Bipolar4LifeSupport

Also known as cyclothymic disorder, the condition is different from other types of bipolar disorder.

Cyclothymia is a milder form of bipolar disorder, sometimes referred to as cyclothymic disorder.

Both cyclothymia and bipolar disorder are characterized by extreme mood swings, from the highs of mania to the lows of depression, with short periods of neutral time in between.

The difference lies in the intensity: People with bipolar disorder will experience major depression and clinically diagnosed mania, while patients with cyclothymia experience low-grade depression and mild mania.

With cyclothymia “it may seem like you’re just going through a string of good days and a string of bad days,” says psychiatrist Kathleen Franco, MD, of the Cleveland Clinic Lerner College of Medicine in Ohio.

“But the mood shifts keep going, and there’s little neutral time in between.”

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Cyclothymia Symptoms

Besides cycling between the two mood extremes, the other criteria that will determine a diagnosis of cyclothymia include:

You’ve experienced these mood swings for at least two years.
At least once in the two-year period, you have significant distress or social impairment.
Your symptom-free intervals last no more than three months.
Your symptoms don’t meet the requirements of any other bipolar disorder.
Cyclothymia vs. Bipolar Disorder: What’s the Difference?

Only a doctor can accurately make the clinical distinction between cyclothymia and bipolar disorder.

But generally speaking, the symptoms of a major bipolar depression include dramatic disturbances in

Symptoms can be long-lasting and dramatically reduce quality of life.

The same symptoms may be present in a cyclothymic depression, but they’re less severe (though they can have a significant impact on quality of life and social functioning).

The symptoms may last no more than two weeks, and they may cause less of a disruption in your daily routine.
The true mania of bipolar disorder, essentially the opposite of major depression, can likewise be debilitating.

It may be accompanied by feelings of euphoria and indestructibility — a sense of being “on top of the world” — that can include reckless behaviors such as driving too fast or abusing drugs or alcohol.

The manic person may go a day or two without sleeping. He may talk rapidly, moving from topic to topic without making much sense.

The hypomania seen with cyclothymia is less dramatic and not as long-lasting. Your symptoms may be so mild as to seem normal — mild sleeplessness, for example, or chattiness and increased energy.

While some people living with cyclothymia are happy to go without treatment, it may be important for others to recognize and monitor the condition, because one-third to one-half of people with cyclothymic disorder go on to develop full-blown bipolar disorder.

This escalation is especially prevalent if bipolar disorders run in the family.

Although preventive treatment hasn’t been identified yet, there is some hope among researchers that early treatment for cyclothymia may prevent full-blown bipolar disorder from developing.

Cyclothymia Treatment

There’s no cure for cyclothymia.

Medicines usually prescribed for bipolar disorder, such as mood stabilizers, don’t always work on cyclothymia.

More often, treatment for cyclothymia involves talk therapy with a trusted psychologist who can help patients recognize the triggers that may increase the severity and frequency of their mood swings.
For example, mood shifts can be triggered by lack of sleep, alcohol consumption, or traveling through many time zones.

Light therapy can also help treat cyclothymia.

In time and with the help of a trusted support team — beginning with your doctor — you can learn to manage your moods and your response to them, and live a life less disrupted by cyclothymia.

Too often, bipolar disorder goes untreated, but it can be managed with the right medical help.

Many people with bipolar disorder don’t recognize the extreme changes in their moods, and the effect these changes have on their lives and the lives of those around them.

As a result, too many people with the condition fail to get the necessary treatment.

If you think you may have bipolar disorder, talk to your doctor, a friend, or a family member. This person may be able to assist you in taking the first steps toward treating the condition.

If you think you may hurt yourself or attempt suicide — or if you think a loved one may do the same or harm others — seek emergency medical help immediately.

Hospitalization may be required in some cases of bipolar disorder. In most cases, though, the condition can be successfully treated in an outpatient setting — ideally by seeing a psychiatrist.

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Most people with bipolar disorder can lead normal and productive lives if they continue with their treatment and regularly see their doctor.

Bipolar Disorder Medications

If you’ve been diagnosed with bipolar disorder, you’ll most likely need to start taking medication to balance your moods immediately.

Once your mood swings and other symptoms are under control, you’ll work with your doctor to develop maintenance treatment to manage your condition over the long term.

A number of medications are used to treat bipolar disorder, including:

Mood stabilizers
Antipsychotics
Antidepressants
Antianxiety medications
Your doctor will prescribe one or more medications based on the type of bipolar disorder you have, as well as the exact nature of your symptoms.

Most people with bipolar I or bipolar II will need mood stabilizers to control their manic or hypomanic episodes.

If you have one of these forms of the condition, your doctor may prescribe one of the following mood stabilizers:

Tegretol (carbamazepine)
Depakote (divalproex sodium)
Lamictal (lamotrigine)
Lithobid (lithium)
Depakene (valproic acid)
Antipsychotic drugs may also be used to control episodes of depression or mania, especially when delusions or hallucinations are occurring.

