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Treatments and drugs
By Mayo Clinic staffCyclothymia is a long-term condition that requires lifelong treatment, even during periods when you feel better. Cyclothymia treatment is usually guided by a mental health provider skilled in treating the condition. Because cyclothymia has a high risk of developing into bipolar disorder, it's important to get effective and appropriate treatment.
Treatment is also vital for reducing the frequency and severity of hypomanic and depressive episodes and allowing you to live a more balanced and enjoyable life. Maintenance treatment — continued treatment during periods of remission — is also important. If you skip maintenance treatment, you may be at higher risk of having a relapse of cyclothymia symptoms or having minor episodes turn into larger problems.
If you have problems with alcohol or substance abuse, you must get treatment for those, too, since they can worsen cyclothymia symptoms.
The main treatments for cyclothymic disorder are medications and psychotherapy.
Medications
Medications may help control cyclothymia symptoms and prevent episodes of hypomania and depression. Medications commonly used to treat cyclothymia include:
- Mood stabilizers. Mood stabilizers are the most commonly prescribed medications for cyclothymic disorder. These medications help regulate and stabilize mood so that you don't swing between depression and hypomania. Lithium (Eskalith, Lithobid) has been widely used as a mood stabilizer and is generally the first line of treatment for hypomanic episodes. Your doctor may recommend that you take mood stabilizers for the rest of your life to prevent and treat hypomanic episodes.
- Anti-seizure medications. The medications, also known as anticonvulsants, are used to prevent mood swings. They include valproic acid (Depakene), divalproex (Depakote) and lamotrigine (Lamictal).
- Other medications. Certain atypical antipsychotic medications, such as olanzapine (Zyprexa) and risperidone (Risperdal), may help people who don't gain benefits from anti-seizure medications. Anti-anxiety medications, such as benzodiazepines, may help improve sleep. In addition, one medication, quetiapine (Seroquel), has been approved by the Food and Drug Administration to treat both the manic and depressive episodes of bipolar disorder, and may also be helpful for cyclothymic disorder.
- Antidepressants. Use of antidepressants in cyclothymic disorder is typically not recommended, unless they're combined with a mood stabilizer. As with bipolar disorder, taking antidepressants alone can trigger potentially dangerous manic episodes. Before taking antidepressants, carefully weigh the pros and cons with your doctor.
If one medication doesn't work well for you, there are many others to consider. Keep trying until you find one that works well for you. Your doctor may advise combining certain medications for maximum effect. It can take several weeks after first starting a medication to notice an improvement in your cyclothymia symptoms.
Be aware that all medications have side effects and possible health risks. Certain antipsychotic medications, for instance, may increase the risk of diabetes, obesity and high blood pressure. If you take these medications, talk to your doctor about being monitored for health problems. Also, mood stabilizing medications may harm a developing fetus or nursing infant. Women with cyclothymic disorder who want to become pregnant or do become pregnant must fully explore with their health care providers the benefits and risks of medications.
Psychotherapy
Psychotherapy is another vital part of cyclothymia treatment. Psychotherapy, also called counseling or talk therapy, can help you understand what cyclothymia is and how it's treated. Some experts recommend that you have therapy with a psychiatrist or psychologist with experience in treating cyclothymic disorder.
Types of therapy that may help cyclothymia include:
- Cognitive behavioral therapy. This is a common form of individual therapy for cyclothymia. The focus of cognitive behavioral therapy is identifying unhealthy, negative beliefs and behaviors and replacing them with healthy, positive ones. In addition, you can explore what may trigger your hypomanic or depressive episodes. You also learn effective strategies to manage stress and to cope with upsetting situations.
- Family therapy. Family therapy involves you and your family members. Family therapy can help identify and reduce stressors within your family that may contribute to unhealthy behavior patterns. Family therapy can also help your family improve its communication style and problem-solving skills and resolve conflicts. And it may help your family — whether parents, siblings or partners — better understand your condition and why you think and behave the way you do.
- Group therapy. Group therapy provides a forum to communicate with and learn from others in a similar situation. It may also help build better relationship skills.
