Mood Disorder Little Bit Info

Dysthymia or dysthymic disorder is a form of the mood disorder of depression characterized by a lack of enjoyment/pleasure in life that continues for at least two years. a depressive mood disorder characterized by a chronic course and an insidious onset. is classified as a type of affective disorder (also called mood disorder) that often resembles a less severe, yet more chronic form of major (clinical) depression Low energy, sleep or appetite disturbances and low self-esteem are usually part of the clinical picture as well. Causes The cause of dysthymia is not clear and is likely multifactorial. A biopsychosocial formulation, considering the interplay of family history and other genetic factors, medical problems, psychological make-up and coping strategies, and social stressors, is helpful when considering the cause of dysthymia. Some examples of common contributing factors include the following:

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Genetic predisposition

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Biological factors, such as alterations in neurotransmitters, endocrine, or inflammatorymediators

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Chronic stress (eg, particularly with feelings of hopelessness and/or helplessness)

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Chronic medical illness

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Psychosocial factors, such as social isolation, losses

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Ruminative coping strategies, as opposed to problem solving or cognitive restructuring strategies, are common among people with dysthymia and may predispose to or sustain dysthymia.14

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Persons diagnosed with antisocial, borderline, dependent, depressive, histionic, or schizotypal personality traits are at an increased risk for developing dysthymic disorder

Diagnostic Criteria 1.

On the majority of days for 2 years or more, the patient reports depressed mood or appears depressed to others for most of the day.

2.

When depressed, the patient has 2 or more of: 1.

Appetite decreased or increased

2.

Sleep decreased or increased

3.

Fatigue or low energy

4.

Poor self-image

5.

Reduced concentration or indecisiveness

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Feels hopeless

3.

During this 2 year period, the above symptoms are never absent longer than 2 consecutive months.

4.

During the first 2 years of this syndrome, the patient has not had a Major Depressive Episode.

5.

The patient has had no Manic, Hypomanic or Mixed Episodes.

6.

The patient has never fulfilled criteria for Cyclothymic Disorder.

7.

The disorder does not exist solely in the context of a chronic psychosis (such as Schizophrenia or Delusional Disorder).

8.

The symptoms are not directly caused by a general medical condition or the use of substances, including prescription medications.

9.

The symptoms cause clinically important distress or impair work, social or personal functioning.

Treatment for Dysthymic Disorder Psychotherapy is the treatment for choice for this psychological problem. Often, antidepressant medication is also recommended because of the chronic nature of the depression in Dysthymia. Psychotherapy is used to treat this depression in several ways. First, supportive counseling can help to ease the pain, and can address the feelings of hopelessness. Second, cognitive therapy is used to change the pessimistic ideas, unrealistic expectations, and overly critical self-evaluations that create the depression and sustain it. Cognitive therapy can help the depressed person recognize which life problems are critical, and which are minor. It also helps them to learn how to accept the life problems that cannot be changed. Third, problem solving therapy is usually needed to change the areas of the person's life that are creating significant stress, and contributing to the depression. Behavioral therapy can help you to develop better coping skills, and interpersonal therapy can assist in resolving relationship conflicts. Treatments and drugs Treatment options: Medications and psychotherapy The two main treatments for dysthymia are:

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Medications

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Psychotherapy

There's no clear evidence that either of these treatments is better than the other. There is some evidence, though, that using a combination of medications and psychotherapy may be slightly more effective in treating dysthymia than using only medications or only psychotherapy. Which treatment approach you take depends on such factors as:

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The severity of your dysthymia symptoms

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Your desire to address emotional or situational issues affecting your life

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Your personal preferences

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Previous treatment methods

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Your ability to tolerate medications

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Whether you're pregnant or breast-feeding

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The availability of mental health services in your community

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Your health insurance coverage

Medications for dysthymia The psychiatric medications most commonly used to treat dysthymia are the same kinds used to treat depression. They include:

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Selective serotonin reuptake inhibitors (SSRIs)

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Serotonin and norepinephrine reuptake inhibitors (SNRIs)

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Norepinephrine and dopamine reuptake inhibitors (NDRIs)

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Combined reuptake inhibitors and receptor blockers

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Tetracyclic antidepressants

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Tricyclic antidepressants (TCAs)