Examples of drugs in this class include:

Abilify (aripiprazole)
Saphris (asenapine)
Symbyax (olanzapine and fluoxetine)
Latuda (lurasidone)
Zyprexa (olanzapine)
Seroquel (quetiapine)
Risperdal (risperidone)
Geodon (ziprasidone)
An antidepressant may also be used to manage depressive episodes, in conjunction with a mood stabilizer or an antipsychotic.

Finally, your doctor may recommend a benzodiazepine — or another type of antianxiety medication — to relieve anxiety or improve sleep.

There’s a certain amount of trial and error associated with finding the right treatment for bipolar disorder.

But given that there are so many options, you and your doctor should be able to find a combination that works well for you.

Bipolar Medication Side Effects

One of the challenges associated with medication for bipolar disorder is the potential for a wide variety of side effects — some of which may be serious.

If you experience side effects from your drug therapy, talk to your doctor. Don’t stop taking your medication(s) unless your doctor advises you to do so.

If you suddenly stop taking a drug, your symptoms may return or you may experience withdrawal.

In addition to their potential for side effects, many of the drugs used to treat bipolar disorder can interact with birth control pills or may have health implications for women who are pregnant or might become pregnant.

If you’re using birth control, are pregnant, or are planning to become pregnant, talk to your doctor before starting on any medication for bipolar disorder.

Brain Stimulation Therapies

If your condition doesn’t respond well to treatment with drugs, your doctor may recommend electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS).
In ECT, your brain is treated with small electrical currents designed to affect the levels of certain neurotransmitters (chemicals that affect the brain).

In TMS, small magnetic pulses are applied to your brain to stimulate nerve cells that control mood regulation.

Both of these approaches typically involve multiple treatments.

Psychotherapy for Bipolar Disorder

In addition to prescribing medication, your doctor will also most likely recommend that you undergo routine psychotherapy or some other form of counseling.

This may include treatment for drug or alcohol addiction, if you’re dealing with addiction in addition to your bipolar disorder.

There are many different types of psychotherapy. Cognitive behavioral therapy (CBT) is the most commonly used form.

In CBT, a mental health professional (psychiatrist or psychologist) will work with you to identify triggers for your bipolar episodes, and develop healthy and effective strategies for dealing with stress and managing your condition.

Your doctor may also recommend educational and support programs for you and your family, which may help you better understand the disease and its symptoms — as well as how to cope with it.

When a child is diagnosed with bipolar disorder, teachers, school administrators, and other support staff are often engaged in treatment to make sure the child is doing well.

Alternative Treatments for Bipolar Disorder

Several so-called alternative treatments, or home remedies, have been recommended for bipolar disorder, although there is limited scientific evidence of their effectiveness in managing symptoms.

Most of these approaches involve taking herbal or dietary supplements, including:

Amino acids
Magnesium
Omega-3 fatty acids (such as fish oil or flaxseed oil)
St. John’s wort (for depression)
Commonly recommended amino acids — such as SAMe (S-adenosyl-L-methionine) — and St. John’s wort may interact with antidepressants or trigger episodes of mania or hypomania in some people.

Some people believe that the ancient Chinese practice of acupuncture may help treat depression. Researchers don’t yet know how effective this approach is for bipolar disorder, but it’s known to be safe overall, and it can be tried along with other prescription treatments.

Talk to your doctor before starting any nontraditional treatment for bipolar disorder, to make sure that it won’t interact with any prescription medications you’re taking.

Most important, don’t stop taking prescribed medications even if you’re feeling better.

Living With Bipolar Disorder

Living with bipolar disorder isn’t without challenges — but with the right treatment, education, and support, it’s possible to lead a quite normal and productive life.

If you’ve been diagnosed with bipolar disorder, make an effort to learn about the disease and its treatment so that you can work with your doctor to find the best course of treatment for you.

Learning about the disorder can also help you educate your family and friends about your struggles, so that they can better support you.

Speaking of support, there are many support groups for people with bipolar disorder and their families. You may find these groups helpful.

As you and your doctor work to refine your treatment to minimize both symptoms and side effects, try to be patient and remain motivated toward achieving your recovery goals. There are many combinations of treatments, and one will most likely work for you.

Finally, find healthy ways to channel your energy and manage or reduce stress.

For example, you should quit drinking alcohol or using drugs, as these substances can worsen the risk-taking behaviors associated with episodes of mania or hypomania — as well as make episodes of depression more severe.

Be sure to surround yourself with supportive, caring friends and family who will help you cope with your condition — and not encourage negative or destructive behaviors.

Exercise regularly, as physical activity can reduce stress, stabilize your mood, and signal your brain to release chemicals — called endorphins — that make you feel good.
Getting enough exercise can also help improve your sleep, which may help stabilize your mood.

Work with your doctor to develop an exercise regimen that’s right for you.

Consider taking on hobbies that help you relax, or explore certain relaxation techniques — such as yoga or meditation — that are designed to reduce stress.

