Talk:Cyclothymia/Archive 1

Archive 1

Dictionary entry

Original poster mislinked the Cyclothymia forums, corrected.

This is like a dictionray entry, it needs to be fixed. -- Mikecnn 22:12, 21 December 2005 (UTC)

Causes

The causes section is absurdly and frivolously sexist in its statements about how the condition affects men and women. —Preceding unsigned comment added by MichaelCarl (talk • contribs) 23:05, 27 April 2009 (UTC)

Cyclothymia lasts for at least 2 years??

Do you know if there is a form of cyclothymia that cycles in periods of days or weeks rather than in periods of years? Frumpter 05:02, 22 May 2006 (UTC)

Ultradian Bipolar Disorder is a possible category, it has been included in the links below euthymia and dysthymia Barrison 10:08, 2 August 2006 (UTC)

http://www.ncbi.nlm.nih.gov/pubmed/18534556 is a refrence for NAC and bipolar

Description

"consists of short periods of mild depression alternating with short periods of hypomania." - How long is "short", how often do these moods cycle? This definition is remarkably unspecific. 69.85.162.173 05:40, 16 January 2007 (UTC)

DSM-IV isn't much more specific. Clinicians need some wiggle-room, frankly.

I have introduced the paragraph on mixed state and misdiagnosis because it's an issue that rarely seems to be mentioned in text books and is estimated to delay correct diagnosis by over a decade.DaiSaw.( I've also added the two new links ) —Preceding unsigned comment added by DaiSaw (talk • contribs) 15:07, 13 May 2008 (UTC)

Accidental inclusion of discussion in article?

I have undone the addition to the article which appended the following text:

eu penso ter uma forma de desordem bipolar, visto ter mudanças de humor repentinas e quase ter tentado suicidio mas se for esse o meu problema penso que tenha soluçao

A Babelfish translation from Portuguese to English returns:

I think to have a form of bipolar clutter, visa to have sudden changes of mood and to almost have attemped suicidio but will be this my problem thinks that it has soluçao

218.215.67.120 18:08, 6 March 2007 (UTC)

Schizothymia

This disorder is often mentioned together with Schizothymia, can anyone start an article explaining the differences which make up schizothymia? Nagelfar 16:48, 17 June 2007 (UTC)

There, I attempted to make such a page. Nagelfar 10:51, 24 July 2007 (UTC)

Merge?

I would also argue against merging:

(a) All major classification systems have cyclothymic disorder as a separate category (both DSM-5 and ICD-10 are keeping it separate, and that is the plan with ICD-11)

(b) It affects a larger number of people than bipolar I or II,

(c) It probably requires a different approach to management than other forms of bipolar disorder. It does not warrant the same types of medication that acute mania or severe depression might justify, and its more chronic nature raises a different set of issues than the acute treatment of other mood disorders

(d) Unfortunately, there is less research about treatment for cyclothymia than for bipolar I or depression. It will be valuable to have the information separated, so that people can clearly see what is most relevant to cyclothymia, and what is an inference based on other, related conditions.

Cyclothymia is considered a form of bipolar disorder, and has been for the last several decades (DSM-III-R and later). Longitudinal data support it being on the bipolar spectrum, with a substantial percentage of people starting with cyclothymia and developing bipolar I (at least one manic episode) or bipolar II (a major depression plus at least one hypomania) in the next several years. The exact percentage of conversion changes depending on the length of follow up. Family history studies and genetic studies also support cyclothymia being in the bipolar "family" of conditions, which is why DSM-5 and ICD are keeping it there.

I can come back and add citations to these points from PubMed later if helpful.

I would also like to invite some colleagues to work on updating the assessment and treatment information, so that it is easier to see which approaches currently have more evidence in their favor. Prof. Eric A. Youngstrom (talk) 13:04, 6 January 2016 (UTC)

Why would Cyclothymia be in a separate article from Bipolar disorder? That article even lists the three types of Bipolar, Bipolar I, Bipolar II, and Cyclothymia. This short article I would think ought to be absorbed into the main article. Thoughts? VigilancePrime 18:47, 15 August 2007 (UTC)

Cyclothymia is a distinct disorder, both in the ICD-10 and DSM-IV classifications. It's a "persistent mood disorder" and could therefore be merged with Dysthymia. --PsychoPiglet (talk) 14:41, 27 February 2008 (UTC)

Cyclothymia is also decidedly _not_ a form of bipolar disorder (be it mild or otherwise). It is as the parent says a distinct disorder. ICD-10 even states explicitly that it is diagnosed where the diagnosis of bipolar disorder cannot be justified. I think this should be amended, because it amounts to disinformation. 82.69.88.230 (talk) 15:13, 15 August 2009 (UTC)

I think we should have a redirect page to here from 'cyclothimia'. I made this misspelling when I first sought the article; and it's hardly at all farfetched. —Preceding unsigned comment added by 81.103.143.126 (talk) 14:34, 11 March 2008 (UTC)

Anonymous people removing contributions to the page without giving explanations

I won't bother to start a Punch and Judy game of undoing other people's edits of what I write, but if people choose to rip out a whole paragraph I'd consider it a courtesy to have an explanation. Clearly people writing here have no direct knowledge of Cyclo whereas I suffer from it and have had decades to chew over the issues involved, of which misdiagnosis is a prominent and obviously important thing to mention in a place where people new to the subject are introduced to it the first time. Furthermore the fact that the whole conceptual basis of diagnosing people as " Bipolar " is questionable should be mentioned, and the ideas about Cyclothymia being some kind of kindling stage to Bipolarity should be exposed to be at best hopeful. And what about all the other theories about Cyclothymia - Psychoanalytic, Social-Transactional, Dietary etc ? DaiSaw (talk) 17:50, 15 June 2008 (UTC)

I cut the reference to Blueprints in Psychiatry. It's a review text for medical students and the reference isn't consistent with the tone of wikipedia. An actually citation to the DSM is probably more appropriate. 69.37.103.41 (talk) 14:49, 9 April 2009 (UTC)GMM

OUT OF CURIOUSITY I decided to browse the history of the page : ( 09-10-12 ) over 600+ edits, mostly uncommented on and goneDaiSaw (talk) 23:34, 8 October 2012 (UTC)

NOTE THAT SIX MONTHS AGO THE CORRECT ETYMOLOGY WAS ON THE FRONT PAGE AND WAS REPLACED BY THE PRESENT WRONG ONE CLAIMING THAT 'CYCLOTHYMIA ' MEANS ' CIRCLE OF ANGER '- six momths ago - " The term derives from the Greek κύκλος (kuklos), "circle"[5] + θυμός (thumos), "temper".[6]" DaiSaw (talk) 23:43, 8 October 2012 (UTC)

Why barely any references?

