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Cyclothymia vs Bipolar: What Patients and Families Need to Know

Under the category of mood disorders, there are several conditions with which a person can be diagnosed. When looking at the subcategory of bipolar disorder, there are three main disorders:

  1. Bipolar I
  2. Bipolar II
  3. Cyclothymic

Distinguishing between bipolar disorder vs cyclothymia is important for patients and physicians alike because the symptoms and subsequent treatments are slightly different. Effectively managing a condition and getting the right type of support requires a correct diagnosis. A correct diagnosis starts with understanding the difference between cyclothymia and bipolar.

Cyclothymia and bipolar

With bipolar disorder, individuals struggle with manic or depressive mood swings, which can last several weeks or longer. 

  1. Bipolar I is categorized by manic episodes primarily, which last at least one week, as well as major depressive episodes, which last at least two weeks.
  2. Bipolar II is categorized by one major depressive disorder and at least one hypomanic episode, which presents with less severe manic symptoms that typically only last four days in a row rather than at least one week, as is the case with Bipolar I manic episodes. 
  3. Cyclothymia is categorized as a milder form of the disorder where hypomania and depressive symptoms occur frequently, but the symptoms are less severe compared to bipolar.
cyclothymia vs bipolar

Key differences between cyclothymia and bipolar disorder

So, what is the difference between cyclothymia and bipolar? 

Symptom severity

The biggest difference with cyclothymia vs. bipolar has to do with the severity of symptoms. 

For bipolar, symptoms include the following:

Manic

During a manic episode, a person will experience severe irritability and energy for at least one week without stopping, including feelings of:

  • Distractibility
  • Uncontrollable or racing thoughts
  • Fast speech
  • Impulsivity
  • Increased activity
  • An inability to focus
  • Decreased need for sleep
  • Inability to finish tasks and instead jumping to the next thing

Depressive

During a depressive episode, a person will experience severe depression at least two weeks long where they have a minimum of four of the following symptoms:

  • Problems concentrating
  • Restlessness
  • Decreased appetite or increased appetite
  • Decreased need for sleep or increased need for sleep
  • Fatigue
  • Hopelessness
  • Despair
  • Loss of interest in activities they once liked
  • Feelings of worthlessness or guilt
  • Suicidal ideations 

Duration and frequency

With bipolar disorder vs cyclothymia, another key difference has to do with the frequency and duration of the symptoms.

With cyclothymia, symptoms must present for at least two years with frequent periods of hypomanic and depressive symptoms. However, both sets of symptoms must present as slightly less severe compared to bipolar. Moreover, during the 2-year time frame, those mood swings must present continually at least half of the time, never dissipating for more than two months.

Causes and risk factors

Research remains uncertain about the exact cause of bipolar disorder, but evidence indicates a strong family tie, which would suggest that genetics play a significant role in whether or not you develop bipolar disorder. 80% of those with any level of bipolar disorder have a first-degree relative with the same. 

Similarly, stressful life events and changes to brain chemistry can contribute to an increased risk of developing either condition.

The impact on daily life

Cyclothymia arguably has a more significant impact on daily life because the episodes are more frequent but less severe. In either case, however, severe mood swings can impact productivity, energy, sleep, and dietary patterns. All of this can contribute to significant fluctuations in physical activity, exercise, healthy diet, sleep patterns, personal relationships, and productivity.

treatment for cyclothymia vs bipolar

Treatment options and management

Treatment options for bipolar disorder heavily center on medication and psychotherapy. As bipolar disorder is not something that can be effectively treated or cured, individuals have to learn how to manage their symptoms with things like:

  • Recognizing triggers of an oncoming manic or depressive episode for those with bipolar
  • Keeping a journal to recognize mood fluctuations for those with cyclothymia

Medication like mood stabilizers can help with bipolar disorder, and those who experience depressive episodes might also be prescribed antidepressants when they are experiencing a depressive episode.

All of these medications are more effective when used in conjunction with therapy. Psychotherapy or talk therapy provides an opportunity to learn more about bipolar vs cyclothymia and how to prevent future episodes or reduce stress that might trigger episodes.

Advice for patients and families

If you are living with a family member who has cyclothymia and bipolar symptoms or you are struggling with a diagnosis yourself, there are things you can do.

Educate yourself and your family

The most important thing with cyclothymia vs bipolar is to educate yourself and your family. The more you understand about your condition, the better able you are to manage it. Having your family participate in that ongoing education is equally important because it provides a chance for your family to better understand when certain symptoms might be related to your condition and how they can help support you during manic or depressive periods. 

Develop a support plan

Equally important is to develop a support plan. As mentioned, individuals who are going through therapy or dealing with a new diagnosis, especially with medication, are more likely to stick to their treatment plan if they have support from their family.

Support can come from support groups for people with bipolar disorder vs. cyclothymia or support groups for family members who are living with someone with a mental health disorder.

Maintain regular treatment and follow-up

As both conditions are things that cannot be cured it’s imperative that you maintain regular treatment and follow up. If you are prescribed medication it’s important that you adhere to that regimen even if you start to notice an improvement in your symptoms. An improvement in symptoms indicates that the medication is working, not necessarily that you should stop using it.

Establish healthy routines

Healthy routines for your physical and mental well-being are important in reducing stress and triggers that might cause subsequent mood swings. With cyclothymia and bipolar disorder, healthy routines for things like meals, sleep hygiene, meditation, exercise, and self-care can go a long way toward providing the foundation you need to continue looking after yourself even when symptoms are severe.

It is always much easier to stick to a routine during the bad times if you have stuck with it during the good times.

Foster open communication

Always foster open communication. Open communication not only involves your family but involves your healthcare practitioners or a therapist with whom you meet. Therapists can offer useful information as well as coping mechanisms based on changes in your symptoms, your environment, your self-esteem, and anything in between. 

With open communication you can let your doctors know when you think you need medicine, when you think you need new medicine, or when you want to try a different management technique.

Summing Up

The biggest difference between cyclothymia and bipolar disorder is the severity of symptoms and their frequency/duration. However, both symptoms can have a detrimental impact on individuals and families. For that reason, ongoing education, support, and advocacy are things you should consider to help improve your life and the lives of those affected by these disorders.

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