I’ve tracked my life in moods: I’ve been happy and productive-super productive-in the spring when around my crush, then irritable and depressed in the summer, even though the weather was so lovely and warm, and fine again until Christmas when all hell broke loose with the stress of holidays just around the corner. But I always thought that was normal- wasn’t everybody a little moody sometimes? I liked to think I just had a “sensitive temperament.” Life could be hard. But I wasn’t what psychiatrists’ would deem “crazy.” It’s not like I’d ever been hospitalized or anything.
But I always thought that was normal- wasn’t everybody a little moody sometimes? I liked to think I just had a “sensitive temperament.”
Still, when I look back, I could see that I fit a certain description. I did have a history of “brief, intense relationships” and if I was honest, I might admit to having frequently “projected my issues” onto my loved ones, accusing them of being angry, moody and emotionally unstable. I tended to fall hard for someone during one of my upbeat periods, feeling each time that I’d finally met “the one”, then after only a short when my agitation or depression would return and, rather than acknowledge its perennial nature, I’d assume the problem was with my crush-everything was going badly because of him, not my mercurial moods.
And I’d often had more than one (unrequited, nonsexual) affair, often finding someone new while still involved with another. I didn’t like to admit that I didn’t want to be alone, but who did? And I couldn’t deny there was a history of hypersexuality, but I hoped it never got this bad, instead thinking of myself as a free spirit and a “sexually liberated feminist.” If I wanted, I could sleep with whomever I liked as often as I liked; it was no one’s business but my own. The problem was that when I came down from the days or weeks of frenzied mood and risky behavior, when everything had seemed so fun and exciting, I often felt miserable, and sometimes ashamed. I didn’t recognize myself in the mirror at those times, and I couldn’t understand how only days before I’d been so carefree and uninhibited.
Then there was the matter of my careless spending. I tried so hard to be frugal with money; I didn’t have a lot and knew full well the value of a dollar, but there had always been these periods when I seemed to lose all rationality. In those times I could spend without thinking, and afterwards always regretted it. Money had, literally, burned holes in my pockets.
But I’d never really hurt anyone or myself, although once or twice I ironically-and unironically-thought I’d be better off dead. While I missed school more than once simply because I was feeling too tired and depressed to go, I’d never made a habit of it. Even at my lowest I could still manage basic care and responsibilities. And all of this is why I doubted the bipolar diagnosis that had been suggested to me by a friend.
When I sat in my therapist’s office explaining all of this, it was a relief when she agreed. So, it surprised me when she suggested something else: Cyclothymia.
Cyclothymia might be thought of as “bipolar lite”, a mood disorder in which the highs and lows are not as severe as the mania or depression of bipolar I or bipolar II disorders, but where the shifting moods are destabilizing enough to present problems for a sufferer. People with cyclothymia are sometimes misdiagnosed as having bipolar disorder NOS or borderline personality disorder, but cyclothymia is different from both of these, and much more unknown.
The moods of cyclothymia range from depression at the low end to hypomania at the high end, not crossing over into full-blown mania.
The symptoms of hypomania may include:
- Extreme feelings of happiness or euphoria
- Intense optimism
- Racing thoughts
- Rapid speech
- Decreased need for sleep
- High sex drive
- Risk-taking behavior
- Intense desire to perform, such as work goals
- Increased productivity
- Spending sprees
- Poor judgment
- Inconsiderate behavior
- Agitation, irritability and restlessness
The symptoms of depression may include:
- Sadness, hopelessness, guilt, regret
- Sleep disturbance
- Problems with appetite
- Loss of interest in things normally found enjoyable
- Loss of sex drive
- Poor concentration
- Headache, stomachache or other somatic complaints
- Suicidal thoughts or behavior
Diagnosis and Treatment
To be diagnosed with cyclothymic disorder, a person will have had symptoms of hypomania and depression for a period of at least two years, and will not have gone without symptoms for more than two months.
Many people with cyclothymia do not even recognize they may be suffering from a mental health issue, and many others who do, don’t elect to seek treatment. However, there are ways to manage the shifting extremes of cyclothymia without medical intervention, such as meditation, yoga and nutrition, but therapy in conjunction with certain pharmaceutical medications has been shown most effective for people experiencing mood disorders. For me, I was prescribed Lamotrigine, an anticonvulsant, and Aripiprazole (or Abilify), an antipsychotic mood stabilizer. Cyclothymia tends to be a lifelong disorder, and can, for some, progress into a more severe form of bipolar disorder.
Regarding occupational and life functioning, Dr. Prentiss Price in The Cyclothymia Workbook, has this to say: “The workplace does not go unaffected. Those with cyclothymia may have a history of variable work performance, sometime struggling to keep the same job for a length of time. They can be argumentative, easily frustrated, inconsistent, and difficult to get along with. For some, hypomania can enhance productivity, but for others, it can create disorganization and unfocused energy that leads to a drop in job performance. The lows of depression can also affect functioning at work and lead to problems with motivation, concentration, energy, and self-esteem.”
It’s never easy to admit to mental health vulnerability, and it can be difficult sometimes to see that we have one. If you have a history of highs and lows, periods of intense irritability, creativity, sadness and distress, your moods may be more changeable than the average. Admitting your vulnerability doesn’t make you weak. Choosing to become aware of who we are and then to make ourselves better, after all, is one of the best choices we get to make for ourselves-if only we will it. Asking for help can mean the difference between living a life on the brink and one of strength, possibility and resilience.