How do you Manage Cyclothymic Disorder?

What Causes Cyclothymic Disorder and How to Treat it?

Cyclothymic disorder is a milder, yet often persistent, type of bipolar disorder. It includes several periods of hypomanic symptoms as well as depressive symptoms, which do not respectively constitute a major depressive episode.

It is as if living with cyclothymic disorder is an emotional rollercoaster ride, with constant mood shifts that can disrupt one's personal, social, or working life. To learn to live with cyclothymia and have a better quality of life, it is important to have a clear insight into its causes and a holistic approach to management.

What are the causes of cyclothymia disorder?

The physiological cause of cyclothymic disorder remains unknown to researchers. Nevertheless, increasingly, it is being accepted that cyclothymia, as with most other psychiatric disorders, is probably the product of an interaction among multiple genetic, biological, and environmental factors.

• Genetic/Heredity factors: The research indicates that cyclothymic disorder is inherited, and it is highly probable that not only genetic elements but also family elements will shape the individual. A person who has a first-degree relative - a parent, sibling, or child - with bipolar I, bipolar II, or major depressive disorder shows an increased risk for cyclothymia. Thus, it seems there is a family link here, which implies that these individuals may have certain genes that predispose them to cyclothymia. Though scientists have not identified the specific genes, genetic susceptibility is a promising target for ongoing research.
• Biological and Neurological Factors: Differences in the architecture and functioning of the brain may also play a role in the causation of cyclothymia. Neuroimaging studies have indicated that an individual with a bipolar spectrum disorder such as cyclothymia might have subtle variations in the workings of those brain regions responsible for mood regulation, emotion, and executive function. Furthermore, the influence of the brain's neurobiology, such as the workings of the neurotransmitters (biological messenger chemicals such as serotonin, dopamine, norepinephrine, and so on), also might have a causative impact. The operation of such important brain chemicals can get disturbed and contribute to problems in controlling mood, thus resulting in high and low swings of cyclothymia.
• Environmental Triggers and Stressful Life Events: Although genetic predisposition can be a background for cyclothymia, environmental factors usually serve as precipitants that cause the first sign of symptoms (or recurrence or worsening of symptoms).
• Traumatic circumstances and negative experiences, particularly in childhood, such as physical or emotional abuse, neglect, or loss of a parent, have been proven to elevate the risk for the development of mood disorders. Also, prolonged stress routine and persistent adversity, or significant changes in life, may cause symptoms of cyclothymia in predisposed people. It is generally believed that genetic susceptibility plays a role in interacting with environmental stressors.

An Integrated Approach to Treating Cyclothymic Disorder

Treating cyclothymic disorder is a chronic process that demands a personalized and comprehensive treatment regimen.

The primary goals of such treatment are to reduce the frequency and severity of mood swings and improve functioning and quality of life. Effectively treating this condition typically entails a combination of psychotherapy, medication, and lifestyle modifications.

Psychotherapy: The Foundation of Treatment

Psychotherapy, sometimes known as "talk therapy," is an integral part of the treatment of cyclothymia. It helps people develop strategies and techniques to better understand and live with their disorder. Several types of therapy have proven to be useful:

• Cognitive Behavioral Therapy, or CBT, is a highly successful and widely used treatment for mood disorders. It allows individuals to identify and challenge those annoying negative patterns of thinking and unproductive behaviours that can derail their moods. By understanding how to change their view of negative thinking and replace unhealthy coping mechanisms with healthier ones, individuals can regain control of their emotional reactions.
• Interpersonal and Social Rhythm Therapy (IPSRT) is all about stabilizing daily routines, particularly for sleep-wake cycles, meal times, and social activities. The concept behind IPSRT is that maintaining a daily rhythm can help stabilize the internal clock of the body, which can lead to greater mood stability. It also addresses interpersonal issues that may be contributing to stress and mood swings.
• Dialectical Behavior Therapy (DBT) is especially helpful to individuals who find themselves struggling with strong emotions and impulsive actions. It aims to educate individuals in four primary skills domains: mindfulness, distress tolerance, emotional regulation, and interpersonal skills. Such skills may help individuals manage their highs and lows emotionally better.
• When stabilising mood swings are concerned, medication can really be an important part of it. Although there are no medications FDA-approved for cyclothymia, some that treat bipolar disorder can effectively treat its symptoms. Finding the right medication is a matter of personal choice and should be carefully supervised by a psychiatrist.
• Mood stabilizers, by name, stabilise the mood swings of cyclothymia. Lithium is a renowned mood stabilizer that has been in use for decades, treating bipolar conditions. Anticonvulsants such as lamotrigine (Lamictal), valproic acid (Depakene), and divalproex sodium (Depakote) are also widely used as mood stabilis
• Atypical Antipsychotics might be employed in some situations, particularly where hypomanic is more severe.

In the treatment of cyclothymia, antidepressants are employed with caution. While they can definitely alleviate depressive symptoms, there is a possibility that they can trigger hypomanic episodes or trigger mood swings more quickly.

Lifestyle Changes and Self-Care

Aside from professional intervention, some lifestyle adjustments are crucial to coping with cyclothymic disorder in the long term.

• Stress Reduction: Learning and practising methods for minimizing stress, such as mindfulness, meditation, deep breathing, and yoga, can indeed aid in reducing stress's effect on your mood.
• Daily Sleep Schedule: Following a routine sleep-wake schedule, as recommended by IPSRT, is essential to maintain your mood in a stable state. Sleeping and rising at the same time daily, including weekends, can be a tremendous difference.
• Exercise Regularly: Being active is a natural mood lifter and can help alleviate depressive and hypomanic symptoms. Try for a minimum of 30 minutes of moderate physical activity most weekdays.
• Staying Away from Alcohol and Recreational Drugs: Substance use can make mood swings worse and interfere with the effectiveness of medications. It's strongly advised that individuals with cyclothymia avoid alcohol and illicit drugs.
• Mood Charting: Maintaining a daily record of your moods, sleeping patterns, and events in your life can assist you and your doctor in identifying triggers and monitoring how well treatments are working.

In summary, while we're still figuring out the exact causes of cyclothymic disorder, it's clear that it's a complex condition influenced by a mix of genetic, biological, and environmental factors. Managing it effectively is a lifelong journey that requires a well-rounded approach, combining therapy, carefully monitored medication, and positive lifestyle changes.

With consistent and thorough care, those living with cyclothymic disorder can learn to manage their symptoms and lead fulfilling lives.