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Monoamine oxidase inhibitors (MAOIs)

SSRIs are often the antidepressant of choice because, in general, they work well and their side effects are more tolerable. MAOIs are usually last choices because they can have serious side effects and require strict dietary restrictions because of rare but potentially fatal interactions. Which one is best for you depends on your individual situation. When you have dysthymia, you may need to take antidepressants long term to keep symptoms under control. The Food and Drug Administration (FDA) requires that all antidepressant medications carry black box warnings. These are the strictest warnings that the FDA can issue for prescription medications. The antidepressant warnings note that in some cases, children, adolescents and young adults ages 18 to 24 may have an increase in suicidal thoughts or behavior when taking antidepressants. Psychotherapy for dysthymia Psychotherapy can help you learn about your condition and your mood, feelings, thoughts and behavior. Using the insights and knowledge you gain in psychotherapy, you can learn healthy coping skills and stress management. Psychotherapy can be especially helpful if:

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You need help learning to make decisions

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You have self-defeating behavior patterns

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You also have other mental illnesses, such as an anxiety disorder

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You have a history of traumatic life experiences

Types of psychotherapy Several types of psychotherapy may be helpful for dysthymia, including:

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Cognitive behavioral therapy

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Interpersonal therapy

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Cognitive therapy

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Behavior therapy

You and your therapist can talk about which type of therapy is right for you, your goals for therapy, and other issues, such as the number of sessions and length of treatment. Seasonal Affective Disorder (SAD)/ winter depression or winter blues is a cyclic, seasonal condition. This means that signs and symptoms usually come back and go away at the same times every year. Usually, seasonal affective disorder symptoms appear during late fall or early winter and go away during the warmer, sunnier days of spring and summer. mood disorder in which people who have normal mental health throughout most of the year experience depressive symptoms in the winter or, less frequently, in the summer,[1] repeatedly, year after year. Causes The specific cause of seasonal affective disorder remains unknown. It's likely, as with many mental health conditions, that genetics, age and perhaps most importantly, your body's natural chemical makeup all play a role in developing seasonal affective disorder. Specifically, the culprits may include:

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Your circadian rhythm. Some researchers suspect that the reduced level of sunlight in fall and winter may disrupt the circadian rhythm in certain people. The circadian rhythm is a physiological process that helps regulate your body's internal clock — letting you know when to sleep or wake. Disruption of this natural body clock may cause depression.

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Melatonin. Some researchers theorize that seasonal affective disorder may be tied to melatonin, a sleep-related hormone that, in turn, has been linked to depression. The body's production of melatonin usually increases during the long nights of winter.

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Serotonin. Still other research suggests that a lack of serotonin, a natural brain chemical (neurotransmitter) that affects mood, may play a role. Reduced sunlight can cause a drop in serotonin, perhaps leading to depression.

Diagnostic criteria The Mayo Clinic[14] describes three types of Seasonal Affective Disorder, each with its own set of symptoms. According to the American Psychiatric Association,[15] for a diagnosis to qualify as SAD, it must meet four criteria: depressive episodes at a particular time of the year; remissions or mania/hypomania also at a characteristic time of year; these patterns must have lasted two years with no nonseasonal major depressive episodes during that same period; and these seasonal depressive episodes outnumber other depressive episodes throughout the patient's lifetime. Treatment Light therapy or photo therapy has been recommended for seasonal affective disorder. This is based on the assumption that decreased exposure to full spectrum light may be responsible for chemical changes that trigger depression in some people. The treatment requires the person to sit under a full spectrum light for several hours per day, throughout the winter months. As an alternative, individuals are encouraged to take walks outdoors whenever possible (depending on weather conditions). More recently, some studies have suggested that the full spectrum is not necessary, but that it does require exposure to bright light conditions for several hours per day. In addition to the light therapy, other more traditional treatment of depression is also recommended, including both psychotherapy and antidepressant medication. Some people have found that a short winter vacation to a warmer climate helps as well. The other treatment methods are described elsewhere on this site. Of course, most of us feel better after a vacation. And, taking a daily walk in the winter would certainly help reverse the impact of isolation or "cabin fever" many people experience in the winter. Even the recommendation to spend several hours per day under the lights, also recommends that the person do something productive while receiving exposure, such as reading. It is not possible to evaluate independently

