Cyclothymic Disorder (Cyclothymia): Early Signs, Diagnosis, and Treatment
Cyclothymic disorder, also known as cyclothymia, is a rare mood disorder that falls within the bipolar spectrum. Because its symptoms appear subtle and are often mistaken for moodiness, cyclothymia often goes undiagnosed for years.
On this page, you’ll learn what cyclothymia is, its signs and symptoms, and how to manage it.
What Is Cyclothymic Disorder?
People with cyclothymia can go through phases where they feel more cheerful, active, or talkative than usual. This is called a hypomanic phase. It’s followed by periods where they feel sad, tired, or hopeless, which is a mild depressive phase. These shifts happen unpredictably and may last for days or weeks.
Cyclothymic symptoms often come and go over a long period; at least two years in adults, and there’s never a long break where the mood is completely steady. Because the highs and lows are mild, many people don’t realize that what they’re experiencing is actually a mental health condition.
What Triggers Cyclothymic Episodes?
Ongoing pressure from work, family, academic demands, or relationship problems all destabilize mood regulation in individuals with cyclothymia. Acute stressors such as a breakup, job loss, or personal loss can also set off mood shifts.2- Sleep disturbances are another well-documented trigger of cyclothymic disorder. Studies show that disrupted or poor-quality sleep can increase the risk of both hypomanic and depressive symptoms.3
- Seasonal changes and hormonal fluctuations have also been identified to cause mood changes. Some people notice their mood changes become more pronounced during certain times of the year (e.g., winter or early spring), similar to seasonal affective disorder. Then you have hormonal shifts that occur during menstruation, postpartum periods, or menopause. They may influence emotional stability.
- A lack of routine in sleep, meals, or activity levels contributes to emotional dysregulation. This concept, known as “social rhythm disruption,” is based on the idea that the body’s internal clock (circadian rhythm) plays an important role in emotional health.
Signs and Symptoms of Cyclothymic Disorder
Hypomanic symptoms include:
- Periods of feeling unusually energetic, upbeat, or “wired”
- Increased self-confidence
- Needing much less sleep than usual but still feeling rested
- Talking more than usual
- Racing thoughts and jumping quickly between ideas
- Being easily distracted
- Taking on many tasks at once
- Engaging in risk-taking behavior (e.g., impulsive spending or risky decisions)
- Feeling overly reactive to small frustrations
Depressive symptoms include:
- Feeling persistently sad, down, or emotionally empty
- Loss of interest in usual activities
- Fatigue or low energy, even after rest
- Sleeping too much with restless sleep
- Feelings of worthlessness, guilt, or self-doubt
- Difficulty concentrating and making decisions
- Withdrawal from social situations or loved ones
- Tearfulness and feeling emotionally overwhelmed
Cyclothymia vs. Bipolar Disorder
Both conditions involve fluctuations in mood, typically alternating between emotional highs and lows.- The mood symptoms in both disorders are cyclical, meaning they come and go over time rather than remaining constant.
- Cyclothymia and bipolar disorder are part of the same mood disorder spectrum, with cyclothymia considered an “atypical” or less severe presentation.
People with cyclothymic disorder are at risk of developing bipolar I or bipolar II disorder if more severe mood episodes eventually emerge. Some studies suggest that up to 15-50% of individuals with untreated cyclothymia may go on to meet criteria for bipolar disorder.5
So, how do the two differ? Here is a table that outlines the differences between the two disorders:
Feature | Cyclothymic Disorder | Bipolar Disorder |
Severity of mood episodes | Hypomanic and depressive symptoms that do not meet full criteria for hypomanic or major depressive episodes | Fully developed episodes of mania (in bipolar I), hypomania (in bipolar II), and/or major depression |
Functional impairment | Symptoms are milder and chronic, but they can still impair daily life | Episodes are severe and disruptive enough to require hospitalization (especially in mania) |
Duration requirement | At least two years in adults (one year in youth) with ongoing mood shifts and no symptom-free period longer than two months | No minimum duration is required; the diagnosis is based on the presence of one or more full episodes |
Diagnosis timeline | Mood instability is persistent and long-term, but with less extreme peaks | Mood episodes are more episodic and intense, with a clear onset and offset |
Mania/hypomania | Symptoms are subthreshold to qualify as hypomania | Bipolar I includes mania, while bipolar II includes hypomania; both meet full diagnostic criteria |
Depression | Depressive symptoms fall short of major depressive episode criteria | Bipolar I may include major depressive episodes; bipolar II requires at least one major depressive episode |
Cyclothymic Disorder vs. Borderline Personality Disorder
Another major difference between the two is in the nature of the mood shifts. In cyclothymic disorder, emotional highs and lows tend to last for days or weeks and occur in a more rhythmic pattern. These mood changes are not usually triggered by specific events and often appear without warning.
