Cyclothymia in Children and Adolescents

Cyclothymia in Children and Adolescents Depression Childhood Depression Print Cyclothymia in Children and Adolescents Symptoms, Treatment and Outcomes By Lauren DiMaria linkedin Lauren DiMaria is a member of the Society of Clinical Research Associates and childhood psychology expert. Learn about our editorial policy Lauren DiMaria Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on February 03, 2020 Image Source/Getty Images More in Depression Childhood Depression Causes Symptoms Diagnosis Treatment Types Suicide Cyclothymic disorder, or cyclothymia, is a mood disorder in which a child experiences alternating episodes of hypomania and depressive symptoms. Cyclothymia is considered to be part of the bipolar disorder spectrum, with mild but chronic symptoms. The Course of Cyclothymia Cyclothymic disorder involves periods of depressive symptoms alternating with periods of hypomania, which is an elevated mood state. In order to receive a diagnosis of cyclothymia, a child must experience symptoms for at least one year, with no more than two months free of symptoms. The onset of cyclothymia typically begins in adolescence, although it may begin as early as childhood. Although the rates of cyclothymia and other bipolar disorders in children and adolescents are not well established, the National Institute  of Mental Health reports the rate of cyclothymia as approximately 1% in children, and as high as 3% in adolescents. A family history of bipolar or cyclothymic disorder is a risk factor for developing cyclothymia. Some research suggests that cyclothymia is a risk factor for developing bipolar II disorder. Symptoms of Cyclothymia Symptoms of cyclothymia are considered to be mild enough to function. However, a child often experiences significant impairment in important areas of daily functioning. Symptoms of cyclothymia may include: IrritabilityShort or quick temperVery little or no sleep, but not feeling tiredEasily distractedLack of concentrationOverly joyfulRecurring thoughts of death or suicideFast speechRacing thoughtsDifficulty completing a taskEngaging in excessive reckless behavior, such as fast driving, overspending, substance abuse, etc. Children or teens with cyclothymia may be described as unreliable, moody, or temperamental because of unpredictable or irritable moods. For a diagnosis of cyclothymia, the depressive symptoms must not meet the criteria for a major depressive episode, and the hypomanic symptoms must not meet the criteria for mania. Additionally, symptoms must not be better explained by substance use or another psychiatric or medical illness. Treatment Options for Cyclothymia Once a child is evaluated and diagnosed, her physician will consider all factors of her situation and determine the most appropriate treatment for her. Mood stabilizing medications, like lithium and mood-stabilizing anticonvulsants, are known to be effective for bipolar disorder in children and adolescents. Psychotherapy has also been shown to be an effective accompanying treatment. Antidepressant medications may be prescribed, but need to be used cautiously in children and adolescents with a family history of bipolar disorder, as they can potentially contribute to manic episodes or increased mood cycling. Outcomes of Cyclothymia Even though cyclothymia is considered to be a chronic disorder, appropriate treatment can significantly help manage symptoms. Without treatment, however, short- and long-term consequences associated with cyclothymia are: Low self-esteemInterpersonal relationship difficultiesSubstance use and abuseAcademic declineIncreased risk for suicide attempt Less than half of people with cyclothymia end up developing bipolar disorder and in some people, cyclothymia actually disappears with time. When to Seek Help If your child or adolescent has symptoms of cyclothymia or another bipolar disorder, talk to her pediatrician or a mental health professional. Cyclothymia is a serious medical illness that requires treatment. Treatment can significantly reduce the severity of symptoms and potentially prevent future episodes.