the effects of these other factors. On the other hand, light therapy is not expensive, and does not appear to be intrusive or potentially harmful. If the combination of traditional treatment and light therapy appears to be more helpful to some individuals, we might not need to wait for researchers to confirm the existence of seasonal factors in some depression. We can recommend the treatment while we wait for the results of the research. Hypomania A condition which is characterized by an abnormal mood which is similar to mania but to a lesser degress. More detailed information about the symptoms, causes, and treatments of Hypomania is available below. Hypomania is defined as a mild or moderate manic state characterized by impulsivity, hyperactivity, euphoria, and racing thoughts. Hypomania can be distinguished from normal happiness by its persistence, non-reactivity and social disability. Causes of Hypomania The cause of Hypomania is unknown. Some causes are -

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heredity factors,

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occupation (high stress occupations),

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age (tends to occurs between 20 and 55 years of age), and

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sex (predominantly see in males).

CRITERIA FOR HYPOMANIC EPISODE

A.

A distinct period of persistently elevated, expansive; or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual nondepressed mood.

B.

During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree: 1.

inflated self-esteem or grandiosity

2.

decreased need for sleep (e.g., feels rested after only 3 hours of sleep)

3.

more talkative than usual or pressure to keep talking

4.

flight of ideas or subjective experience that thoughts are racing

5.

distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)

6.

increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation

7.

excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., the person engages in unrestrained buying sprees, sexually indiscretions, or foolish business investments)

C.

The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic.

D.

The disturbance in mood and the change in functioning are observable by others.

E.

The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features.

F.

The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).

Note: Hypomanic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar II Disorder. Treatment It is unknown to what degree hypomanic symptoms can occur without a depressive component. Patients may be relatively unlikely to seek psychiatric treatment for hypomania alone. However, many hypomanic patients experience:

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lower need for sleep

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racing thoughts

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obsessive behavior, whether mild or severe

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poor judgment relative to a particular situation's judgment call

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uncontrollable, or only partially controllable, impulsivity

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excessive sexual activity

Plus other out-of-character behaviors that the person may regret following the conclusion of the mood episode. Hypomania can signal the beginning of a more severe manic episode, and often does result in a more severe manic episode if the hypomanic episode remains untreated. A hypomanic episode can also directly precede a depressive episode. Virtually all clinical trials of medications for the non-depressive phases of bipolar illnesses involve treating patients for psychotic mania during the initial, or acute, phase of mania. Such trials are the basis upon which appropriate medication is recommended; high doses are justified in the case of mania, in order to remove the patient from immediate danger. This is in direct contrast to hypomania, however, which involves different considerations and almost always demands much greater case-by-case clinical judgment. Typical prescribed medications for hypomania include mood stabilizers such as Depakote and lithium carbonate as well as atypical antipsychotics such as Zyprexa and Seroquel. Treatment of Hypomania Mania can vary in severity from hypomania, where, in addition to mood and energy elevation, the person shows mild impairment of judgement and insight, to severe mania. The same medications as for mania. These include mood stabilizers such as lithium, Tegretol, Depakote, Topamax, Lamictil and Neurontin. Hypomania can be difficult to diagnose because it may masquerade as mere happiness.

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Engage yourself in relaxing and calming activities. Stay away from over stimulating environments.

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Do not consume excess sugar, caffeine and alcohol. Eat balanced diet.

Bipolar I Disorder is a form of mental illness Bipolar I disorder, an individual has experienced one or more manic episodes with or without major depressive episodes. is characterized by episodes of mania that alternate with periods of depression or periods in which individuals have simultaneously occurring manic and depressive symptoms called mixed states. Bipolar 2 disorder is characterized by recurrent episodes of depression and milder symptoms of mania, called hypomania.

