Cyclothymic
Disorder is a chronic bipolar disorder consisting of short periods
of mild depression and short periods of hypomania. These symptoms
may last a few days to a a number of weeks. The onset is separated
by short periods of normal mood. Individuals with cyclothymia
are never totally free of symptoms of either depression or hypomania
for more than a number of months at a time. Diagnostic criteria
is as follows:
Symptoms present fro at least 2 years, the patient has had periods
of hypomanic symptoms and periods of low mood that don't fulfill
the criteria for Major Depressive
Disorder.
The longest period the patient has been free of mood swings is
2 months.
During the first 2 years of this disorder, the patient has not
fulfilled criteria for Manic,
Mixed, or Major
Depressive Episode.
Schizoaffective disorder doesn't explain the disorder better,
and it isn't superimposed on Schizophrenia,
Schizophreniform Disorder,
Delusional Disorder or Psychotic
Disorder Not Otherwise Specified.
The symptoms are not directly caused by a general medical condition
or the use of any substances,
including prescription medications.
These symptoms cause the patient clinically important distress
or impair work, social or personal functioning.
Associated
Features:
Euphoric
Mood
Depressed
Mood
Somatic
or Sexual Dysfunction
Hyperactivity
Addiction
Odd or Eccentric
or Suspicious Personality
Dramatic or Erratic or Antisocial
Personality
Differential Diagnosis:
Some disorders
have similar or even the same symptom. The clinician, therefore,
in his diagnostic attempt has to differentiate against the following
disorders which he needs to rule out to establish a precise diagnosis.
Psychiatric:
Mood
Disorder Due to a General Medical Condition; Substance-Induced
Mood Disorder; Bipolar
I Disorder, With Rapid Cycling;
Bipolar II Disorder, With Rapid Cycling; Borderline
Personality Disorder.
Medical:
Organic
Mood Syndromes caused by: Acquired Immune Deficiency Syndrome
(AIDS), Cushing's Disease, Epilepsy, Fahr's Syndrome, Huntington's
Disease, Hyperthyroidism, Premenstrual Syndrome, Migraines,
Multiple Sclerosis, Neoplasm, Postpartum, Stroke, Systemic Lupus
Erythematosus, Trauma, Uremia, Vitamin Deficiency, Wilson's
Disease.
Drugs:
Amphetamines,
Antidepressants (treatment or withdrawal), Baclofen, Bromide,
Bromocriptine, Captopril, Cimetidine, Cocaine, Corticosteroids
(including ACTH), Cyclosporin, Disulfiram, Hallucinogens (intoxication
and flashbacks), Hydralazine, Isoniazid, Levodopa, Methylphenidate,
Metrizamide (following myelography), Opiates, Procarbazine,
Procyclidine, Yohimbine.
Treatment:
In some cases
individuals may prefer no treatment or supportive psychotherapy
alone. Lithium, a mood stabilizer used commonly in the treatment
of Bipolar Disorder, has been
proven to help a substantial number of people with Cyclothymia.
Counseling
and Psychotherapy [
See Therapy Section ]:
Couples
or Family
therapy is often sought to help with the problems in relationships
brought on by the disorder.
Pharmacotherapy
[
See Psychopharmacology Section ] :
Biomedical treatment of cyclothymic disorder should be empirically
derived and should be offered only if the individual's functioning
is significantly adversely affected.
Antimanic
Drugs.
Lithium Carbonate.
Carbamazepine (Tegretol).
Valproic Acid (Depakene, Depakote).
Verapamil (Calan).
