What is cyclothymia?

Cyclothymia is a mental health condition characterized by chronic fluctuations in mood. This condition is classified as a form of bipolar disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). But unlike the heightened manic and depressive states characteristic of bipolar disorder, the changes brought on by cyclothymia are less severe.

People living with cyclothymia shift between episodes of mild mania (sometimes referred to as hypomania) and mild depression. Research suggests that this condition affects about 1% while some clinics have found that it affects approximately 5% of the population. But because mood changes can signal the presence of many other mental health concerns, cyclothymia may be misinterpreted or underreported.

Although research on cyclothymia has lagged over the past few decades, there’s evidence to suggest that it may be the most common form of bipolar disorder among both young people and adults.

Cyclothymia symptoms and what they look like

Everyone experiences mood changes sometimes. Our emotions are affected by what happens in our daily lives — the good, the bad, and everything in between. Having a bout of “the blues” or periods of excitement and joy are typical parts of life for most people.

Having cyclothymia, however, is more than just being “moody” once in a while. Some people view this condition as a milder form of bipolar disorder. But its symptoms, while seemingly subtle, can still have debilitating effects.

The most common symptoms of cyclothymia are hypomanic episodes and “mini” depressive episodes. These highs and lows can come on suddenly and last a few days, but they’re less intense than those in bipolar disorder or major depressive disorder (MDD).

During hypomanic episodes, you may:

• Feel extra excited, happy, or euphoric

• Speak faster than usual

• Be easily irritated or agitated

• Have a stronger libido

• Have trouble focusing or controlling your thoughts

• Experience a self-confidence or self-esteem boost

• Be more physically active than usual

• Feel overly outgoing or friendly

• Not need to sleep

• Engage in risky behaviors (like speeding or overspending)

During “mini” depressive episodes, you may:

• Have trouble concentrating

• Feel tired or fatigued

• Find it hard to stay awake or go to sleep

• Eat more or less than you usually do

• Wish to spend time alone instead of with other people

• Experience feelings of hopelessness, low self-worth, or guilt

To be diagnosed with cyclothymia, these symptoms must be present for more than half the days for at least two years. If your mood shifts quickly from one episode to the next, your cyclothymia may be considered rapid cycling.

Risk factors and causes of cyclothymia episodes

We don’t have a full understanding of the causes of cyclothymia. But research suggests that it’s likely linked to a combination of genetics, brain chemistry, and environmental factors.

There’s also growing evidence that differences in brain chemistry and how the brain regulates mood may play a role. Stress, major life changes, and past trauma can also make mood symptoms more likely to appear or worsen over time. Some people may also be more vulnerable if they tend to have a pessimistic outlook or have challenges with emotional regulation, though personality alone doesn’t cause cyclothymia.

Living with cyclothymia

Cyclothymia can be unpredictable, but there are ways to manage the ups and downs. Small daily habits can help you stay more balanced and reduce the impact of mood swings. 

Here are some daily habits that can help you best live with cyclothymia: 

• Keep a steady routine. Waking up, eating, exercising, and going to bed around the same time can help stabilize your mood.

• Track your mood. Simple notes on how you feel each day can help you notice patterns or early warning signs.

• Prioritize sleep. Good sleep is one of the most effective tools for managing emotional swings.

• Use grounding skills. Techniques like deep breathing, mindfulness, or taking a short walk can help you reset when emotions rise quickly.

• Reach out to others. Checking in with a trusted friend or family member can help you feel more supported and less alone.

• Add structure on hard days. When your energy is low, make a short checklist with only one or two must-do tasks.

• Plan ahead for high-energy days. If you tend to overschedule or overspend during “up” periods, set limits ahead of time.

With the right daily habits and support, it’s possible to live a full and meaningful life with cyclothymia.

Cyclothymia treatment and therapy options

If you think you might have cyclothymia or you’re concerned about your mental health for any reason, talking to a therapist can help. They can provide a professional evaluation to ensure that you receive an accurate diagnosis.

If your provider determines that you have cyclothymia, your treatment experience will be individualized to reflect your unique needs. However, it may include:

• Education: Learning more about cyclothymia can help you better understand yourself and your symptoms. These insights can help you manage your mood more effectively.

• Therapy: Cognitive behavioral therapy (CBT) is the most effective form of talk therapy for cyclothymia. CBT can encourage you to explore the relationship between your thoughts, behaviors, and mood. It can also help you learn coping strategies to manage your mood changes in healthy ways.

• Medication: Currently, there are no FDA-approved medications for treating cyclothymia. But your provider may recommend medications to manage co-occurring conditions. You can decide together whether this is the right option for you.

Clinician’s take

I have seen multiple clients with cyclothymia experience major change by adding a morning check-in into their routine. After waking up, they take a few minutes to check in with their body and emotions, and recognize how they’re doing that day. Being able to move forward in their day with that awareness has made a world of difference.

Elise Miller, MA, LPC

Clinical reviewer