How is it that such an informative article has next to NO references? Why should anyone believe even one word in this article unless we provide a reference? The grammar is uncomfortable, but I want to be kind. I can't find out who wrote the very first version, can anyone help me. I want to make sure that the future edits I make go along with whatever goals the originator had in the beginning.

bpage (talk) 21:10, 3 January 2010 (UTC)

Copyright problems with diagnostic criteria

The American Psychiatric Association has not released its Diagnostic and Statistical Manual of Mental Disorders into public domain, but claims copyright. The Wikimedia Foundation has received a letter of complaint (Ticket:2010030910040817, for those with access) about the use of their diagnostic criteria in this and a number of other articles. Currently, this content is blanked pending investigation, which will last approximately one week. Please feel free to provide input at the copyright problems board listing during that time. Individuals with access to the books would be particularly welcome in helping to conduct the investigation. Assistance developing a plan to prevent misuse of the APA's material on Wikipedia projects would also be welcome. Thank you. Moonriddengirl ^(talk) 13:54, 11 March 2010 (UTC)

I've fixed the problems noted above, with the results in Talk:Cyclothymia/Temp. Eubulides (talk) 20:49, 11 March 2010 (UTC)

A personal Account of Cyclothymia

[ 22-11-12 When I first put this in here it was partly because I was disatisfied with people pontificating about Cyclothymia from text books with no personal knowledge, and from personal experience and discussion I believe that the response of the individual personality to their experience and understanding of Cyclothymia matters considerably in how the illness is presented - now that more and more personal accounts are appearing publicly on blogs etc I am going to start listing them in another Talk section below ]DaiSaw (talk) 01:09, 22 November 2012 (UTC)

Dear Friends,

I'm still very unhappy about this Wikipedia page on Cyclothymia and I see that it has got even worse recently due to these copy-right problems. People will naturally be turning to Wikipedia as a first step to find out something about Cyclothymic Personality Disorder and they will be unaware of the controversies surrounding it e.g. that it is even disputed to be a personality disorder. http://s13.zetaboards.com/TheCollective/index/ and http://www.chatarea.com/TheCyclothymiaCollective appeared to have died since I last visited them so active discussion with other people who have been diagnosed or hope to be diagnosed is not presently possible, so let me offer this letter for the casual enquirer to read about the actual symptoms of somebody who has been diagnosed as Cyclothymic. The reader will note from the complaint above that I am unhappy that the main article does not contain any warning about such 'mixed state' Cyclothymia which frequently causes misdiagnosis as depression resulting in medication with anti-depressants which makes the condition worse. My attempt to rectify that state of affairs resulted in my contribution being removed, so I will not waste any time on making a new ammendment. Please be kind enough to leave this in the discussion though. The following is not for diagnostic purposes but solely to provide the enquirer with a taste of the sorts of symptoms that can be diagnosed as Cyclothymia. I was diagnosed 16 years after the onset of these symptoms, and this is a letter applying to volunteer to be the subject of some research conducted by my local university. (Note: owner of Cyclothymia Collective states forum is still active as of May 2012)

Dear Dr X,

I recently participated in the [ cognitive behavioural ] research, I was in the control group. I was handed a letter inviting me to participate in your research involving an MRI scan which intrigues me. I was intending to write this email several weeks ago but I put it off because I wanted to write you an account of what happens to me in my disorder that has been diagnosed as Cyclothymia. Since I am not getting around to writing you a longer account let me write you a short account, because I would very much like to be put in that MRI scan twice. Once I know that I am becoming hyperthymic ( hypomanic ) I can roughly predict when I am going to be hypothymic ( depressed ). This is because my cycles are extremely regular - given a distinct stress such as losing a job or starting a relationship I can mark out in advance on a calender when I will be high ( at end of the fifth week following ) and when I will be low ( at the end of the seventh week following ) and when I will come out on a level again ( at the end of the twelth week following ). I've always felt that the mechanical predictability of this should intrigue researchers, and I believe that what has happened to me is that the stress response mechanism has had its period reset. This first happened when I was 19 circa September 1981 and has continued ever since, but it took me until I was 25 to clearly identify that it was a cycle because it had disrupted my life so much. Originally I believed that I was dealing with the sort of kaleidoscope of problems that perhaps are typical of young people but having dealt with those problems with various counselling psychologies I was left facing a problem that could not be taken away. By the age of 35 I was chronically depressed because of the host of problems that came in its wake - unemployment, poverty, social isolation and depression - and my doctor at the time wrote me off onto Sick Benefit. This resulted in an interview with the Department of Social Security doctor who not only recognised that I was being discriminated against in employment but diagnosed me as having Cyclothymia of a mixed state variety and recognised that doctors had kept interpretting my presenting symptoms as acute depression. I have since been moved onto Incapacity Benefit and have been monitored by a psychiatrist ever since, presently Dr X of the Community Mental Health Team in the X clinic.

I'd prefer to present this with diagrams, but it's not possible in an email - please feel free to draw your own !

The Basic Cycle

There is a stress event - a good example is a car crash that I was in with my partner at the time in which the car somersaulted down the ditch and yet we got out of it only bruised. She was shaking and very excitably upset at the time, couldn't sleep that night and the following day was tearful but then slept properly and was fairly normal the following day but wouldn't drive. She was bemused that I was so calm, arranged for help, drew a measured sketch map, slept well except for the bruises and drove us the 200 miles home. My own response to this stressful event was similar to hers only my excitable state came five weeks later and my depressed state seven weeks after the event. I was on a level again after twelve weeks.