Major Depressive Disorder clinical depression, major depression, unipolar depression, or unipolar disorder) is a mental disorder typically characterized by a pervasive low mood, low self-esteem, and loss of interest or pleasure in usual activities. is a condition characterized by a long-lasting depressed mood or marked loss of interest or pleasure (anhedonia) in all or nearly all activities. when five or more symptoms of depression are present for at least 2 weeks. serious mental disorder that profoundly affects an individual's quality of life. Unlike normal bereavement or an occasional episode of "the blues," MDD causes a lengthy period of gloom and hopelessness, and may rob the sufferer of the ability to take pleasure in activities or relationships that were previously enjoyable. Causes The exact cause of depression is not known. Many researchers believe it is caused by chemical imbalances in the brain, which may be hereditary or caused by events in a person's life. Some types of depression seem to run in families, but depression can also occur in people who have no family history of the illness. Stressful life changes or events can trigger depression in some people. Usually, a combination of factors is involved. Each year, more than 18 million Americans -- men and women of all ages, races, and economic levels -- have depression. It occurs more often in women. Women are especially vulnerable to depression after giving birth. This is a result of the hormonal and physical changes. While new mothers commonly experience temporary "blues," depression that lasts longer than 2-3 weeks is not normal and requires treatment. Major depression can occur in children and teenagers, and they can also benefit from treatment.

Depressive disorders are characterized by sadness severe enough or persistent enough to interfere with function and sometimes by decreased interest or pleasure in activities. Exact cause is unknown but probably involves heredity, changes in neurotransmitter levels, altered neuroendocrine function, and psychosocial factors. Diagnosis is based on history. Treatment usually consists of drugs, psychotherapy, or both, and sometimes electroconvulsive therapy. The term depression is often used to refer to any of several depressive disorders. Three are classified in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) by specific symptoms: major depressive disorder (often called major depression), dysthymia, and depressive disorder not otherwise specified. Two others are classified by etiology: depressive disorder due to a general physical condition and substance-induced depressive disorder. Depressive disorders occur at any age but typically develop during the mid teens, 20s, or 30s. In primary care settings, as many as 30% of patients report depressive symptoms, but < 10% have major depression. The term depression is often used to describe the low or discouraged mood that results from disappointments or losses. However, a better term for such a mood is demoralization. The negative feelings of demoralization, unlike those of depression, resolve when circumstances or events improve; the low mood usually lasts days rather than weeks or months, and suicidal thoughts and prolonged loss of function are much less likely. Etiology Exact cause is unknown. Heredity has an uncertain role; depression is more common among 1st-degree relatives of depressed patients, and concordance between identical twins is high. Hereditary genetic polymorphisms for the serotonin transporter active in the brain may be triggered by stress. People who have a history of child abuse or other major life stresses and have the short allele for this transporter are about twice as likely to develop depression as those who have the long allele. Other theories focus on changes in neurotransmitter levels, including abnormal regulation of cholinergic, catecholaminergic (noradrenergic or dopaminergic), and serotonergic (5-hydroxytryptamine) neurotransmission. Neuroendocrine deregulation may be a factor, with particular emphasis on 3 axes: hypothalamic-pituitary-adrenal, hypothalamic-pituitary-thyroid, and growth hormone. Psychosocial factors also seem involved. Major life stresses, especially separations and losses, commonly precede episodes of major depression; however, such events do not usually cause lasting, severe depression except in people predisposed to a mood disorder. People who have had an episode of major depression are at higher risk of subsequent episodes. People who are introverted and who have anxious tendencies may be more likely to develop a depressive disorder. Such people often lack the social skills to adjust to life pressures. Depression may also develop in people with other mental disorders. Women are at higher risk, but no theory explains why. Possible factors include greater exposure to or heightened response to daily stresses, higher levels of monoamine oxidase (the enzyme that degrades neurotransmitters considered important for mood), and endocrine changes that occur with menstruation and at menopause. In postpartum depression (see Postpartum Care: Management in the Hospital), symptoms develop within 4 wk after delivery; endocrine changes have been implicated, but the specific cause is unknown. Also, thyroid function is more commonly dysregulated in women. In seasonal affective disorder, symptoms develop in a seasonal pattern, typically during autumn or winter; the disorder tends to occur in climates with long or severe winters. Depressive symptoms or disorders may occur with various physical disorders, including thyroid and adrenal gland disorders, benign and malignant brain tumors, stroke, AIDS, Parkinson's disease, and multiple sclerosis.

CRITERIA FOR MAJOR DEPRESSIVE EPISODE

A.

Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.

1.

depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful) Note: In children and adolescents, can be irritable mood.

