Cyclothymic disorder (also known as cyclothymia) is characterized by a person experiencing numerous periods of hypomanic symptoms and periods with depressive symptoms. Neither periods of hypomania nor depression meet the criteria for a diagnosis of hypomania, bipolar II disorder, or a major depressive episode
Cyclothymic disorder is typically a chronic disorder that can be challenging to treat. In order to qualify for a diagnosis of this disorder, a person must experience periods of mood disturbance for at least 2 years (1 year in children and adolescents), and has never been without the symptoms for more than 2 months at a time. Cyclothymic disorder usually begins in adolescence or early adult life and is sometimes considered to reflect a temperamental predisposition to other bipolar and related disorders.
Specific Symptoms of Cyclothymic Disorder
- Numerous periods of hypomanic symptoms and of depressive symptoms that do not meet the criteria for either disorder, for at least a period of 2 years (1 in teens and children).
- The periods of hypomanic and depressive symptoms are present more at least half the time, and the individual has not been without the symptoms for more than 2 months at a time.
- Criteria for a major depressive episode, manic episode, or hypomanic episode have never been met.
- The symptoms are not better explained by schizoaffective disorder, schizophrenia, or a related delusional disorder.
According to the American Psychiatric Association (2013), after the initial 2 year period (1 year in children and adolescents) of cyclothymic disorder, there may be superimposed manic or mixed episodes. In this case, bipolar I disorder or bipolar II disorder should be diagnosed and the cyclothymic disorder diagnosis should be dropped. If the person experiences a major depressive episode after the 2 year period, a diagnosis of major depression disorder should be made instead.
Many people with this diagnosis also experience high levels of anxiety. Therefore a clinician may add the clinical specifier, “with anxious distress” when making a diagnosis of cyclothymic disorder.
In order for this disorder to be diagnosed, the disturbance should not be better accounted for by schizoaffective disorder and cannot be superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder not otherwise specified. The symptoms can not be due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism). Furthermore, the symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The lifetime prevalence of cyclothymic disorder is approximately 0.4 to 1 percent in the United States. In the general population, cyclothymic disorder is apparently equally common in males and females. In clinical settings, females with cyclothymic disorder may be more likely to present for treatment than males.
For more on treatment, please see general treatment guidelines for cyclothymic disorder.
This entry has been updated in accordance with DSM-5 changes; diagnostic code 301.13.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, Fifth edition. Arlington, VA.
Caponigro, J.M. & Lee, E.H. (2012). Bipolar Disorder: A Guide for the Newly Diagnosed. New Harbinger.
Fountoulakis, K.N. (2015). Bipolar Disorder: An Evidence-Based Guide to Manic Depression. Springer: New York.