When a cycle starts it is not always obvious that anything is happening, but gradually I lose my apetite, people start to complain that I am talking loudly, I start to write at length and my handwriting becomes more of a scrawl as I scramble to get ideas down and then I start to lose sleep until in the fifth week I stop sleeping entirely for four or five days, I become exhausted and irritable and withdrawn and am living in squalor until suddenly at the end of the fifth week the high state of arousal stops abruptly. I label this hyperthymia to avoid the associations of hypomania - to other people I look depressed and I feel depressed, the 'volume control' of my thoughts is relentlessly turned up and because my thoughts are generally depressive because my life is miserable I become suicidal when painfully exhausted by my lack of sleep for several days. I label this stage that leads up to my thoughts racing at three times normal speed 'hyperthymia' to distinguish it from the kinds of experience had by my Bi-Polar friends who are mystified by how my expriences differ from theirs despite superficial similarities such as the impulse to spend money ( I channel this into buying socks and underpants generally, but have made some mistakes when I was younger ). My body is full of energy and I have muscular spasms and huge downloads of adrenalin just lying in bed so I often get up and go for long walks. I am now wary of starting jobs that will take a long time and a lot of energy and the ability to concentrate that I will not have later.

The second stage is generally a smooth slide from 'high' to 'low' although sometimes it seems to come in jagged steps, and I label it 'transthymia'. The end of hyperthymia is a huge relief physically but I still feel bouts of agitation and thoughts still flow but it is notable that they are much more insightful, coherent and truly creative instead of just torrents of ideas spilling out. I often find myself sitting alone in the early hours of the morning making up rather poor jokes that amuse me greatly. I get a lot more sleep, am a little more interested in food and bemoan the squalor that I'm living in but usually still preoccupied internally and withdrawn socially. This stage takes two weeks the end of which is signalled by my mind slowing down to a third of normal speed.

The third stage begins with being mostly asleep for four or five days, the seventh week mirroring the hyperthymic high of the fifth week, and I lable this 'hypothymia'. I seem to do little more in these days than get up, go to the loo, get something to eat because ravenously hungry and then go back to bed. My thoughts are running like a dripping tap, at a third of their normal rate, and other people can get frustrated with me for not taking in what they say to me and they complain that my replies are monosyllabic and that my voice is very quiet. Emotionally I experience a great sense of peace and security because I know that I am beyond all of the risks of hyperthymia such as suicidal impulses, and people scratch their heads and do not understand that in this 'depressed' part of the cycle I am actually very happy and not suicidal. On the other hand I am usually tearful, especially when viewing films in which people are nice to each other, which I do not think is suprising considering that I have withdrawn from others' company for a month. I usually have strong impulses to go and find company but my encounters with other people can be very painful because this neediness is juxtaposed with not being equipped at these moments with a mind working at normal speed that I can be good company. After a fortnight or so of lying around in a state of exhaustion I regain the energy to start clearing up the mess, I can focus and think straight without suffering the constant worrying of my normal state of mind.

The fourth stage arrives after twelve weeks, and I label this 'isothymia' i.e. implying that I am experiencing a level state of energy or that my 'spirit' ( literal meaning of 'thyme' ) is running even. My 'normal' state is to be in some degree of clinical depression because of the mess that my life is in, partly due to living with Cyclothymia for 29 years. In the 16 years that I wasn't diagnosed I mostly was given tricyclic anti-depressants which intensified the hyperthymias and made me much more depressed, and early on I got into the habit of asking for sleeping tablets at the same time and taking them first to cope with the first stage and the tricyclics later once the third stage had started. Since being diagnosed I have tried a variety of medications and I seem to have settled for taking Lithium Carbonate permanently supplemented with Flupenthixol and Temazepam when I reckon that I need them. I turn to cigarettes if I am wracked with tension when hyperthymic and get off them as soon as possible once I am into hypothymia ( Likewise I survive on biscuits and coffee when I am trying to get through hyperthymia and then get fussy about eating properly and avoiding caffeine when I am safely harboured in hypothymia ). Generally I seem to be indifferent to alcohol but I will drink to be sociable which means I am drinking for 'dutch courage' when I am seeking people out because I am hypothymic, but I try to avoid alcohol when hyperthymic because of it being a disinhibitor. Very occasionally I drink alcohol alone for pleasure, if I can afford decent whiskey.

Overlapping and Interfering Cycles : The 'Saw Tooth' Phenomenon and 'Schiz-' Phenomenon

Now here comes the bits that doctors say cannot happen but I have observed many times. I believe that the explanation can be found in a recent observation : I got a letter that was from X Planning Office and because of constantly fighting property developers who want to build office blocks here I assumed that it was another application to build behind the house and so I felt extremely distressed by it and I couldn't even face going to their office to examine it for a week. It turned out not to be another application but a declaration of variation of a previous application and so a routine matter. But this imagined stress set off a cycle that arrived in force, so the origins of cycles lie not in the limbic system but in the higher centres of the brain. So I think that the cycles are not taking place in the limbic system as usually assumed but elsewhere and can be driving the limbic system's stress responses simultaneously - one phase of one cycle interfering or reinforcing another phase of another cycle and producing the following effects.