2.

markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)

3.

significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: in children, consider failure to make expected weight gains.

4.

insomnia or hypersomnia nearly every day

5.

psychomotor agitation or retardation nearly every day) observable by others, not merely subjective feelings of restlessness of being slowed down)

6.

fatigue or loss of energy nearly every day

7.

feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely selfreproach or guilt about being sick)

8.

diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)

9.

recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

B.

The symptoms do not meet criteria for a Mixed Episode.

C.

The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D.

The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).

E.

The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

Treatment Depression can be treated in a variety of ways, particularly with medications and counseling. Most people benefit from a combination of the two. Some studies have shown that antidepressant drug therapy combined with psychotherapy appears to have better results than either therapy alone. Medications include tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin re-uptake inhibitors (SSRIs), and some newer antidepressant drugs. While antidepressant medications can be very effective, some may not be appropriate for everyone. For example, in September, 2004 the FDA began considering a warning that some antidepressants may increase the risk of suicidal tendencies in children. In 2007, the FDA proposed that all antidepressant medicines should warn of the risk of suicidal behavior in young adults ages 18 - 24 years. Lithium and thyroid supplements may be needed to enhance the effectiveness of antidepressants. For persons with psychotic symptoms, such as delusions or hallucinations, antipsychotic medications may be needed. Electroconvulsive therapy (ECT) is a treatment that causes a seizure by means of an electrical current. ECT may improve the mood of severely depressed or suicidal people who don't respond to other treatments. Research is now being conducted on transcranial magnetic stimulation (TMS), which alters brain functioning in a way similar to ECT, but with fewer side effects. Use of light therapy for depressive symptoms in the winter months and interventions to restore a normal sleep cycle may be effective in relieving depression. As treatment takes effect, negative thinking diminishes. It takes time to feel better, but there are usually day-to-day improvements. It is important to maintain a healthy lifestyle. Eat well-balanced meals, avoid alcohol and drugs (which make depression worse and may interfere with medications), get regular exercise and sleep, and seek supportive interpersonal relationships. Many consumers try herbal products for depression. St. John's wort has a long history of use in Germany and has gained popularity as an herbal antidepressant in the United States. Most of the German studies indicated that St. John's wort was comparable to some antidepressants. However, a large study conducted by the National Center for Complementary and Alternative Medicine found that St. John's wort was NOT effective for treating major depression. Because herbal products can have side effects, always tell your doctor if you are using them. Bipolar I disorder is defined by alternation of full-fledged manic and major depressive episodes. It commonly begins with depression. Depression can occur immediately before or after mania, or depression and mania can be separated by months or years. Bipolar II disorder is defined by a history of at least one major depressive episode and at least one hypomanic episode. Depressive episodes alternate with hypomania. During the hypomanic period, mood brightens, the need for sleep decreases, and psychomotor activity accelerates. Often, the switch follows circadian factors (eg, going to bed depressed and waking early in the morning in a hypomanic state). Hypersomnia and overeating are characteristic and may recur seasonally (eg, in autumn or winter); insomnia and poor appetite occur during the depressive phase. For some patients, hypomanic periods are adaptive because they produce high energy, confidence, and supernormal social functioning. Psychosocial Treatments As an addition to medication, psychosocial treatments—including certain forms of psychotherapy (or “talk” therapy)—are helpful in providing support, education, and guidance to people with bipolar disorder and their families. Studies have shown that psychosocial interventions can lead to increased mood stability, fewer hospitalizations, and improved functioning in several areas.12 A licensed psychologist, social worker, or counselor typically provides these therapies and often works together with the psychiatrist to monitor a patient’s progress. The number, frequency, and type of sessions should be based on the treatment needs of each person. Psychosocial interventions commonly used for bipolar disorder are cognitive behavioral therapy, psychoeducation, family therapy, and a newer technique, interpersonal and social rhythm therapy. NIMH researchers are studying how these interventions compare to one another when added to medication treatment for bipolar disorder.

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Cognitive behavioral therapy helps people with bipolar disorder learn to change inappropriate or negative thought patterns and behaviors associated with the illness.

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Psychoeducation involves teaching people with bipolar disorder about the illness and its treatment, and how to recognize signs of relapse so that early intervention can be sought before a full-blown illness episode occurs. Psychoeducation also may be helpful for family members.

