two months of stability in the mood, Cyclothymia could be taken off the table. The manual further states that the symptoms of a person suffering from Cyclothymia are affected socially by the symptoms of the problem and they affect social performance at work, at school and also at home. In order to classify a disorder as the Cyclothymic Disorder, the doctors also have to make sure that the symptoms are not surfacing because of Bipolar Disorder I or II or due to depression. After ruling our Bipolar Disorder and Depression, the doctor also has to rule our depression of elation from substance abuse or as a result of any medical condition.
Knowing all of these requirements for the purpose of diagnosis means that if a doctor checks all of the five fields during the diagnosis of a patient; that patient could be ruled as suffering from cyclothymia. However, if any of one these conditions does not hold, the person cannot be diagnosed with the Cyclothymic Disorder.
Treatment of Cyclothymic Disorder
There is has not yet been found any cure for cyclothymia. There are however treatments that may help the patient manage the symptoms of the condition. The Cyclothymic Disorder is a chronic condition which stays with the patient throughout his/her life and therefore, the treatment for the disorder is also supposed to be life-long. So if a patient stops taking medication, the symptoms are likely to come back unless the treatment is started back up again. The treatment of
the problem is also crucial because no one wants the condition to progress to Bipolar Disorder. The patients are also warned that the use of drugs and alcohol could also make the symptoms worse.
There are a number of medications that are used to treat Cyclothymia. These could include mood stabilizers like lithium, medications that could prevent seizures; these may include drugs like Divalproex Sodium, lamotrigine, valproic acid and olanzapine. Treatments also involve the use of anti-anxiety medications like a benzodiazepine. These anti-anxiety medications have to be taken alongside mood stabilizers because, on their own, they could result in potentially destructive episodes of mania. Like every other psychological disorder, the Cyclothymic disorder is also where the prescription of medication is also paired with psychotherapy and the two methods of therapy include cognitive-behavior therapy and well-being therapy.
The focus of the Cognitive behavior therapy is to identify and resolve the beliefs and behaviors which may be considered negative by the psychotherapist. The ultimate aim of the exercise is to replace these negative attitudes and through processes with positive ones. The Well-being therapy, on the other hand, fixates on the improvement of the general quality of life, and it does not look at fixing any psychological symptoms. There was a study which revealed that these two therapies, when used in conjunction with one another, could significantly improve the lives of patients who live with the cyclothymic disorder.
Understanding the problem better by looking into a real life example
The cyclothymic disorder is seen to affect the social abilities, and the relationships of the patient and the same could be demonstrated in the case study mentioned as follows. Alice had a history of indulging in relationships that were brief and intense, and she could admit that being her fault for her moods changed quite frequently. During her periods of elevation, she mostly seemed to fall for just another guy and harbored expectations regarding the future of the relationship until the periods of her depression came around once again and she started to assume that there were problems with her lovers.
With every patient, the disorder could make the person erratic in his/her moods and in these moods of escalation or depression they may find themselves making crucial life decisions which they may not even be able to live with once their moods changes. Possible as it may be, living with the disorder is no simple task and functioning normally is a requirement to lead a healthy and stable life.
Conclusion
The Cyclothymic disorder is a condition that can be treated but cannot be cured and the risk with the condition is in its worsening into a condition that is even more serious and harder to manage. It is a condition that seems harmless from afar but the person living through it mostly faces a number of challenges. There is also a problem with treatment that once the person reaches a stage of optimism, it becomes easier to stop. So it requires a great deal of willpower to keep the treatment going.
List of References
Cirino, M. K. (2016, February 11). Cyclothymia. Retrieved from Healthline: http://www.healthline.com/health/depression/cyclothymia#Overview1
Mayoclinic Staff. (2015, June 04). Cyclothymia (cyclothymic disorder). Retrieved from Mayo clinic: http://www.mayoclinic.org/diseases-conditions/cyclothymia/basics/causes/con-20028763
Promises. (2013, September 3). Cyclothymia: A Story of Shifting Moods. Retrieved from Promises treatment centers: https://www.promises.com/articles/mental-health/cyclothymia-a-story-of-shifting-moods/