The 'Saw Tooth' Phenomenon was the first one that I unravelled after ten years or so. I was studying my diaries wondering how it came to be that the woman that I loved had left me. I discovered that we had had blazing rows at five week intervals for several months - and I concluded that perhaps each time that I was hyperthymic I had become withdrawn because overloaded by stimuli and when she tried to get close to me - because she was concerned for me - I was in an irritable and exhausted state and so a major row broke out at each peak, setting off another cycle that peaked five weeks later which resulted in another major row which started the next cycle etc etc

The 'Schiz-' Phenomenon took another ten years to identify, but then for over twenty years I had been intrigued and worried by phenomena that were very rare and sort of 'schiz-' : I've variously experienced an arc of stars in my vision, music, voices, presences, strange pains and muscle spasms, robot-like sensations as if under some other's control, and especially 'chatter' which is essentially intrusive daydreaming disrupting my thoughts etc etc. I finally realised that if cycles could be overlaid as in the 'Saw Tooth' Phenomenon they could be interfering with each other, and started sketching graphs in which the lines rising from the zero isothymic stress points had arrows on them pointing forwards and upwards to the hyperthymic high, then dropping forwards and downwards to the hypothymic low, then upwards again to the isothymic end of the cycle. I finally successfully predicted an episode of 'schiz-' symptoms only a couple of years ago : the perfect starting condition is that the stresses have to be two weeks apart so that the second cycle's hyperthymic high lies directly over the first cycle's hypothymic low. The 'schiz-' symptoms occur when the arrows of the cycles are moving in opposite directions, pointed up over down or pointed down over up.

I do not expect anybody to agree to my explanation, but this is the model of my illness that I am working with, the result of 29 years of self observation to an obsessive degree in wanting to master it and control it. Personally, I treat the 'Cyclothymia' label as something of a bin that awkward people with anomolous symptoms are thrown into, this after watching the Cyclothymia Collective debate their symptoms in an online bulletin board. But what I am suffering from may well be something relatively simple that might be identifiable in an MRI scan and I would very much like to have one - or rather one for each of the four stages mentioned.

I hope that you will include me as a subject in your proposed research into [ brain function in psychiatric disorders ]

Yours Sincerely DaiSaw (talk) 10:17, 18 May 2010 (UTC)

Coming back to re-read the above posting later in the day and tinker with its grammar ( not spell-checked ! ) it occurs to me that it is not as useful as I might hope it to be for somebody looking for information - so let me add some encouraging comments for those grappling with such problems.

Firstly, you may be surrounded by people arguing with you that you lack sufficient will-power and in particular they may be arguing to you that the DSM or other schemes of diagnostics say that Cyclothymia is a Personality Disorder and therefore can be conquered by the sorts of psychotherapy offered by people who also claim to be able to treat homosexuality. If you follow the impulses that arise in hyperthymic episodes Cyclothymia will lead you into exactly the sorts of situations that are full of the stresses that set off further bouts of Cyclothymia until you are living in a bewildering forest of overlapping and interfering cycles producing frightening Schiz- effects. Make use of psychological interventions to develop yourself as a mature individual who can cope with Cyclothymia, but ignore those who think that they can cure you of it with nice words or electric shocks.

Secondly ( and controversially ) you will note from my description that Cyclothymia is characterised by the features of a disordered nervous system not a disordered mind, and the problem most likely lies in the interaction between the limbic system and the cerebral cortex which is so complicated that multiple things can go wrong due to multiple possible causes. Medicine goes through fashions and it is fashionable at the moment to suppose that the cause of Cyclothymia is a genetic inheritance, and some years ago in another fashion fad the medical profession chose to re-classify Cyclothymia as a Personality Disorder. The truth is that very little is known about it - but you have to cope with it never the less. Since the term Cyclothymia has been constantly changing its meaning over the past 150 years, we can safely assume that it will continue to do so and that what it signifies is little more than ' wobbly people who are not like us nice safe clean doctors ' - doctors who cannot provide us sufferers with any factually based meaning for the term Cyclothymia, any more than they can for the term 'Bi-polar', a newly fashionable term. Your nervous system's malfunctioning may be due to genetic inheritance, viral or bacterial infection, toxic or physical damage - but whatever the cause of the problem that your doctor has labelled Cyclothymia neither he nor you will be able to stop it.

Thirdly ( and less controversially ) although you cannot stop Cyclothymia you can slow it down a bit if you choose to do so. There are a number of drugs available but I will not stand as an advocate for any of them because I do not think that Cyclothymia is a single disorder but rather a whole range of different sorts of neurological damage that have similar sorts of results. Listening to people discuss their medication I think that it is clear that not only do people diagnosed with Cyclothymia vary considerably in their symptoms but that people sharing broadly similar symptoms can vary considerably in their response to the same medication. A lot of people fear that medication will take away some part of themselves, or that people will think the less of them, or that they will become drug dependent. Cyclothymia as a disorder can be coped with un-medicated and I find that after long periods on medication I sort of miss the raw experience and need to revisit it to ascertain the reality of what underlies my persisting cycles, but I can assure you that if medication is available you should use it but on your own terms. Your doctor is there to serve you not the other way round - take the medication as prescribed and give it a proper trial and then if you are unhappy about it for some reason explain to your doctor respectfully that you wish to try some other medication or some other doctor. Visit your doctors on a regular basis so that they get to know you and trust you - so they don't throw a fit when you ask to discontinue your medication and clean out your body of its lingering effects before experimenting with the next one. If you do not take a break between medications it is impossible to assess their comparative merits, or to remember exactly why you need medication.

Fourthly ( controversially ) - doctors will either try to tell you that Cyclothymia is a mild disorder or that it is the kindling stage of Bi-Polar disorder and therefore very serious. Both of these opinions reflect how little Cyclothymia has been researched since Kraepelin's day. Kraepelin imagined that the psychiatric disorders that he saw could be arranged on a spectrum, hence Cyclothymia is usually tacked onto Bi-Polar I and Bi-Polar II and is sometimes even called Bi-Polar III as part of an imagined spectrum in which the milder disorder evolves or degenerates into more and more serious disorders. There is no factual evidence for this, rather all of the evidence points towards huge complexities in mental ill health. Anecdotally, because I am curious about what Bi-Polar people experience I've talked with a number and the result every time is mutual incomprehension because despite the supposed similarities the Bi-Polar experience is very different to the Cyclothymic experience. I find it tremendously frustrating to be told that huge amounts of money is spent researching Bi-Polars because they are seriously ill when they are generally symptom free in some instances for decades - yet Cyclothymes have no money being spent on researching our disorder and yet are rarely symptom free. When I tell Bi-Polars that I typically have four or five cycles a year they generally disbelieve me, and those that know me well are shocked by how many months of the year I lose to it in comparison to themselves - none. Yet we both take the same medication ( Lithium Carbonate ) most probably because doctors think that Cyclothymia is 'Bi-Polar III'.

