Cyclothymia and bipolar are similar

[Phyllis]

Q: What's the difference between bipolar disorder and cyclothymia?

A: The difference between the two is a matter of degree. Cyclothymia is a milder version of bipolar disorder.

There are no sharp lines dividing the different categories of mood disorders. These labels are a starting point for understanding a person's problem.

When trying to diagnose a person, mental health professionals consider a short list of probable or possible problems. This creates a framework for treatment. Refining the diagnosis is a gradual process. As the patient and doctor learn more about the problem, they modify the treatment based on what helps and what doesn't.

Here are short definitions for bipolar disorder and cyclothymia:

Bipolar disorder. Doctors make this diagnosis if a person has had at least one manic or mixed episode. This is a period (of at least one week) when the person is in a high, expansive or elated mood. People with bipolar disorder often also have episodes of depression. Sometimes these are severe enough to be called "major depression."

Think of a manic episode as the polar opposite of a major depressive episode. A person in a manic state feels energetic and active, has little need for sleep, and may behave recklessly and be overly optimistic. In a mixed episode, symptoms of both depression and mania alternate. Sometimes the symptoms overlap in confusing ways.

Cyclothymia. This is a less intense but often longer-lasting version of bipolar disorder. A person with cyclothymia has both high and low mood, but never as severe as either mania or major depression. To make this diagnosis, the person usually has symptoms that last for at least two years.

I would not be too concerned with these labels. The treatment for both can be very similar. A person with cyclothymia, for example, may be helped by the same mood-stabilizing medications that help a person with bipolar disorder.

By the way, the reverse can also be true: Two people with the same diagnosis (whether it be bipolar disorder or cyclothymia) may receive very different treatments!

It's confusing, I know. Fortunately, these disorders are often treated successfully with a combination of psychotherapy and medication. The key is to find a doctor who can help you with your situation without getting too hung up on the label.

Michael Craig Miller, M.D., is an assistant professor of psychiatry at Harvard Medical School and an associate physician at Beth Israel Deaconess Medical Center, Boston. Miller is editor in chief of the Harvard Mental Health Letter. For additional consumer health information, please visit health.harvard.edu.

[high maintenence]

I've never heard of Cyclothymia. Interesting....

[Cathy]

Cyclothymia. This is a less intense but often longer-lasting version of bipolar disorder.

Not sure what this means, as surely you have BP all your life, it can just be managed? Does it mean it takes longer for Cyclothymia to get diagnosed than BP?

[Phyllis]

I know someone with Cyclothymia. They go through very very long periods of depression (Called Dysthymia). And very short spurts of hypomania or mania. It is considered to be in the Bipolar "Spectrum" as it is a mood disorder with highs and lows.

DSM-IV-TR

    * During the first two years of the disorder, the patient has not fulfilled enough criteria to qualify as having either bipolar disorder or major depressive disorder.
    * Symptoms are present for at least two years: periods of hypomanic symptoms and periods of low mood that do not fulfill the criteria for major depressive disorder.
    * The longest period the patient has been free of symptoms is two months.
    * The disorder cannot be better explained as schizoaffective disorder, and it is not superimposed on schizophrenia, schizophreniform disorder, delusional disorder or psychotic disorder not otherwise specified.
    * Symptoms are not directly caused by a general medical condition or the use of any substances such as prescription medicines.
    * The symptoms cause the patient clinically significant distress or impair work, social or personal functioning.
    * A person with this disorder may experience euphoric highs, boosts of energy and require less sleep in one phase, followed by a severe mood swings into a depressive state coupled with negativity & sadness for no particular reason.
    * These mood swings are not as severe as bipolar I disorder or bipolar II disorder.
    * Cyclothymia is to bipolar disorder as Dysthymia (a mild form of clinical depression) is to major depressive disorder.