What is Cyclothymia?

Karen Doll, Psy.D., L.P
May 4, 2019

Cyclothymia, also known as Cyclothymic disorder is characterized as a less severe, more chronic type of biopolar disorder.  It involves episodes of hypomanic symptoms (euphoria and elevated mood) as well as depressive symptoms. These fluctuations in mood do not meet the full criteria for a hypomanic or depressive episode, yet they are experienced in more than 50 percent of the time for the patient and occur with less than two months passing.


The primary difference between cyclothymia and bipolar disorder is the level of intensity. The mood swings are not as severe in cyclothymia. However, if it is not treated, cylothymia can increase the risk of developing bipolar disorder.

A hypomanic episode involves a state of elevated mood, excitement, and euphoria.  It does not involve psychotic symptoms or a disconnect from their sense of reality.  They may even feel good during hypomania and demonstrate behaviors of high functioning and productivity. Hypomanic symptoms last for at least four days and may include the following changes in behavior:

  • Agitation
  • Insomnia
  • Easily distracted
  • Extreme happiness or euphoria
  • Restlessness
  • Unusually high opinion of self and one’s abilities
  • More physical activity than usual
  • Change in impulse control and increased risk taking
  • Excessive talkativeness

Official DSM -5 Signs and symptoms of hypomania:

  • A distinct period of abnormally and persistently elevated, expansive, or irritable mood
  • An increase in goal-directed activity—sexually, socially, at work, or at school
  • Inflated self-esteem or grandiosity
  • Decreased need for sleep
  • Talkativeness
  • Racing thoughts, jumping from one idea to another
  • Distractibility, inability to concentrate
  • Excessive involvement in activities that have a high potential for painful consequences, , such as buying sprees, sexual indiscretions
  • The episode represents a distinct change in functioning and the changes in mood and behavior are observable by others..

Individuals in a depressive state may experience the following changes in behavior:

  • Increased isolation
  • Excessive crying
  • Difficulty focusing and concentrating
  • Change in lifestyle: eating more or less, sleeping more or less
  • Fatigue, lethargy
  • Reduced experience of pleasure in activities one used to enjoy

DSM-5 Criteria of depressive symptoms include:

  • Persistent sadness
  • Fatigue or listlessness
  • Excessive sleepiness or, conversely, inability to sleep
  • Loss of appetite and weight loss or overeating and weight gain
  • Loss of self-esteem
  • Feelings of worthlessness, hopelessness, and/or guilt
  • Difficulty concentrating, remembering, or making decisions
  • Withdrawal from friends
  • Withdrawal from activities that were once enjoyed
  • Persistent thoughts of death

According to the DSM-5, in order to be diagnosed with cyclothymia, the following criteria are present:

  • Stable moods, (lapse between mood episodes), last for less than two months.
  • Both hypomanic and depressive episodes have occurred for at least two years (one year for children and teens). These mood highs and lows are experienced at least half of the time.
  • Symptoms don’t meet the diagnostic criteria for other mental health illnesses such as depression, bipolar I, or bipolar II disorder.
  • The symptoms are negatively impacting your day-to-day functioning and your life overall.
  • Symptoms are not a result of substance abuse or a physical illness.

Cyclothymia can also be dual diagnosed. Individuals with cyclothymic disorder can present with co-occurring substance abuse and sleep disorders.  There are various treatment methodologies available for Cyclothymia. Similar to Bipolar Disorder treatments, it varies depending on the severity of the symptoms. The most common and understood to be effective treatments combine prescription medicine with psychotherapy. If you or someone you know is experiencing symptoms related to cyclothymia, consult a professional. It is considered a treatable condition that many people can experience relief from their symptoms with proper interventions.

Karen Doll, Psy.D., L.P

Karen Doll has been a Licensed Psychologist in the Twin Cities for 20 years, working in organizational consulting. She leverages her education in Clinical Psychology with her leadership assessment expertise in her practice. She is an executive coach focusing on helping people maximize their potential.