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Cyclothymia is often mistaken for other mental health conditions. When it comes to cyclothymia treatment, talk therapy, the right meds for you, and self-care strategies can help.
Cyclothymia, also called cyclothymic disorder, involves alternating episodes of hypomania — or “mild” mania — and depression.
While cyclothymia is a type of bipolar disorder, its symptoms are less severe than those of bipolar I disorder and bipolar II disorder. This is why it’s sometimes referred to as bipolar III disorder.
Even so, it can still impact big parts of your life, such as work or your relationships.
Because cyclothymia can be mistaken for other conditions — many of which are better understood — it’s often misdiagnosed. It’s also underdiagnosed. This means you may get the right diagnosis only after many years of living with symptoms.
Since cyclothymia is a long-lasting condition, symptoms and mood episodes tend to crop up over long periods of time.
Research on cyclothymia treatment methods is scarce but ongoing. What’s known so far is that medication, psychoeducation, therapy, and coping routines can all help you manage the condition.
If you have cyclothymia, chances are you might have been misdiagnosed in the past. Maybe you’re still looking to get a diagnosis.
Getting a cyclothymia diagnosis involves talking with a mental health professional. You can connect with one directly or ask your primary care doctor to refer you to a mental health specialist.
According to the Diagnostic and Statistical Manual of Disorders (DSM-5), criteria for a diagnosis of cyclothymic disorder include:
- multiple periods of hypomanic symptoms that don’t meet the criteria for a full episode of hypomania or mania
- multiple periods of depressive symptoms that don’t meet criteria for major depression
A cyclothymia diagnosis applies when these mood episodes continue for at least 2 years (or 1 year in children).
With cyclothymia, mood changes tend to be abrupt. Your symptoms may also vary in how long they last and how severe they are.
While it’s not uncommon for cyclothymia to progress into bipolar disorder, treatment can help keep this from happening.
Research on evidence-based cyclothymia treatment is still scarce.
The research that is available, according to a 2015 review, suggests that people with cyclothymia could benefit from a type of therapy that meets needs specific to their condition.
For example, cyclothymia is connected to:
- substance use
- personality disorders
Still, much of what we know about cyclothymia treatment comes from research on mood conditions like bipolar disorder.
Some forms of psychotherapy that could help you manage cyclothymia include:
- cognitive behavioral therapy (CBT)
- well-being therapy (WBT)
In a broad sense, psychoeducation empowers you through knowledge. It can teach you about your own mental health condition in a way that equips you with coping skills for living well with cyclothymia.
Psychoeducation for cyclothymia could boost your understanding of:
- the causes of this condition
- what triggers your mood changes
- your medication options
- the importance of tracking your mood episodes
- the role of routines in managing mood changes
Psychoeducation can also teach you to recognize thought and behavior patterns that may stem from cyclothymia, like:
- emotional dependency
- sensitivity to rejection
Many of the topics you might explore in psychoeducation for cyclothymia involve how you view and react to your own thoughts. You might also explore how you perceive conflict in relationships.
Cognitive behavioral therapy (CBT)
CBT could also help you manage cyclothymia. Like psychoeducation, CBT can be adapted to help you handle cyclothymia-specific issues.
In CBT, the focus is on becoming aware of thought patterns that lead to mood changes.
For example, CBT can help you:
- address thought patterns that contribute to mood changes
- track your moods and energy levels
- create routines that help you manage your moods
- learn skills to help you cope with “high” and “low” moods
- reduce anxiety-related symptoms
- build up your self-esteem
- create a social support network
One study showed promising outcomes for managing cyclothymia symptoms — especially depressive symptoms — using CBT.
Well-being therapy (WBT)
WBT is a fairly new form of therapy that could help people reduce some cyclothymia symptoms, especially when used alongside CBT.
The goal of WBT is to focus your attention on times you feel a strong sense of well-being, often through journaling. Then, you identify thoughts that lead to these times of well-being and thoughts that get in the way of them.
WBT has been helpful to people with mood disorders and anxiety, and
If your symptoms are severe enough to negatively impact your day-to-day life and well-being, certain meds can help stabilize your moods. A mental health professional can help you determine which medication would work best for you.
Research on medication for cyclothymia is limited. Most of the current recommendations come from small studies and clinical experience.
It’s also common for cyclothymia to co-occur with other conditions, such as anxiety and substance use. When this happens, it can influence what type of medication your doctor prescribes.
Mood stabilizers can help you balance the “high” and “low” moods that come with cyclothymia.
Lithium is a common mood stabilizer you might take to help you manage depressive, hypomanic, or mixed symptoms.
Anticonvulsants, another type of medication most often used to treat seizures and bipolar disorder, could also help with some cyclothymia symptoms.