In contrast, the emotional changes seen in BPD are very rapid, i.e., shifting within hours or minutes, and are closely tied to interpersonal stress. These mood swings are intense and come in response to how a person feels they are being treated.
Another difference is in the sense of identity. People with cyclothymia feel emotionally unstable but generally maintain a stable sense of who they are. In BPD, however, there is often a deep and painful struggle with self-image. Individuals feel like they don’t know who they are, changing their values, goals, or appearance frequently. The instability in identity leads to chaotic relationships, as they idealize someone one moment and devalue them the next.6
Impulsive behaviors can occur in both disorders, but in BPD, they are linked with efforts to cope with overwhelming emotions. These behaviors include self-harm, suicidal threats, substance abuse, or reckless spending, especially during emotional crises. People with cyclothymia may also act impulsively during hypomanic phases, but the behavior is more tied to elevated mood than interpersonal distress.
Diagnosing Cyclothymic Disorder
Chronic mood fluctuations. The individual must have experienced numerous periods of hypomanic symptoms and numerous periods of depressive symptoms over at least two years (for adults) or one year (for children and adolescents).- Duration and consistency. During this two-year (or one-year) period, the person must not have gone more than two consecutive months without experiencing symptoms.
- Functional impact. While the hypomanic and depressive symptoms may not be severe on their own, together they must cause significant distress or impairment in social, occupational, or other important areas of functioning.
- Exclusion of major mood episodes. The individual must not have met the full criteria for a major depressive, manic, or hypomanic episode during the first two years of symptoms. If such episodes have occurred, the diagnosis may change to another type of bipolar disorder.
- Not better explained by another mental health condition. The mood disturbances should not be better explained by other mental health conditions such as schizoaffective disorder, schizophrenia, or delusional disorder.
- Not due to substance use or another medical condition. The symptoms should not be caused by the physiological effects of a substance (like drugs, alcohol, or medications) or a general medical condition (such as hyperthyroidism).
How to Manage Cyclothymic Disorder
Maintain a consistent routine. Structure brings stability. Going to bed, waking up, eating meals, and engaging in activities at the same time each day helps regulate your body’s internal clock (circadian rhythm).- Prioritize sleep hygiene.. Poor sleep can trigger both hypomanic and depressive symptoms. Aim for 7-9 hours of quality sleep each night, create a calming bedtime routine, avoid screens before sleep, and so on.
- Track your triggers. Use a mood journal or app to monitor patterns in your emotional highs and lows. Over time, you’ll start to notice what events, people, or habits tend to trigger mood changes, and how early signs show up in your body or behavior.
- Limit digital pressure. Excessive screen time, especially doomscrolling or overstimulating content, affects mood and sleep. Set screen time boundaries and take regular digital detox breaks to recharge your emotional reserves.
- Practice mindfulness and grounding techniques. Deep breathing, body scans, and mindful awareness can help you stay connected to the present moment.
Treatment for Cyclothymic Disorder
It’s true that managing cyclothymic disorder starts with lifestyle changes. But for many people, these strategies alone aren’t enough to fully control the highs and lows. That’s where therapy and medication can provide much-needed structure.
Therapy Options for Cyclothymic Disorder
Cognitive behavioral therapy (CBT) is also well-researched for mood disorders. In CBT, you challenge unhelpful thought patterns that intensify mood swings. You also learn coping strategies to reduce impulsivity, self-doubt, and emotional reactivity.