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Family therapy uses strategies to reduce the level of distress within the family that may either contribute to or result from the ill person’s symptoms.

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Interpersonal and social rhythm therapy helps people with bipolar disorder both to improve interpersonal relationships and to regularize their daily routines. Regular daily routines and sleep schedules may help protect against manic episodes.

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As with medication, it is important to follow the treatment plan for any psychosocial intervention to achieve the greatest benefit.

Cyclothymia is a mood disorder. This disorder is a milder form of bipolar II disorder consisting of recurrent mood disturbances between hypomania and dysthymic mood. cyclothymia is a chronic mood disorder that causes emotional ups and downs. DSM-IV-TR

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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.

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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.

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The longest period the patient has been free of symptoms is two months.

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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.

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Symptoms are not directly caused by a general medical condition or the use of any substances such as prescription medicines.

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The symptoms cause the patient clinically significant distress or impair work, social or personal functioning.

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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.

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These mood swings are not as severe as bipolar I disorder or bipolar II disorder.

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Cyclothymia is to bipolar disorder as Dysthymia (a mild form of clinical depression) is to major depressive disorder.

Causes Cyclothymia appears to have a genetic contribution, which has been shown by a range of twin studies involving dizygotic (fraternal) and monozygotic (identical) twins. [1][2] Psychosocial factors have also been implicated, for example stressful life events or living conditions, and interpersonal difficulties. In addition, some hypotheses posit that the hypomanic episodes have meaning in the context of a person seeking to achieve goals or to avoid depression. Causes It's not known specifically what causes cyclothymia. As with many mental disorders, research shows that it may result from a combination of:

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Genetics

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Your body's biochemical processes, such as changes in brain chemistry

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Environment

Treatment Treatment for cyclothymia can include a variety of cognitive behavioral therapy techniques. Prescription drugs such as lamotrigine, lithium, verapamil [3] and benzodiazepines are often used to treat cyclothymia. Treatments and drugs Cyclothymia is a long-term condition that requires lifelong treatment, even during periods when you feel better. Cyclothymia treatment is usually guided by a mental health provider skilled in treating the condition. Because cyclothymia has a high risk of developing into bipolar disorder, it's important to get effective and appropriate treatment. Treatment is also vital for reducing the frequency and severity of hypomanic and depressive episodes and allowing you to live a more balanced and enjoyable life. Maintenance treatment — continued treatment during periods of remission — is also important. If you skip maintenance treatment, you may be at higher risk of having a relapse of cyclothymia symptoms or having minor episodes turn into larger problems. If you have problems with alcohol or substance abuse, you must get treatment for those, too, since they can worsen cyclothymia symptoms. The main treatments for cyclothymic disorder are medications and psychotherapy. Medications Medications may help control cyclothymia symptoms and prevent episodes of hypomania and depression. Medications commonly used to treat cyclothymia include:

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Mood stabilizers. Mood stabilizers are the most commonly prescribed medications for cyclothymic disorder. These medications help regulate and stabilize mood so that you don't swing between depression and hypomania. Lithium (Eskalith, Lithobid) has been widely used as a mood stabilizer and is generally the first line of treatment for hypomanic episodes. Your doctor may recommend that you take mood stabilizers for the rest of your life to prevent and treat hypomanic episodes.

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Anti-seizure medications. The medications, also known as anticonvulsants, are used to prevent mood swings. They include valproic acid (Depakene), divalproex (Depakote) and lamotrigine (Lamictal).

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Other medications. Certain atypical antipsychotic medications, such as olanzapine (Zyprexa) and risperidone (Risperdal), may help people who don't gain benefits from anti-seizure medications. Anti-anxiety medications, such as benzodiazepines, may help improve sleep. In addition, one medication, quetiapine (Seroquel), has been approved by the Food and Drug Administration to treat both the manic and depressive episodes of bipolar disorder, and may also be helpful for cyclothymic disorder.

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Antidepressants. Use of antidepressants in cyclothymic disorder is typically not recommended, unless they're combined with a mood stabilizer. As with bipolar disorder, taking antidepressants alone can trigger potentially dangerous manic episodes. Before taking antidepressants, carefully weigh the pros and cons with your doctor.

