I once met a man at a writer’s conference whose behavior screamed “hypomanic”. He spoke rapidly, walked fast, made grand gestures, and was prone to heavy drinking and smoking. I often saw him pacing or fidgeting. At any given moment, I expected him to burst out of his skin, unable to contain his elation.
He was also an inspiration to many. The great majority of his conversations consisted of probing questions about who the addressee was, and how were they going to improve themselves—today? What were their dreams, and why weren’t they acting on them already? He oozed charisma, and garnered quite a fan following.
Lucky for him, he had an amazing Team You present at the conference: a group of his friends who had all known each other since their school days. They took shifts watching over him when he inevitably crashed. They explained that their colleague would go, go, go–sometimes for up to a month and a half. Then he’d sleep for about a week, curling into himself in the throes of an awful depression.
When I explained his behavior to my therapist, she said, “That sounds like cyclothymia.”
Cyclothymia is largely considered to be a “weaker” form of bipolar disorder. Episodes of mania and depression are not as severe and do not last as long. Psychotic features aren’t usually present. Some people with the weaker form eventually develop full-blown bipolar. It is suspected that cyclothymia is passed down genetically.
The disorder is difficult to diagnose because it shares so many characteristics with Attention Deficit Hyperactivity Disorder (ADHD), including, “increased energy, distractibility, and impulsive or risk-seeking behavior.” The symptoms also overlap with certain personality disorders. In addition, cyclothymia is frequently comorbid with other disorders, which means that a doctor may have one or more diagnoses to sift through.
Symptoms are usually treated with lithium carbonate and Seroquel, provided the patient desires treatment. Most people with cyclothymia are productive, sometimes to extremes.
Disclaimer: I do not claim to know enough to have diagnosed my friend, nor do I expect or want my therapist to do the same.
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