If it’s not an herb, vitamin, or mineral, you can simply call it a nutritional supplement. That means the manufacturer agrees not to market it as a drug, and the FDA agrees to consider it a food. Meanwhile, consumers are left unsure about whether these supplements provide nutrients (they usually don’t), cure disease (rarely, if ever), or simply promote health.

The supplements category includes amino acids. There are 22 of these simple compounds, which combine to create all of the body’s proteins. Most amino acids are produced by the body itself, but some people do report benefits from taking amino acid supplements. These may combine several amino acids, or include just one.

Along with amino acids, supplements that may be suggested for symptoms ofbipolar disorders include:

• Lecithin (phosphatidyl choline). A phospholipid found mostly in high-fat foods. It is said to have the ability to improve memory and brain processes. Lecithin is necessary for normal brain development; however, double-blind studies of patients with Alzheimer’s disease did not substantiate claims that it can help people recover lost brain function. The ketogenic diet increases the amount of lecithin in the body, which may be one of the reasons for its success in some cases of hard-to-treat epilepsy. Some people with epilepsy have also reported reducing their number and severity of seizures from taking lecithin alone.

Some studies of lecithin-use by people with bipolar disorder indicate that it can stabilize mood, while others indicate that it tends to depress mood (and might therefore be more useful to a person who is manic or hypomanic). It does not appear to cause harm, and there are some logical reasons to think it might help — especially for patients who also have seizures. Lecithin capsules are available, but many people prefer the soft lecithin granules. These are a nice addition to fruit juice smoothies, adding a thicker texture. Lecithin is oil-based, and it gets rancid easily. It should be refrigerated.

• Choline. One of the active ingredients in lecithin. It is needed by the brain for processes related to memory, learning, and mental alertness, as well as for the manufacture of cell membranes and the neurotransmitter acetylcholine. Acetylcholine is involved in emotional control and other regulatory functions. Its effectiveness for bipolar symptoms is unknown.
• Inositol. Another active ingredient in lecithin. It is required by the neurotransmitters serotonin and acetylcholine, and may repair some types of nerve damage. Clinical studies indicate that inositol supplements may be helpful for some people with obsessive-compulsive disorder, depression, and panic disorder. Its effectiveness for bipolar symptoms is unknown.
• Taurine. An amino acid that appears to have antiseizure capabilities, and has gotten good reviews from some adults with bipolar disorders. It inhibits abnormal electrical activity in the brain, and is often found to be deficient in brain tissue where seizures have been occurring. Interestingly, rapid cyclers report the best results. Recommendations range from 500 to 1000 mg per day, divided into as many as three doses. Experts recommend buying only pharmaceutical-quality L-taurine from reputable manufacturers. Unusual EEG activity has been reported in patients using doses over 1000 mg per day.
• GABA. (gaba-amino butyric acid) An amino acid-like compound that acts like a neurotransmitter by inhibiting other neurotransmitters. A number of medications are under development that would affect GABAproduction or usage; some existing drugs that affect GABA, such as Gabapentin and Depakote, are used to treat manic depression. You should not take these medications with GABA supplements unless your physician recommends it and oversees the process. Supplementation with over-the-counter GABA is sometimes recommended for anxiety, nervous tension, and insomnia, especially insomnia associated with racing thoughts. If you experience shortness of breath, or tingling or numbness in your hands or feet when taking GABA, lower or discontinue this supplement.
• Tyrosine. An amino acid that serves as a precursor to the neurotransmitters norepinephrine and dopamine. It may help the body form more of these neurotransmitters, and is also believed to provide support for optimal thyroid gland function. Tyrosine can raise blood pressure, so talk to your child’s doctor about using it if your child takes other medications that affect blood pressure.
• Phenylalanine. An essential amino acid, as well as the precursor of tyrosine. It has an indirect effect of boosting production of norepinephrine and dopamine. Like tyrosine, phenylalanine can raise blood pressure.
• Methionine. An antioxidant amino acid that has been shown to be helpful for some individuals suffering from depression. It has an energizing effect–and as with SAME, below, that could precipitate mania in bipolar patients.
• SAME (S-adenosyl-methionine). A metabolite of methionine that is used to treat depression and arthritis in Europe. It became available in the US in early 1999. It is believed to affect dopamine and serotonin, and to have anti-inflammatory effects. However, it is not recommended for people with bipolar disorder, as it may cause mania.

Top 5 Questions to Ask Your Doctor About Bipolar Disorder

1. What type of bipolar disorder do I have? How severe is it? Can you explain the disorder to me?
2. What is the best method (or combination of methods) of treatment for bipolar disorder?
3. Does bipolar disorder change with age? Do people ever outgrow it?
4. How will bipolar disorder affect me over the long term?
5. What are the key components for successfully managing the challenges of bipolar disorder?

Additional Questions You May Consider Asking About Bipolar Disorder

1. Are there other types of medical or mental health specialists who should be involved in my care?
2. When might hospitalization be beneficial or necessary?
3. Should I (or a member of my family) alert you if there are any changes in my behavior? What kind of changes do you want to be informed about?
4. What should I do if I feel I’m in crisis or need emergency help?