Cyclothymia Symptoms

Please see our separate note on Treatment, Mental Disorders and Basic Science for important caveats on the role and definition of diagnostic criteria.

Symptoms of Cyclothymia

According to the DSM, "The essential feature of Cyclothymic Disorder is a chronic, fluctuating mood disturbance involving numerous periods of hypomanic symptoms and numerous periods of depressive symptoms" (p. 398). The following specific diagnostic criteria are reproduced verbatim (except for codings and page references) from the DSM-IV TR (where 'IV TR' indicates fourth edition, text revision), page 400.

Diagnostic Criteria for Cyclothymic Disorder

A. For at least 2 years, the presence of numerous periods of hypomanic symptoms and numerous periods of depressive symptoms that do not meet criteria for a Major Depressive Episode. Note: In children and adolescents, the duration must be at least 1 year.

B. During the above 2-year period (1 year for children or adolescents), the person has not been without the symptoms in Criterion A for more than 2 months at a time.

C. No Major Depressive Episode , Manic Episode, or Mixed Episode has been present during the first 2 years of the disturbance.

Note: After the initial 2 years (1 year in children or adolescents) of Cyclothymic Disorder, there may be superimposed Manic or Mixed Episodes (in which case both Bipolar I Disorder and Cyclothymic Disorder may be diagnosed) or Major Depressive Episodes (in which case both Bipolar II Disorder and Cyclothymic Disorder may be diagnosed).

D. The symptoms in Criterion A are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.

G. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).

H. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Special note on counselling and manic depression: Although it is sometimes thought that bipolar disorder is treated solely through psychopharmacological means (i.e., with medication), in fact counselling and psychotherapy play an important and sometimes indispensable part in helping clients living with the disorder. Writing in a recent Medscape column, Dr Deborah Spitz calls psychotherapy "a necessary and invaluable adjunctive treatment" and notes that medication alone cannot help clients to accept the disorder or learn preventative and coping strategies. The Managing Editor has a special interest in counselling for cyclothymia and manic depression, the more severe cyclic mood disorder. Just visit MyTherapist.com if you'd like to try this private, low-cost service.