Fifthly ( controversially maybe... ) - cheer up ! Cyclothymia can be gift as well as a curse, it depends how you ride the roller-coaster : in the beginning you've been abducted and strapped in with a bag over your head and you are ( metaphorically ) throwing up into it and its messy and confusing and more than sickening ... but if you can get that bag off your head and see what lies ahead it becomes a lot less scary, and if your doctor can give you some pills to calm your stomach you can not only cope but you can begin to appreciate some of the advantages it gives you. Hyperthymia deeply intensifies your experience of your self, a lot of ideas and emotions that would never have been noticed other than in deep psychotherapy come pouring into consciousness ; Transthymia can offer you moments of creative insight that otherwise would have eluded you ; Hypothymia is the sort of mental state that others spend years trying to achieve in various disciplines of meditation ; Saw Tooth's energy can be purposefully channeled into sustained applied activity over months ; 'Schiz-' phenomena can prove intriguing not disturbing, a source of artistic inspiration ; and hell, it's not like you have to be crazy all the time because there are those periods of Isothymia in which you are plain normal until next time...DaiSaw (talk) 21:38, 18 May 2010 (UTC)

Sixthly ( contoversial ? ) - I have not referred to the terms euthymia ( 'good spirits' ) or dysthymia ( 'bad spirits' ) in the above descriptions because I am describing a 'mixed state' Cyclothymia in which to refer to a 'high' as 'euthymia' or a 'low' as dysthymia would be misleading. This leads back to the problem of 'mixed state' Cyclothymia being misdiagnosed as 'depression' because the person presents to the doctor complaining of periodic bouts of 'acute depression' and the doctors do not think of Cyclothymia because they imagine that Cyclothymes experience blissful euphoria when in a state of 'euthymia' and miserable dysphoria when in a state of 'dysthymia'. Thus the reason why I am avoiding these terms is because my model is one of states of arousal caused by a distorted stress response which basically intensifies the expression of the personality. This is not inconsistent with insisting that Cyclothymia is wrongly classified as a Personality Disorder, a good metaphor is to think of the personality as being like a record on a stereo gramaphone - there is nothing wrong with the records save that the music of human personality to be found on them reflects the prevailance of personality types in the general population. What the stress response does is to turn the volume control up for a while so that there is a high state of arousal available to deal with a threatening situation and then once the threat is passed to turn it down so that there is a low state of arousal to recuperate in from the stress. Thus Cyclothymia is the same stress response as exhibited in normal people except that its periodicity is so greatly extended that its operation bears no relation, atleast superficially, to the stress event that caused it. How people respond to stress in terms of their personality is a different issue but since one in four people in the general populace have depressive-type personalities so it follows that one in four Cyclothymes will present depressive symptoms in hyperthymia and get misdiagnosed with acute depression and be given anti-depressants which will accentuate the 'high' that they are experiencing already making them more acutely depressed and suicidal.

Seventhly ( controversial ) - my personal model of Cyclothymia as the normal human stress response with its periodicity altered for some reason predicts that the definition given in DSM and other diagnostic models is incorrect in the arbitrariness of the diagnostic criteria : the period could be reset to any length of time, resulting in loss of sleep over only a couple of days or many weeks. I think that to qualify as Cyclothymia there would however need to be a periodicity and this is one way to potentially differentiate Cyclothymia from the Bi-Polar disorders which seem not to be about the stress response mechanism itself though they may be triggered by stress events. Bi-Polar disorders seem to have no periodicity but rather their hypomanias and manias have a meandering quality that suggest that the behaviour of the Limbic System is being driven by other mechanisms or factors that may be chaotic or even random in their nature. Nobody however should assume that mental health problems have any solutions as simple as taking Lithium Carbonate which medicates the whole body on the basis that somewhere inside it is the cause of the patients' distress : social and environmental factors have to be considered as well. It has been argued that Cyclothymia might be a conditioned stress response e.g. for a child trapped in the care of an abusive parent the normal stress response would be mal-adaptive and an icy calm with no display of emotion to risk triggering a violent attack by somebody looking for any excuse would be adaptive to the child's survival in such a situation. DaiSaw (talk) 06:24, 19 May 2010 (UTC)

Eighthly ( not controversial ) - I have re-read the above several times and I want to re-sound a note of caution that this is a personal account given my own experience in which I am preoccupied with the problem of mis-diagnosis which happened to me. It is not unusual for this to happen and sixteen years to finally being diagnosed is not unusual but can be improved upon. It happens because sufferers naturally tend to go to doctors only when they experience symptoms that they find distressing whereas they may put up with other symptoms ( or even like them ! ) and doctors naturally tend to asssess only those symptoms that sufferers present to them. Because of this mis-diagnosis occurs because Cyclothymia presents a chameleon-like appearance for the occasional observer e.g. there can be a dramatic shift in symptoms overnight across the peak of a hyperthymic high or the sudden disappearance of 'Schiz-' symptoms in a matter of minutes that have been running for days. A doctor will tend to assess what they see or have described to them and may classify the symptoms as clinical depression, Bi-polar illness, some sort of 'Schiz-' disorder, obsessive-compulsive disorder, etc. Thus it is important to make a written account of this 'chameleon' in its many states by keeping diaries on a daily basis at least, if possible actually recording what it feels like moment by moment when odd things are happening. If possible, visit your doctors on a regular basis so that they can assess your differing states of mind directly. There is a risk in doing this ofcourse because you may be accused of an obsessional self-preoccupation, of hypochondria, or in my case it was alleged that I was malingering. The alternative is to not seek medication for the disorder but instead to put up with the reputation of being seen an erratic and unreliable person, of your life becoming chaotic and complicated by situations that in themselves contain the sorts of multiple stress events that will sow the seeds of many overlapping cycles thus risking the more severe symptoms that will incapacitate you completely without you ever experiencing the fullying functioning stages of isothymia. Good Luck ! DaiSaw (talk) 08:29, 20 May 2010 (UTC)

