## Definition - A chronic mood disorder characterized by alternating periods of **[[Hypomania|hypomanic symptoms]]** and **mild [[Depression|depressive symptoms]]**. - Symptoms do not meet full criteria [[Bipolar Disorder]] - Considered part of the Bipolar Spectrum ## Core Features - Fluctuations between: - **[[Hypomania|Hypomanic symptoms]]**: increased energy, elevated mood, irritability, decreased need for sleep, impulsivity - **Mild [[Depression|depressive symptoms]]**: low energy, sadness, hopelessness, poor concentration - Mood swings are **less severe** than those in full [[Mania|manic]] or [[Depression|major depressive]] episodes. - Duration: **At least 2 years** in adults; **1 year** in children/adolescents. - Symptoms present for **at least half the time**, with no symptom-free period longer than **2 months**. ## Diagnostic Criteria ([[DSM-5]]) - Numerous periods of [[Hypomania|hypomanic]] and [[Depression|depressive]] symptoms over 2+ years. - Symptoms cause **clinically significant distress** or impairment. - Criteria for [[Depression|major depression]], [[Mania|mania]], or [[Hypomania|hypomania]] have **never been fully met**. - Not better explained by another mental disorder or [[Substance Use Disorder|substance use]]. ## Common Traits - Chronic instability of mood - Erratic interpersonal relationships - Periods of increased productivity followed by withdrawal and fatigue - May appear as a "moody" or "temperamental" personality to others ## Differential Diagnosis - [[Bipolar Disorder|Bipolar I Disorder]] - [[Bipolar Disorder|Bipolar II Disorder]] - [[Borderline Personality Disorder]] - [[ADHD]] (if mood instability is mistaken for attentional issues) ## Treatment - **[[Psychotherapy]]**: [[CBT]], interpersonal therapy, psychoeducation - **[[Medication]]** (less standardized than for [[Bipolar Disorder|bipolar I/II]]): - [[Mood Stabilizers]] (e.g., [[Lithium]], [[Lamotrigine]]) - [[Atypical Antipsychotics]] - Lifestyle: routine, sleep hygiene, stress reduction ## Prognosis - Often persists long-term without treatment - Increased risk of developing [[Bipolar Disorder|bipolar I]] or [[Bipolar Disorder|bipolar II]] - Better outcomes with early recognition and management ## Notable Quotes - "Cyclothymia is to [[Bipolar Disorder|bipolar disorder]] as [[Dysthymia]] is to [[Depression|major depression]]." ## References - American Psychiatric Association. (2013). _DSM-5: Diagnostic and Statistical Manual of Mental Disorders_. - Akiskal, H. (1996). _The cyclothymic temperament as a predisposing factor to bipolarity_.