Cyclothymia: A Story of Shifting Moods
Alice tracked her life in moods—she was happy and productive, super productive, in the spring when she met Charlie; irritable and depressed in the summer, even though the weather was so lovely and warm; and fine again until Christmas when all hell broke loose with the stress of the holidays. But she thought that was normal; wasn’t everybody a little moody sometimes? She liked to think she just had a “sensitive temperament”—life could be hard. But she wasn’t “crazy.” It’s not like she’d ever been hospitalized or anything.
Still, when Alice looked back, she could see that she fit a certain description. She did have a history of “brief, intense relationships” and if she was honest, she might admit to having frequently “projected her issues” onto her lovers, accusing them of being angry, moody and emotionally unstable. She tended to fall hard for someone during one of her upbeat periods, feeling each time that she had finally met “the one.” Then after only a short while her agitation or depression would return and rather than acknowledge its perennial nature, she’d assume the problem was with her lover—everything was going badly because of him, not her mercurial moods.
She’d had more than one affair, often finding someone new while still involved. Alice didn’t like to admit that she didn’t want to be alone, but who did? And there was her history of “hypersexuality,” but she liked to think of herself as a free spirit and a “sexually liberated feminist.” She could sleep with whomever she liked as often as she liked; it was no one’s business but her own. The problem was that when she came down from the days or weeks of frenzied mood and risky behavior, when everything had seemed so fun and exciting, she often felt miserable, and sometimes ashamed. She didn’t recognize herself in the mirror at those times, and she couldn’t understand how she’d only days before been so carefree and uninhibited.
Then there was the matter of her careless spending. She tried so hard to be frugal with money; she didn’t make a lot and she knew well the value of a dollar. But there had always been these periods when she seemed to lose all rationality; it was like “Invasion of the Body Snatchers,” or wallet snatchers, if you will. In those times she could spend without thinking, and afterward she always regretted it. She was thousands of dollars in debt and her depression sank lower every time just thinking about it.
But she’d never really hurt anyone or herself, although once or twice she’d thought she might be better off dead. And although she’d called in sick more than once simply because she was feeling too tired and depressed to go to work, she didn’t make a habit of it. Even at her lowest she could still manage basic care and responsibilities. And all of this is why she doubted the bipolar diagnosis that had been suggested to her by a friend.
When she sat in her new therapist’s office explaining all of this, it was a relief when he agreed. So it surprised her when he suggested something else: cyclothymia.
Cyclothymia might be thought of as “bipolar lite.” It is a mood disorder in which the highs and lows are not as severe as the mania or depression of bipolar I or bipolar II disorders, but where the shifting moods are destabilizing enough to present problems for a sufferer. People with cyclothymia are sometimes misdiagnosed as having bipolar disorder NOS or borderline personality disorder, but cyclothymia is different from these disorders.
The moods of cyclothymia range from depression at the low end to hypomania at the high end, not crossing over into full-blown mania.
The symptoms of hypomania may include:
- Extreme feelings of happiness or euphoria
- Intense optimism
- Racing thoughts
- Rapid speech
- Decreased need for sleep
- High sex drive
- Risk-taking behavior
- Intense desire to perform, such as work goals
- Increased productivity
- Spending sprees
- Poor judgment
- Inconsiderate behavior
- Agitation, irritability and restlessness
The symptoms of depression may include:
- Sadness, hopelessness, guilt, regret
- Sleep disturbance
- Problems with appetite
- Loss of interest in things normally found enjoyable
- Loss of sex drive
- Poor concentration
- Headache, stomachache or other somatic complaints
- Suicidal thoughts or behavior
Diagnosis and Treatment
To be diagnosed with cyclothymic disorder, a person will have had symptoms of hypomania and depression for a period of at least two years, and will not have gone without symptoms for more than two months.
Many people with cyclothymia do not ever recognize they may be suffering from a mental health issue, and many others who do, don’t elect to seek treatment. There are ways to manage the shifting extremes of cyclothymia without medical intervention, such as meditation, yoga and nutrition, but therapy in conjunction with certain pharmaceutical medications has been shown most effective for people experiencing mood disorders. Cyclothymia tends to be a lifelong disorder, and can for some, progress into a more severe form of bipolar disorder.
Regarding occupational and life functioning, Dr. Prentiss Price in The Cyclothymia Workbook, has this to say:
The workplace does not go unaffected. Those with cyclothymia may have a history of variable work performance, sometime struggling to keep the same job for a length of time. They can be argumentative, easily frustrated, inconsistent, and difficult to get along with. For some, hypomania can enhance productivity, but for others, it can create disorganization and unfocused energy that leads to a drop in job performance. The lows of depression can also affect functioning at work and lead to problems with motivation, concentration, energy, and self-esteem.
It’s never easy to admit to mental health vulnerability, and it can be difficult sometimes to see that we have one. If you have a history of highs and lows, periods of intense irritability, creativity, sadness and distress, your moods may be more changeable than the average. Admitting your vulnerability doesn’t make you weak. Choosing to become aware of who we are and then to make ourselves better, after all, is one of the best choices we get to make for ourselves—if only we will. Asking for help can mean the difference between living a life on the brink and one of strength, possibility and daring.