Weeks when you’re on fire: sleeping little, talking fast, starting ten projects. Then weeks when everything is heavy. If that has been your pattern for years, it may have a name.
Cyclothymia is a long-lasting pattern of mild highs and lows, present at least half the time for two years or more, that never reach full bipolar episodes. It’s often dismissed as personality, but it’s treatable, mostly with therapy and routine.
Symptoms
The highs can include:
- More energy, needing less sleep without feeling tired.
- Talking faster, feeling unusually confident or creative.
- Impulsive decisions, such as spending, new plans or risky choices.
- Irritability and restlessness.
The lows can include:
- Low mood, hopelessness or emptiness.
- Low energy, poor concentration, withdrawing from people.
- Sleeping too much or too little.
What makes it cyclothymia is the pattern: many periods of highs and lows, milder than full bipolar episodes, present at least half the time, with no more than two months at a stretch feeling level, for at least two years. (Some clinicians use one year for children and teenagers.) And it causes real problems in your work, relationships or finances.
Why it’s often missed
The highs can feel good. You’re productive, sociable and full of ideas, so nobody, including you, thinks it’s a problem. The lows get blamed on laziness, stress or spiritual causes. In many Nigerian families it’s simply “his temperament” or “she’s moody like that”. So people often live with it for years before anyone names it.
How it differs from other conditions
- Bipolar I involves at least one full manic episode lasting a week or more, or needing hospital care. Bipolar II involves full hypomanic episodes and full depressive episodes. In cyclothymia, the highs and lows never reach those full thresholds. Our guide to bipolar 1 vs bipolar 2 explains the difference.
- Borderline personality disorder also involves mood shifts, but they’re usually sharp reactions to relationship stress that pass within hours. The two can occur together, and telling them apart needs a professional. Read more about borderline personality disorder.
- Ordinary moodiness comes and goes with life events. Cyclothymia persists for years, includes high-energy phases with less need for sleep, and causes real difficulties.
How common is it, and does it turn into bipolar disorder?
Cyclothymia affects roughly 0.4 to 1 percent of people, about equally men and women. It usually begins in the teenage years or early adulthood.
Some people with cyclothymia later develop bipolar I or II. Estimates vary widely, and nobody knows the true proportion. That uncertainty is a good reason to keep an eye on your moods over time.
What helps
- Learning about it. Understanding your pattern is the foundation of treatment.
- Therapy. Cognitive behavioural therapy has shown promising results, and talking therapy helps with the fallout of the highs and lows on relationships and work.
- Tracking your mood. A daily mood log shows your patterns and early warning signs. The mood tracker in the Mytherapist.ng app works for this.
- Regular routines. Steady sleep and meal times help. This advice comes from bipolar care, and it suits cyclothymia too.
- Avoiding alcohol and drugs, which can worsen mood swings.
- Planning for the highs, for example a cooling-off rule for big purchases.
Medication
Not everyone with cyclothymia needs medication. A psychiatrist may suggest a mood stabiliser if the swings are causing serious problems. Antidepressants on their own are generally avoided, because they can trigger highs or faster cycling. That’s a decision for a psychiatrist, not a chemist. Our guides to psychiatric hospitals in Lagos and in Abuja list where to find one.
When to get help
Talk to a professional if your mood swings are affecting your work, relationships or money, if the lows are getting deeper, or if other people have noticed a pattern. Read more about bipolar disorder, or find a therapist who works with mood disorders.
Suggested read: Living With a Partner Who Has Bipolar
If you ever have thoughts of ending your life during a low, please tell someone today. If you’re in immediate danger, call 112, or 767 in Lagos. Safe Place Nigeria is free on 0800 800 2000, 24 hours a day. Our helplines page lists more.
Frequently asked questions
What is cyclothymia?
A long-term mood condition with many periods of mild highs and lows, present at least half the time for two years or more, that are milder than full bipolar episodes.
Is cyclothymia a type of bipolar disorder?
It’s grouped with bipolar and related disorders, and is sometimes described as being on the bipolar spectrum. It’s milder than bipolar I or II, but long-lasting.
Does cyclothymia turn into bipolar disorder?
Sometimes. Some people later develop bipolar I or II, but nobody knows how many. Tracking your moods and staying in touch with a professional helps catch changes early.
Can cyclothymia be treated without medication?
Many people manage well with therapy, mood tracking and steady routines. Some need medication, which a psychiatrist should decide on.
How is cyclothymia diagnosed?
A psychiatrist or clinical psychologist looks at your mood history over time. A mood diary from the months before your appointment helps a lot.
This article is awaiting clinical review. It’s based on published research and health guidelines, and we’ll update it once a clinician has reviewed it.
