Opening up to Cyclothymia

All my life, I’ve considered my frequent mood swings as part of my personality. Part of who I am. I never knew there was a name to it. I never would have thought I’d have a mental illness, a mood disorder.

Cyclothymia, also known as cyclothymic disorder, is a mood disorder in the same spectrum of Bipolar disorder. Cyclothymia has episodes of emotional ups and downs, but not as severe as Bipolar Type II or the beast of all of them, Bipolar Type I.

With cyclothymia, I experience episodes where my mood dramatically shifts up or down from my baseline. I may feel on top of the world for a short time, but it’s quickly followed by a low period where I feel worthless. In between these episodes, I’ll feel fine, normal, “stable”.

The highs of cyclothymia are characterized by elevated mood that resemble those of mania but a lot less severe, also known as hypomania. The lows consist of mild depressive episodes known as dysthymia. Cyclothymia symptoms are similar to that of Bipolar I and II, but a lot less extreme. I can function normally in daily life while in an episode, but not always at optimal level. My mood shifts are so unpredictable that I never know how they may affect the following day.

Graph showing the three different Bipolar spectrums and how the highs and lows are different for each category.

Hypomanic Phase of Cyclothymia

The hypomanic stage of cyclothymia meets the same criteria as that for Bipolar Type II. Signs and symptoms include:

• An exaggerated feeling of well-being (Euphoria)
• Extreme optimism
• Inflated self-esteem
• Poor judgement
• Rapid speech
• Racing thoughts
• Aggressive or hostile behavior
• Easily agitated
• Excessive physical activity
• Risky behavior
• Increased drive to achieve or perform goals
• Increased libido
• Decreased need for sleep
• Easily distracted
• Inability to concentrate or focus on a task, even something simple

Depressive (Dysthymia) Phase

Depressive episodes include a combination of any of these symptoms:

• Sadness
• Hopelessness
• Thoughts of suicide
• Anxiety
• Inability to sleep
• Appetite problems
• Fatigue
• Loss of interest in activities considered enjoyable
• Decreased libido
• Irritability
• Pain with no known cause or reason

It sounds a lot like Bipolar, but I never experienced a full blown psychotic manic episode nor have I been crippled or bed ridden from major depression. From my research, Cyclothymia is often classified as a rapid cycling bipolar. My episodes are so quick on-coming and short lasting that they don’t have enough time to manifest into either extreme. But that doesn’t mean I don’t suffer the effects from the swings. This ties in so much with how I feel now and how I have felt in the past. I’ve suffered through this my whole life, for as far back as I can remember. I can clearly remember my first Dysthymic episode when I was in the 6th grade. I remember it was caused by a rejection from a group of girls I had at the time wanted to be friends with. Rejections hurts, sure, but for me it cut so deep that I was literally in a deep fog for several days.

Cyclothymia is seen as the “mild” version of bipolar. I personally feel like using the word mild for something where thoughts of suicide and self-harm can be commonplace as nothing mild at all. Less than a week ago, I had a thoughts of throwing myself from the balcony of my third floor apartment but telling myself it was stupid because it wasn’t high enough. I’d be most likely hospitalized, but dead? No. I’ve had more thoughts of suicide than I care to count, but I have never yet acted upon any of them. I feel like I would have already if I was serious. But I still can’t help but feel that one day I may come close.

I remember back to my failed marriage. To the memories of a husband who was not supportive. Not understanding. I would lash out at him because he would choose work over me. He would leave when I was having an episode, coming back home several hours later, sometimes the next day. All I ever wanted from him was his attention and his love. When I found out of his affair, I dove even deeper into my head.

I’m sure we all have moments of highs and lows. It’s part of being human. We get hurt. We get rejected. We go through happy moments and feel so alive. But I’ve always felt like my ups and downs were different from everyone else. My ups and downs happen so frequently they make my own head spin. This can’t be normal for everyday people. I’ve never felt like I fit in with the “normal” folk. When I am in a episode, it’s usually not until after it has surpassed that I realized I was in one. When I’m in a hypomanic state, I feel like everyone around me is amazingly boring. When I’m in dysthymia, I feel like everyone around me is stupidly happy and annoying. It’s not until after an episode that I cringe at the thoughts I had or what I may have done or got myself into.

The lows are scary. I have woken up in the middle of the night not wanting to live anymore. Wondering what the fuck I’m doing on this planet. Why do I even bother anymore? When I’m on a high, I get so many ideas of what I want to do, but very few if any even see fruition. I’ve had plans of writing a novel. I’ve wanted to read a whole stack of books in one sitting but I’d start reading and 5 minutes later I’d be distracted by something, the dripping of the kitchen sink for instance, and never get back to the book. I’d rearrange my bathroom cabinets but only get halfway done. When I’m in a normal state, I end up “fixing” what I attempted.

What is the cause of cyclothymia? The sad thing is there is no known cause. It is thought to be a mix of social environment and genes. If someone in the family has a mental illness, the chances of someone else in the family having an illness is high. It is most likely due to a chemical imbalance in the brain. In bipolar case, it’s when the brain doesn’t produce enough serotonin or dopamine, which causes the ups and downs. So it’s inherited, caused by environmental stressors, or a chemical imbalance in the brain. But most likely a combination of all of the above. Getting diagnosed officially is hard. Most will diagnose as another mental illness. Cyclothymics are often first diagnosed as Borderline Personailty Disorder, but we miss many traits of that disorder and Borderline doesn’t have certain symptoms from Cyclothymia. It’s estimated only 1% of the population has cyclothymia, but the estimates can be very far off as most people never seek professional help. Our episodes are never severe enough to warrant a visit to a therapist. I personally have not sought out a professional yet as I do not wish to be jockeyed back and forth between other professionals and through tests for someone to tell me what I am 99.9% sure of myself.

Treatments for cyclothymia are inclusive and often don’t work effectively.

• Therapy, or
• Psychoactive medication

I do not wish to mess with any of those drugs as I feel the side effects are worse than anything it intends to “treat”. Those who are treated with anti-depressants or mood stabilizers have a 50% chance of going into a full blown Manic episode, which would then classify them as Bipolar I.  And the symptoms after that have been recorded to intensify…Dysthymia becomes full blown crippling depression and another possible psychosis Manic episode. So basically, there is no cure and no effective treatment for cyclothymia. Why would I bother seeking help from a professional when in the end there is nothing they can do? I must treat this myself. The holistic way. For me, it’ll be through taking care of my body and my mind the best I can in hopes the mood swings are less frequent and continue to stay at a “mild” state. Again, mild is not a term I like to use to describe my episodes.

I have not told anyone, not even my parents of my discovery. I fear the stigma that may come with it. My parents are not understanding of anything that is in the field of mental illness. I don’t think they would be upset. I just don’t think they would know what to do or how to cope if I told them. Obviously keeping this quiet from work is of extreme importance. In a field where my paycheck depends on other people giving me money, i.e. I am commission based, that last thing they need to know is I have a “mental illness”. I have learned from years of experience to hide my mood swings. I have become good at wearing a mask, good at appearing like I am a normal person, albiet with a few “nerd” tendencies that wouldn’t throw anybody off.

I’m going to continue to study the field of cyclothymia and all strains of bipolar in hopes I can find the ultimate fix for myself and my friends who are suffering from the same thing.