If one medication doesn't work well for you, there are many others to consider. Keep trying until you find one that works well for you. Your doctor may advise combining certain medications for maximum effect. It can take several weeks after first starting a medication to notice an improvement in your cyclothymia symptoms. Be aware that all medications have side effects and possible health risks. Certain antipsychotic medications, for instance, may increase the risk of diabetes, obesity and high blood pressure. If you take these medications, talk to your doctor about being monitored for health problems. Also, mood stabilizing medications may harm a developing fetus or nursing infant. Women with cyclothymic disorder who want to become pregnant or do become pregnant must fully explore with their health care providers the benefits and risks of medications. Psychotherapy Psychotherapy is another vital part of cyclothymia treatment. Psychotherapy, also called counseling or talk therapy, can help you understand what cyclothymia is and how it's treated. Some experts recommend that you have therapy with a psychiatrist or psychologist with experience in treating cyclothymic disorder. Types of therapy that may help cyclothymia include:

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Cognitive behavioral therapy. This is a common form of individual therapy for cyclothymia. The focus of cognitive behavioral therapy is identifying unhealthy, negative beliefs and behaviors and replacing them with healthy, positive ones. In addition, you can explore what may trigger your hypomanic or depressive episodes. You also learn effective strategies to manage stress and to cope with upsetting situations.

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Family therapy. Family therapy involves you and your family members. Family therapy can help identify and reduce stressors within your family that may contribute to unhealthy behavior patterns. Family therapy can also help your family improve its communication style and problem-solving skills and resolve conflicts. And it may help your family — whether parents, siblings or partners — better understand your condition and why you think and behave the way you do.

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Group therapy. Group therapy provides a forum to communicate with and learn from others in a similar situation. It may also help build better relationship skills.

Bipolar I disorder is a mood disorder that is characterized by at least one manic or mixed episode. There may be episodes of hypomania or major depression as well. It is a sub-diagnosis of bipolar disorder, and conforms to the classic concept of manic-depressive illness.

DSM-IV-TR diagnostic criteria The essential feature of bipolar I disorder is a clinical course that is characterized by the occurrence of one or more manic episodes or mixed episodes. Often individuals have also had one or more major depressive episodes. Episodes of substance-induced mood disorder (due to the direct effects of a medication, or other somatic treatments for depression, a drug of abuse, or toxin exposure) or of mood disorder due to a general medical condition do not count toward a diagnosis of bipolar I disorder. In addition, the episodes are not better accounted for by schizoaffective disorder and are not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder not otherwise specified. Who Is at Risk for Bipolar I Disorder? Virtually anyone can develop bipolar I disorder. About 2.5% of the U.S. population suffers from bipolar disorder -- almost 6 million people. Most people are in their teens or early 20s when symptoms first start. Nearly everyone with bipolar I disorder develops it before age 50. People with an immediate family member with bipolar are at higher risk. Bipolar II Disorder is a bipolar spectrum disorder that is characterized by at least one hypomanic episode and at least one major depressive episode; with this disorder, depressive episodes are more frequent and more intense than manic episodes. It is believed to be underdiagnosed because hypomanic behavior often presents as high-functioning behavior Who Is At Risk for Bipolar II Disorder? Virtually anyone can develop bipolar II disorder. About 2.5% of the U.S. population suffers from some form of bipolar disorder -- almost 6 million people. Most people are in their teens or early 20s when symptoms first start. Nearly everyone with bipolar II disorder develops it before age 50. People with an immediate family member with bipolar are at higher risk. DSM-IV-TR Diagnostic Criteria A. Presence (or history) of one or more Major Depressive Episodes. B. Presence (or history) of at least one Hypomanic Episode. C. There has never been a Manic Episode or a Mixed Episode. D. The mood symptoms in Criteria A and B are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. E. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Treatments Social rhythm therapy - Maintaining a regular daily schedule. Interpersonal therapy - Acceptance of the illness. Behavioral therapy - Limiting toxicants like alcohol, maintain a healthy body by exercising. Cognitive Therapy - Relying on only positive, helpful thoughts. Psycho Education - Learning about the disorder. Light therapy - Light therapy used mainly for the depressive symptoms. Family-focused therapy - The family acknowledges the disorder and helps.