Thankyou User:Daisaw for your general contribution especially for explaining euthymia and dysthymia in your sixth paragraph and analyzing them from vis a vis cyclothymia. I quite like cyclothymia! Alan347 (talk) 10:00, 26 July 2011 (UTC)

What the hell is this self-indulgent, self-absorbed, self-aggrandizing crap doing here? This page isn't a place to post your personal experience; it's a place to discuss specific edits to the page. What you have here is a really long narrative that adds nothing of value to the article. Get a blog or something. 184.38.34.78 (talk) 23:58, 6 September 2011 (UTC)

Yeah looks like someone was on his "up" phase 134.129.90.29 (talk) 21:23, 6 December 2011 (UTC)

( Dai ) No - I was not in an " up " phase - clearly you have not clocked the fact that I do not have them because I am mixed state : and if you think that that was " self-indulgent, self-absorbed, self-aggrandizing crap " you have not paid attention to the context in which I pasted over that letter and then added to it. I had already complained about a very specific and important warning about the misdiagnosis of mixed state and its being made worse by the prescription of anti-depressants that I had added to the front page but was removed : the person who removed it was taking his version of what Cyclothymia out of a book and standing on his authority as a medic to edit the front page without having to agree it with anybody else or even provide them with the common courtesy of an explanation for his actions. Now it is fair on the one hand to have nothing on the official front page that is not agreed and referenced, but this talk page is for discussing those references and making those agreements. The trouble is that there is little in the way of research that can be referenced and many Cyclothymes think that what is in medical text books is conjecture not observation. Here I decided to write a piece of personal self-observation since I dislike the front page and I know that it comes up first when people google " Cyclothymia " - and this contains the warning about the misdiagnosis of mixed state which I think is very important and should be on the front page. I fully understand the attitude of medics who are concerned for the agreed conventions of diagnosis to be represented, but do medics understand the attitude of people subjected to the label Cyclothyme ? The stuff written on the front page might equally well be labelled " self-indulgent, self-absorbed, self-aggrandizing crap " by a Cyclothyme : it conveys next to nothing that is important other than to the medical profession and most of these labels were created in smoke filled back rooms between academics and drug companies with a view to getting academic credits and pushing some banned pesticide out as the new psychiatric wonder-drug. There is room on this talk page for a bit of abuse and humour - and Wikipedia is not an academically acreditted, peer reviewed journal of scientific research but a more rounded collaborative enterprise : I have nothing to propose for the front page other than that it should not be the sole preserve of one or two egotists who know nothing about the subject but like the idea of borrowing their personal sense of authority from a text book. Where does any information about Cyclothymia originate ? Not from the medical profession reading or indeed writing books about it but from the sources that they derive their ideas from - Cyclothymes who have observed and described their experiences : I am not proposing anything for the front page besides the warning about the misdiagnosis of mixed state Cyclothymia, but I think that there ought to be room on it for a more objective account of what it is like to be a Cyclothyme instead of this subjective self-regarding excercise of citing medical texts : you will note that I specifically dis-regarded the diagnostic status of the above, it was offered to help others.DaiSaw (talk) 13:29, 23 August 2012 (UTC)

Exercise

the Exercise thing is used by alternative therapy groups but doesn't help 98% of people (it belongs in the category: homeopathy) Markthemac (talk) 15:12, 18 February 2011 (UTC)

Ginseng

Has it ever occured to anyone how helpful Ginseng is ?

Alan347 (talk) 09:49, 26 July 2011 (UTC)

Cyclothymia

This article needs fixing, and it's hard to know where to start. Bipolar Disorder is a major mental illness and its subtypes, including cyclothymia, certainly merit their own entries in addition to a main article. The articles need to be in a consistent format and include multiple expert references. I'm a new member of Wikipedia (and, FWIW, a psychiatric NP who treats women on the bipolar spectrum). How can I help? — Preceding unsigned comment added by PepperCollins (talk • contribs) 21:07, 14 July 2012 (UTC)

( Dai ) What makes you think that " Bi-polar Disorder " or " Cyclothymia " exist other than in the collective delusions of the medical profession ?  :-) I have just been responding to critics above and I look down and see " The articles need to be in a consistent format and include multiple expert references." Well true such things lend credibility, and can be of interest - but why try to do this here ? If you treat women on the bipolar spectrum you will I hope appreciate the point that such women may look at this Cyclothymia page and find nothing useful.If you create something useful and add it to the front page you will most probably find it removed without explanation : " enjoy " ... DaiSaw (talk) 13:44, 23 August 2012 (UTC)

ETYMOLOGY : κῦκλος + θῡμός = circle + spirit > ( French Cyclothymie ? ) > German Zyklothymie > English Cyclothymia

ONCE AGAIN I AM NOT GOING TO CHANGE THE FRONT PAGE BUT WISH TO DRAW ATTENTION TO IT BEING DEFECTIVE : " Cyclothymia is derived from the Greek word κυκλοθυμία (from κῦκλος kyklos, "circle"[6] and θυμός thymos, "anger".[7] " WELL HERE ARE SOME DICTIONARY DEFINITIONS - ( 1 ) http://oxforddictionaries.com/definition/english/cyclothymia - a mental state characterized by marked swings of mood between depression and elation; bipolar disorder : 1920s: from cyclo- + Greek thumos 'temper' ( 2 ) http://www.yourdictionary.com/cyclothymia - an emotional condition characterized by alternate periods of elation and depression: considered by some to be a mild form of bipolar (affective) disorder : Modern Latin from "cyclo-" + Greek thymos, spirit ( 3 ) http://www.merriam-webster.com/dictionary/cyclothymic - : relating to or being a mood disorder characterized by alternating episodes of depression and elation in a form less severe than that of bipolar disorder : New Latin cyclothymia (from German Zyklothymie, from zykl- cycl- + -thymie -thymia) + English -ic ( 4 ) http://en.wiktionary.org/wiki/cyclothymia - (medicine) a chronic mental disturbance characterized by mood swings and depression : From the Ancient Greek κῠκλος (kuklos, “circle”) + θῡμός (thūmos, “temper”, “disposition”). P.S. ( 5 ) http://www.lovewins.us/bible/strongs/G2372 θυμός = soul ; passion (as if breathing hard) ; fierceness, indignation, wrath ; passion, angry, heat, anger forthwith boiling up and soon subsiding again ; glow, ardour, the wine of passion, inflaming wine (which either drives the drinker mad or kills him with its strength)