Limited research has looked into the effectiveness of these anticonvulsant meds for cyclothymia treatment:
- valproate (Depakote)
- lamotrigine (Lamictal)
Antipsychotic meds help people smooth out extreme mood changes, especially “high” moods. But when antipsychotics are used to treat cyclothymia, they’re usually prescribed in low doses.
Antipsychotics that might be prescribed for cyclothymia include:
- quetiapine (Seroquel)
- olanzapine (Zyprexa)
When used, antipsychotic medication could help people with cyclothymia reduce the feelings of irritability and impulsivity that can come with hypomanic periods.
The use of antidepressants for cyclothymia treatment is controversial.
Some antidepressants — tricyclic antidepressants (TCAs) — have shown some limited, positive results for depression, according to the 2017 article mentioned above.
Others — selective serotonin reuptake inhibitors (SSRIs) — may worsen cyclothymia by triggering hypomania and other severe mood symptoms.
SSRIs are also associated with a “wear off” effect. In other words, symptoms eventually return after the meds have worked for a while.
Experts generally caution against prescribing antidepressants. But if you and your doctor have already tried many other treatments (or if you have long-lasting depressive symptoms), some antidepressants could be an option.
It’s worth noting that if you have cyclothymia, you may be more sensitive to certain side effects of some psychoactive meds. These side effects could include:
- muscle spasms and movement issues
- skin rashes or sensitivity
- thyroid issues
One bit of expert advice from the previously mentioned 2017 article is to “go slow and stay low.”
In other words, it’s usually most helpful to take lower doses of medication and have regular check-ins with your doctor.
Your doctor may look at your unique symptoms when helping you decide what meds are best for you. For instance, if you experience anxiety or panic due to cyclothymia, your doctor might prescribe meds that are better at addressing those symptoms.
In addition to psychotherapy and medication, there are plenty of ways you can manage cyclothymia yourself. Many of these strategies work well alongside therapy or meds, too.
Since cyclothymia is a long-lasting condition, you might find that working self-care strategies into your daily routine also helps you manage symptoms in the long term.
There isn’t a lot of research on supplements and remedies for cyclothymia. But what we know about natural remedies for mood disorders may help you treat specific symptoms of cyclothymia.
You can increase your omega-3 intake by adding a supplement to your daily routine. You can also eat foods that are high in omega-3s, including:
Adding fish oil to your diet is another way to increase your daily omega-3 intake.
Choline is a nutrient made by your body and consumed through food. According to a
High-choline foods include:
- beef liver
Most people get enough choline through their diet without trying. But you can also take choline in the form of a capsule or supplement.
Since cyclothymia is a mood disorder, many self-care strategies center around building routines that have a stabilizing effect.
Routines and activities that help with self-expression can lend to a holistic cyclothymia treatment approach that encourages physical, mental, and emotional well-being.
Track your symptoms
Keeping track of your moods and symptoms can help you spot patterns, triggers, and stressors.
If you’re taking meds, tracking your moods can also shed light on whether they’re working and how they’re affecting you.
You might keep a log of your:
- energy levels
Logging your symptoms in a tracking app can make this process smoother. There are many tracking apps to choose from, including:
Stick to routines
What kinds of self-care practices would you like to incorporate into your day-to-day life? Routines can help give your days (and your mood) some structure and stability.
For example, establishing a regular routine around sleeping and waking could help you get better sleep and reduce sleep-related symptoms. If you’re having trouble setting this routine, talking with a sleep specialist could help.
You also might set a short morning routine, such as showering, meditating, and savoring your breakfast at the table.
Consider a workbook
Workbooks help some people learn more about their mental health condition and offer tips on how to manage them. You can use a workbook on your own or as a supplement to therapy sessions.
One workbook for people living with cyclothymia is The Cyclothymia Workbook: How to Manage Your Mood Swings and Lead a Balanced Life. This book features cognitive-behavioral exercises aimed at helping you reduce the impact of mood symptoms.
Avoid alcohol and substances
Alcohol and other substance use can trigger or worsen:
- mood episodes
- sleep problems
If you’re finding it difficult to curb substance use, help is available. Clinicians who specialize in helping people overcome substance dependence can offer support and guidance in this area.
Create coping strategies
Stress can spark cyclothymia symptoms — so one key to living well with cyclothymia can include coping strategies and stress management.
Some effective stress management activities might include:
- guided meditation
When it comes to finding the right coping strategy, it’s important to choose something that’s meaningful to you or that acts as an outlet for self-expression.
Though cyclothymia is often a lifelong condition, there are many ways to reduce your symptoms. The right meds, therapy, and a self-care plan can all add up to an effective way to manage cyclothymia.
If you’re not sure whether you have cyclothymia and want to find out, the best route may be through your primary care doctor. They can often refer you to a mental health professional who specializes in mood disorders.
As a part of talk therapy and on your own, you can also develop a self-care plan centered around reducing mood episodes. With the right tools and approach for you, cyclothymia treatment is possible.