Cyclothymia: Wikis

  

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Cyclothymia
Classification and external resources
ICD-10 F34.0
ICD-9 301.13
MeSH D003527

Cyclothymia (pronounced /ˌsaɪklɵˈθaɪmiə, ˌsɪklɵ-/) a condition which causes mild hypomanic and depressive episodes. It is defined in the bipolar spectrum. Specifically, this disorder is a milder form of bipolar II disorder consisting of recurrent mood disturbances between hypomania and dysthymic mood. A single episode of hypomania is sufficient to diagnose cyclothymic disorder; however, most individuals also have dysthymic periods. The diagnosis of cyclothymic disorder is not made when there is a history of mania or major depressive episode or mixed episode. The lifetime prevalence of cyclothymic disorder is 0.4-1%. The rate appears equal in men and women, though women more often seek treatment. Unlike some forms of bipolar disorder (specifically, bipolar I disorder), people with cyclothymia are almost always fully functioning.

Cyclothymia is similar to bipolar II disorder in that it presents itself in signature hypomanic episodes. Because hypomania is often associated with incredibly creative, outgoing, and high-functioning behavior, both conditions are often undiagnosed. Typically, like most of the disorders in the bipolar spectrum, it is the depressive phase that leads most sufferers to get help.

Contents

Diagnostic criteria

Diagnosis requires a history of hypomanic episodes with periods of depression that are not major depressive episodes. The diagnosis is excluded if there are manic episodes or mixed episodes, or if a number of other conditions such as schizophrenia or drug abuse are present.[1]

Differential diagnosis

This disorder is common in the relatives of patients with bipolar disorder and some individuals with cyclothymia eventually develop bipolar disorder themselves. It may persist throughout adult life, cease temporarily or permanently, or develop into more severe mood swings meeting the criteria for bipolar disorder or recurrent depressive disorder in rare cases.

Symptoms

Dysthymic phase

Difficulty making decisions; problems concentrating; poor memory recall; guilt; self-criticism; low self-esteem; pessimism; self-destructive thinking; continuously feeling sad; apathy; hopelessness; helplessness; irritability; quick temper; lack of motivation; social withdrawal; appetite change; lack of sexual desire; self-neglect; fatigue or insomnia [2]

Euphoric phase

Unusually good mood or cheerfulness (euphoria); Extreme optimism; Inflated self-esteem; Poor judgment; Rapid speech; Racing thoughts; Aggressive or hostile behavior; Being inconsiderate of others; Agitation; Increased physical activity; Risky behavior; Spending sprees; Increased drive to perform or achieve goals; Increased sexual drive; Decreased need for sleep; Tendency to be easily distracted; Inability to concentrate [3]

Causes

Biological

  • Family
    One is 2-3 times more likely to have the disorder if someone in the immediate family has it or if an identical twin has it. In a study by Bertelsen, Harvard, and Huage (1977), if an identical twin had depression, 59% of the identical twins had it also.
    Gender
    Heritability for women ranges from 36-44%; for men, 18-24%.
    Genes
    The same genes may contribute to depression and anxiety.
    Serotonin
    Serotonin regulates other hormones like norepinephrine and dopamine, so when serotonin is low, the other chemicals may fluctuate, causing irritability, impulsivity and mood irregularities such as dysthymia and depression.
    Cortisol
    depressed individuals can have high cortisol levels. Cortisol is a stress hormone, and mood disorders often occur during stressful points in one’s life. Elevated stress hormones can affect functioning of the hippocampus, an important centre for memory and cognitive processes. Overproducing cortisol can also impair the brain’s ability to regenerate neurons in the hippocampus.

Psychological

  • Stressful events, as perceived by the individual
    Job loss, relationship failure, identity change, natural disaster, learned helplessness and hopelessness, extreme feelings, negative thinking patterns.

Social

  • Environment
    Influences the disorder 60-80% of the time.
    Parenting styles[4]

Treatment

Exercise

It has been repeatedly demonstrated that regular, vigorous physical exercise can help with mood regulation and emotional stability.

Medications

Therapy

See also

References

  1. ^ American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th, text revision (DSM-IV-TR) ed. 2000. ISBN 0-89042-025-4. Diagnostic criteria for 301.13 Cyclothimic Disorder.
  2. ^ http://www.psychologyinfo.com/depression/dysthymic.htm
  3. ^ http://www.mayoclinic.com/health/cyclothymia/DS00729/DSECTION=symptoms
  4. ^ "Abnormal Psychology: An Integrative Approach" 4th ed. David Barlow and Mark Durand, 2005

External links








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