Cyclothymic Personality Disorder

(The Composer)

Cyclothymic Personality Disorder is a pervasive pattern of pronounced changes in mood, behavior, thinking, sleep, and energy levels, beginning by early adulthood and present in a variety of contexts, as indicated by seven (or more) of the following:

     

  • has depressive periods: depressed mood or loss of interest or pleasure in all, or almost all, activities and pastimes alternating with hypomanic periods: elevated, expansive, or irritable mood;

     

  • has a decreased need for sleep alternating with hypersomnia;

     

  • has shaky self-esteem: naive grandiose overconfidence alternating with lack of self-confidence;

     

  • has periods of sharpened and creative thinking alternating with periods of mental confusion and apathy;

     

  • displays marked unevenness in the quantity and quality of productivity, often associated with unusual working hours;

     

  • engages in uninhibited people-seeking (that may lead to hyper-sexuality) alternating with introverted self-absorption;

     

  • becomes excessively involved in pleasurable activities with lack of concern for the high potential of painful consequences alternating with restriction of involvement in pleasurable activities and guilt over past activities;

     

  • alternates between over-optimism or exaggeration of past achievement and a pessimistic attitude toward the future, or brooding about past events;

     

  • is more talkative than usual, with inappropriate laughing, joking, and punning, and then less talkative, with tearfulness or crying;

     

  • frequently shifts line of work, study, interest, or future plans;

     

  • engages in occasional financial extravagance;

     

  • makes frequent changes in residence or geographical location;

     

  • has a tendency toward promiscuity, with repeated conjugal or romantic failure;

     

  • may use alcohol or drugs to control moods or to augment excitement.

 

Cyclothymic personality (see also Ch. 189)

In persons with this personality disorder, high-spirited buoyancy alternates with gloom and pessimism; each mood lasts weeks or longer. Characteristically, the rhythmic mood changes are regular and occur without justifiable external cause. This personality disorder is a spectrum variant of manic-depressive illness (bipolar disorder), but most cyclothymic persons do not develop bipolar disorder. Cyclothymic personality is considered a temperament, present in many gifted and creative people.

 

Common symptoms and behavioral traits

Very common symptoms and behavioral traits (Papolos, pg. 51) that have been consistently observed in children with early-onset bipolar disorder include:

Separation anxiety
Rages and explosive temper tantrums lasting up to several hours
Marked irritability
Oppositional behavior
Rapid cycling (frequent mood swings, occurring within an hour, a day, or several days) or mood lability
Distractibility
Hyperactivity
Impulsivity
Restlessness/fidgetiness
Silliness, giddiness, goofiness
Racing thoughts
Aggressive behavior
Grandiosity
Carbohydrate cravings
Risk-taking behaviors
Depressed mood
Lethargy
Low self-esteem
Difficulty getting up in the morning
Social anxiety
Oversensitivity to emotional or environmental triggers

 

Sources:

  1. Ptypes proposal (Dave Kelly)
  2. The Merck Manual of Diagnosis and Therapy   
  3. Papolos, Demitri F. and Janice Papolos. The bipolar child: the definitive and reassuring guide to childhood's most misunderstood disorder. New York: Broadway, 2000.

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