THERE IS NOT A SINGLE MENTION OF ' THYMOS ' MEANING ' ANGER ' IN THESE DICTIONARY DEFINITIONS [ except see later P.S. (5) ] BECAUSE IT DOES NOT MEAN THAT : IN MODERN GREEK IT HAS BECOME HOWEVER A EUPHEMISM FOR ANGER - I.E. IT PAYS TO KNOW WHERE THE WORD CAME FROM AND HOW IT IS USED E.G. READ THESE PAGES - http://wiki.riteme.site/wiki/Thumos - http://wiki.riteme.site/wiki/Thyme - http://wiki.riteme.site/wiki/Thymol - NOW ME BEING ME I IMMEDIATELY DEBATED THE ORIGINS OF THE WORD WHEN I WAS FIRST DIAGNOSED AND I UNDERSTAND IT TO DERIVE THUS : the ancient Greeks and other peoples burned various herbs in their temples and noted their effects and theorised about the origins of those effects believing them to arise by liberating the spirits within the vegetable matter by burning them. The fumes of burning thyme apparently created a mild arousal which was taken to be in-spiriting amd therefore by analogy ' thymos ' became a word for ' spirit ' - perhaps there was even a hangover after intoxification so the ' high ' was followed by a ' low ' - note that a distinction should be made between high arousal and high mood : Cyclothymia is about states of excitement of the nervous system not about the variety of emotional reactions being had by those experiencing those states of high or low arousal, the emotions being sharpened or dulled reflect the diverse personalities of those sharing the same cyclothymic states : optimists will expect to win the lottery even though they will not even buy a ticket and pessimists will prepare for the day of judgement when hyper-thymic, upbeat people will hate their arousal plunging downwards afterwards whereas pessimists will enjoy the rest provided by hypo-thymia. My contention is that ' mood ' is commonly taken to be about emotions so that it is commonly thought that there are two forms of Cyclthymia - ' a high followed by a low ' and vice versa, but no there is only one kind of cycle, the stress response distorted, but there are myriad individual emotional reactions to it due to the myriad individual personalities of those struggling to deal with their changed stress response.

The ancient Greek word " θυμός " encapsulates this sense of unruly energy, the unwanted surges of adrenalin and speeding thoughts followed by the unexpected inability to think at all and the listlessness - the brain being alternatively fried then frozen, thoughts first tumbling over each other then stumbling to a halt : nothing to do with mental illness in a psychological sense except that individuals become neurotic in struggling to cope with this, especially if they are unaware of its cyclic nature and it just seems unaccountably random which is very frightening. In Plato's Phaedrus the metaphore offered is of a charioteer ( intellect ) struggling with two horses ( emotion and excitement ) and in the Republic the object is to achieve a balance the three parts of the soul : nous ( intellect ), thumos ( spirit ), and epithumia ( desire ), arguably our minds, spirits and bodies. So when Kraepelin adopted the term Cyclothymia ( I don't think that he coined it, I think that the term was originally French, but he adopted it and popularised it in Germany and he became internationally influential ) this was the sort of classical education that he was drawing upon in defining the terms he used - http://www.minddisorders.com/Br-Del/Cyclothymic-disorder.html - " The noted psychiatrist Emil Kraepelin first described the symptoms of cyclothymic disorder in the late nineteenth century. Kraepelin described four types of personality disorders  : depressive (gloomy); manic (cheerful and uninhibited); irritable (emotionally unstable and explosive); and cyclothymic. He viewed the irritable personality as simultaneously depressive and manic, and the cyclothymic personality as alternating between depressive and manic states."

The psychological - psychiatric definition of Cyclothymia keeps wandering and will wander again in DSM 5 - http://www.dsm5.org/proposedrevision/pages/proposedrevision.aspx?rid=494 - and as you can guess, I think that labels are of limited use because - for individuals wrestling to control their over-driven emotions by exercising their intellects to deal with the excess of spirits caused by their distorted stress responses - that only gets the Cyclothyme as far as getting a prescription which admittedly does help by applying the brake to the metaphorical runaway chariot but it still means you have to find your way back onto the main road, or choose a road less traveled, or blaze your own trail altogether in order to have a life worth living : drugs can not provide this

P.S. - I felt that the word Cyclothymie had a definitely French ring to it, the kind of word that French psychiatrists would coin in the early 19th century and which would then be borrowed by German psychiatrists in the next wave of medical science and humane treatment but the Larousse dictionary - http://www.larousse.fr/encyclopedie/medical/cyclothymie/12326 - attributes it to Emil Krapelin's predecessor Karl Kahlbaum - http://wiki.riteme.site/wiki/Karl_Ludwig_Kahlbaum - and that page attributes it to Ewald Hecker - http://wiki.riteme.site/wiki/Ewald_Hecker - which has a link to this paper - http://hpy.sagepub.com/content/14/3/377.full.pdf ( HELL - IS EVERYTHING THAT I WRITE HERE MERELY AN EXAMPLE OF KAHLBAUM's SYNDROME ? )[ [User:DaiSaw|DaiSaw]] (talk) 01:57, 17 September 2012 (UTC)

Cyclothymia Bulletin Boards, Blogs etc

I am having an email discussion with somebody who wanted to know the status of Mc Man's account of Cyclothymia, it is OK, I know the site - it has been around a while and is popular.