Then there’s mindfulness-based cognitive therapy, which combines traditional cognitive therapy techniques with mindfulness practices. It teaches people how to observe their thoughts and emotions without judgment to reduce emotional intensity.
Medications That May Be Used
Although cyclothymic disorder symptoms are typically milder than those in bipolar I or II disorder, medication can be used if symptoms are persistent.
Lithium is the classic mood stabilizer effective in reducing the frequency and intensity of cyclothymic symptoms.
Anticonvulsant medications like lamotrigine, valproate, or carbamazepine are also used to stabilize mood. In cases where mood instability is more severe or accompanied by agitation, quetiapine or lurasidone may be prescribed.
Get Help for Cyclothymic Disorder at Mission Connection
If you’re struggling with emotional ups and downs that disrupt your daily life, you don’t have to go through it alone. At Mission Connection, licensed therapists help you understand your symptoms and regain emotional balance.
Our therapists are trained in therapies proven to help mood disorders, and we work with you to build a plan that fits your life. You can get the support you need from the comfort and privacy of your home with online therapy options.
Call us today or get started online.
FAQs
Can Cyclothymic Disorder Go Away on Its Own?
Cyclothymic disorder does not go away on its own. Without treatment, symptoms persist and may progress to bipolar I or II disorder. However, you can achieve long-term mood stability with consistent lifestyle changes, therapy, and, if needed, medication.
Is Cyclothymia Considered a Disability?
Cyclothymia can be considered a disability if its symptoms significantly impair daily functioning, relationships, or work performance.
Is Cyclothymia Inherited?
Yes, cyclothymia can be inherited. Research suggests that there is a genetic link among families with bipolar disorder or other mood disorders. However, environmental factors also play a role in its development.
References
- Bielecki, J. E., & Gupta, V. (2023, July 17). Cyclothymic disorder. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK557877/
- Van Meter, A. R., Youngstrom, E. A., & Findling, R. L. (2012). Cyclothymic disorder: A critical review. Clinical Psychology Review, 32(4), 229–243. https://doi.org/10.1016/j.cpr.2012.02.001
- Song, Y. M., Jeong, J., De Los Reyes, A. A., Lim, D., Cho, C., Yeom, J. W., Lee, T., Lee, J., Lee, H., & Kim, J. K. (2024). Causal dynamics of sleep, circadian rhythm, and mood symptoms in patients with major depression and bipolar disorder: insights from longitudinal wearable device data. EBioMedicine, 103, 105094. https://doi.org/10.1016/j.ebiom.2024.105094
- Perugi, G., Hantouche, E., & Vannucchi, G. (2016). Diagnosis and Treatment of Cyclothymia: The “Primacy” of Temperament. Current Neuropharmacology, 15(3), 372–379. https://doi.org/10.2174/1570159×14666160616120157
- Van Meter, A., Youngstrom, E. A., Youngstrom, J. K., Feeny, N. C., & Findling, R. L. (2011). Examining the validity of cyclothymic disorder in a youth sample. Journal of Affective Disorders, 132(1–2), 55–63. https://doi.org/10.1016/j.jad.2011.02.004
- Perugi, G. (2010). Cyclothymic temperament and/or borderline personality disorder. Annals of General Psychiatry, 9(S1). https://doi.org/10.1186/1744-859x-9-s1-s77
- Porter, D. (n.d.). Cyclothymic Disorder DSM-5 301.13 (F34.0). Theravive. www.theravive.com/therapedia/cyclothymic-disorder-dsm–5-301.13-(f34.0).
- Shen, G. H. C., Sylvia, L. G., Alloy, L. B., Barrett, F., Kohner, M., Iacoviello, B., & Mills, A. (2008). Lifestyle regularity and cyclothymic symptomatology. Journal of Clinical Psychology, 64(4), 482–500. https://doi.org/10.1002/jclp.20440
- Baldessarini, R. J., Vázquez, G., & Tondo, L. (2011). Treatment of Cyclothymic Disorder: Commentary. Psychotherapy and Psychosomatics, 80(3), 131–135. https://doi.org/10.1159/000322234