But I think that it is the response of the individual personality to their experience and understanding of Cyclothymia that matters - I read a a whole variety of accounts of the illness and its mediction as part of the Cyclothymia Collective [ requires registration - but the blog that is the front page is here : http://thecyclothymiacollective.blogspot.co.uk/search/label/About%20me ] - but I skimmed these recently and they demonstrate a similar variety of accounts of Cyclothymia and the diverse reactions to it often mistaken for the illness that appeared in the CC's BB -

http://www.thatscousebastard.com/cyclothymia.html

http://biopsychiatry.com/misc/cyclothymia.html

http://christiandavidholmes.com/blog/2010/03/25/cyclothymia/

http://cyclothymia.livejournal.com/

http://loopylonelyandlost.wordpress.com/2008/09/27/cyclothymia/

http://www.cyclothymic.me.uk/1.html

http://www.psychforums.com/cyclothymia/

http://unhappyhappiness.com/2010/09/15/cyclothymia/

http://dannyibbitson.wordpress.com/2012/11/02/cyclothymia-explained/

http://davidcornes.wordpress.com/2012/10/12/cyclothymia-keeping-the-bi-polar-bear-in-its-cage/ DaiSaw (talk) 01:21, 22 November 2012 (UTC)

B-Class criteria checklist

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Is the article is suitably referenced, with inline citations? Does it have has reliable sources, and any important or controversial material which is likely to be challenged?

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Does the article reasonably cover the topic, and does not contain obvious omissions or inaccuracies? Does it contain a large proportion of the material necessary for an A-Class article, although some sections may need expansion, and some less important topics may be missing?

Layout and organization

Does the article has a defined structure? Is the content organized into groups of related material, including a lead section and all the sections that can reasonably be included in an article of its kind?

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Is the article reasonably well-written? Does the prose contain no major grammatical errors and flows sensibly?

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Does the article contain supporting materials where appropriate? Illustrations? Diagrams? Infobox?

Understandable

Does the article present its content in an appropriately understandable way? Is it is written with as broad an audience in mind as possible? Does the article incorrectly assume unnecessary technical background OR are technical terms explained or avoided where possible.

Input anyone?

  Bfpage |leave a message  02:32, 28 January 2015 (UTC)

( DaiSaw ) - Hello Bfpage - I look in on this Cyclothymia page every so often to see if it is improving : I was so annoyed by what was on it when I first saw it a few years ago I joined up as a contributor to Wikipedia specifically to improve this page by including a warning about how Cyclothymia is rarely diagnosed and instead General Practioners assume that they are encountering depression and when their anti-depressants do not improve the condition they blame the patient - especially when they find the patient getting more ' depressed ' because the anti-depressants are driving the hypothymia ever harder. I added such a warning to the front page and it was removed and you can see my response to that being done above. I fully understand that people are concerned that the front page should be academically / medically respectable, but to be honest - as something of a hack myself, on other subjects submitting articles to printed magazines where my contributions are assessed by proper editors - I want to question why anyone thinks that a Wikipedia page should pretend to be even as respectable as a magazine whose contents are determined by an editor - it most certainly should not be pretending to be the equivilent of a professional peer-reviewed journal.

As somebody diagnosed with Cyclothymia I still feel that this page fails because I am thinking of it in terms of it being the first result in a search engine - it is not going to be used as a source of information for academic or medical research - it is going to be the first thing which a frantically worried parent or their child who will be a bewildered young adult will read. To see it in those terms is to see this page as at best inadequate and at worse recklessly irresponsible - and that is why I resolved to be so indiscrete about my own life above : as Cyclothymes we are human beings not ****ing freak shows ! Some people find the medicalisation of their bodies' disorders encouraging in that they learn that they will either be cured or killed by their doctors but either way they will not have to live with their problems. This page is not written for Cyclothymes or those that have to live with them in their families or where they work - it has been written for doctors by ( wannabe ? ) doctors - and the only doctors who are ever going to read it are the ( wannabe ) doctors who wrote it !

That is and has been and will be my constant reaction to the front page, but I am not going to touch it - but what I think should be considered is who this ought to be written for. I do think that it should quote the agreed medical definitions being used for diagnosis but I do not think that Wikipedia should pretend to be a medical textbook or an academic encyclopedia - Wikipedia's role ought to be more akin to the old fashioned Everyman's Home Encyclopaedia, explaining what Cyclothymia is in an easy to understand way, describing how people live with it and then recommending methods to deal with it that any reasonably useful handyman can improvise upon using readily available items which can purchased in any well-appointed local grocery or hardware store ... but not from Walmart of courseDaiSaw (talk) 01:29, 20 February 2015 (UTC)

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Proposed reference

Please add this reference https://www.healthyplace.com/bipolar-disorder/bipolar-types/rapid-cycling-bipolar-disorder-symptoms-treatment-effects/ TrulyEoptomstrozogist (talk) 20:05, 17 April 2018 (UTC)

Disagree that this reference should be included. The reference is a non-peer reviewed web page.Emcmanus1 (talk)

Infobox

Added further details. As the image was controversial I left it out. Only noticed after adding it that it had previously been removed. Doc James (talk · contribs · email) 00:19, 20 May 2018 (UTC)

Content inconsistency

On the lead paragraph it says "Males and females are affected equally often." but under Epidemiology we find "Cyclothymia is more common among women than men." - Which one is correct? 213.158.139.50 (talk) 08:50, 6 August 2018 (UTC)

Thanks and adjusted Doc James (talk · contribs · email) 16:17, 8 August 2018 (UTC)

What was wrong with

"symptoms of depression"?

Why was "symptoms resembling that of depression" needed? Doc James (talk · contribs · email) 08:42, 15 October 2019 (UTC)

Overreliance on a single source

Does anyone else think it might be a bit of an issue that so much of this article cites one specific source for its information (Koukopoulos, A (January 2003). "Ewald Hecker's description of cyclothymia as a cyclical mood disorder: its relevance to the modern concept of bipolar II". Journal of Affective Disorders. 73 (1–2): 199–205. doi:10.1016/S0165-0327(02)00326-9. PMID 12507752.)

This is an article describing the thinking of a nineteenth-century psychiatrist, and I imagine that thinking has progressed at least a little since then. — Preceding unsigned comment added by 51.149.9.118 (talk) 16:47, 11 November 2021 (UTC)