Cyclothymia is not a new disease; besides its history within psychiatric research, it has not been examined as closely as bipolar disorders I and II. A cyclothymic disorder is a less severe version of bipolar disorder, while still being very similar to both bipolar I and II disorders. Cyclothymia and bipolar disorder both experience subtle depressive and hypomanic disposition signals and can act as a step in dividing mood changes and full-fledged bipolar disorder episodes. Due to symptoms beginning during adolescence, cyclothymic disorder often goes misdiagnosed or not diagnosed at all. This improper, or even absent diagnosis during adolescence, “may result in insufficient or inappropriate treatment for up to a third of adults with a bipolar spectrum disorder.” (Van Meter, A., Youngstrom, E., Demeter, C., & Findling, R., 2013, p.368).
Though genetics and hereditary features do not play a significant role in determining overall mental illness history, studied performed predict that, “youth with cyclothymic disorder may have more family history of psychiatric disorders than the other bipolar subtypes. Familial history of psychiatric illness, specifically bipolar spectrum disorders, may be an important factor in the phenomenology and course of early-onset bipolar disorders.” (Van Meter, A., et al. 2013, p. 369). A type of examination to determine if genes and hereditary features are constant factors in mental illness in adolescence is named as Genetic Linkage analysis. “Genetic linkage analysis specifies regions of a chromosome by the use of polymorphic DNA markers that are unambiguously associated with the illness. This region of genetic material will tend to be inherited by all other affected individuals within a specific family.” (Gurling, H. M., Read, T., & Potter, M. 1991, p. 100). If this analysis proves to be effective, it provides evidence and interpretation of the method of transition, unlike other forms of testing. As with cyclothymic disorder itself, the relationship between family history with a psychiatric disorder, versus those without and how their offspring are affected, is scarcely looked into.
Cyclothymic disorder and other disorders are still attempting to be linked with some sort of family history, but cyclothymic disorder does not discriminate pertaining to gender. Studies provide evidence of a unique mental illness, with women and men experiencing different types of stress and symptoms. Research conducted on gender and mental disorders found, “a higher preponderance of cyclothymic disorder among women have drawn participants from clinical samples, confounding incidence and treatment seeking.” (Meter, A.R., Youngstrom, E. A., & Findling, R.L., 2012, p.235). Although there is no similar sex difference between other mental illnesses, “women have higher levels of affective disorders, such as depression, and of anxiety disorders, and men have higher levels of substance abuse and conduct disorders.” (Busfield, Joan, 2014, para. 1). While women and men can both suffer from mental illness, women are possibly more affected by mental illnesses, such as cyclothymic disorder, than men due to hormone imbalances and expressing more negative emotions than the average male.
A study performed on substance abuse among adolescents by The American Journal on Addictions make the case that substance abuse is an option adolescent turn to when prescription medication and counseling are unavailable, or out of their financial comfort zone. The study performed hypothesizes that ‘individuals may try to manage their overt and covert underlying psychological conflicts and symptoms by modulating them with substances of abuse.’ (Lorberg, B., MD, Wilens, T., MD, Martelon, M., MPH, Wong, P., BA, & Parcell, T., BS., 2010, p. 474). The analysis continues on by providing that the study is centered around adolescents who partake in tobacco, alcohol, and other forms of substance abuse. The results are intended to reveal adolescents substance of choice and prevent abuse, along with guide treatment of cyclothymic disorder and bipolar disorder. The researchers in the journal entry state that, ‘Overall, our findings add to a growing literature on self-medication and its relation with SUD (substance use disorder) in BPD (bipolar disorder) and other pediatric psychiatric diagnoses.’ (Lorberg, B., MD, et. al., 2010, p. 477). This investigation, along with many more, provides a window into the maintenance of cyclothymic disorders. Adolescents are commonly choosing a route of substance abuse for various reasons such as sleep, mood change, or other reasons that are not mentioned. Luckily, these studies help psychotherapists and doctors everywhere find a safe, affordable, and effective method to treat these disorders in the future.
Suicidal actions and thoughts are one of the many problems young people face in life. Risk-related levels of adolescence and suicide are the second cause of death among young people in today’s society. Studies indicate that people affected by cyclothymic disorder are more prone to experience suicidal thoughts or develop suicidal tendencies. A study performed by a team of researchers found that “81% of youths with a cyclothymic temperament reported at least one episode of suicide ideation, as compared to only 36% of youths without a cyclothymic temperament.” (Halfon, N., Labelle, R., Cohen, D., Guile, J., Breton, J., 2013, p. 147). Several features, including their environment, family, social lives, and psychological state all play a role in multiplying the suicide rate. The role of the family in the adolescents’ life can either increase or decrease their suicidal tendencies. Some important contributors to self-mutilation or suicidal thoughts are, “genetic vulnerability and psychiatric, psychological, familial, social, and cultural factors. The effects of media and contagion are also important, with the internet having an important contemporary role.” (Hawton, K., Saunders, K. E., & O’Connor, R. C., 2012, p. 2373). Adolescence who experience a stressful life event or being the victim of sexual abuse also increases the suicidal tendencies among youth. While there is little evidence of antipsychotic drugs or therapy being effective in diminishing these thoughts and actions, preventing suicidal tendencies requires a global effort targeted towards aiding our youth and publicizing practices to larger groups.
Cognitive behavioral therapy is one of the many solutions adolescents can turn to when struggling with cyclothymic disorder or other mental health ailments. This therapy places an emphasis on guiding the individual to be their own therapist. Cognitive behavioral therapy is an example of a specific “treatment that takes into account the critical developmental tasks and milestones relevant to a particular adolescent’s presenting problems (e.g., pubertal development, cognitive development, the development of behavioral autonomy and social perspective taking during adolescence).” (Holmbeck, G. N., O’Mahar, K., Abad, M., Colder, C., & Updegrove, A., 2006, p.420.) The therapists that specialize in cognitive behavioral therapy emphasize what is going on in the person’s current life, rather than what has led up to their difficulties. Philip C. Kendall, the editor of Child and Adolescent Therapy Fourth Edition: Cognitive-Behavioral Procedures states that “Given a focus on children and adolescents (i.e., youth), they can benefit greatly from consideration of theories that deal with psychological change in youth, and that address aspect of human development that unfolds during youth.” Overall, the focus in cognitive behavioral therapy is primarily on moving forward from the past and developing more effective ways of coping with life’s stresses.
Psychotherapy is a form of face-to-face speech therapy and a possible resolution towards helping people with many types of mental illness and emotional problems. Psychotherapy can help to eliminate or control troubling symptoms in order for a person to function better in everyday life. This therapy can be held in a person, family, couple, or group situation, and can help both children and adults. Psychotherapy has been proven to have a positive effects on adolescents suffering with emotional issues and mental illness. However, Alan Kazdin, the author of an article in the Journal of Consulting and Clinical Psychology, states that “Although important advances can be readily identified in outcome research, the pace of progress has been thwarted by challenges of the subject matter (e.g., developmental issues, comorbidity, and the diverse parent, family, and other contextual factors in which child dysfunction is embedded).” Kazdin makes the point that though psychotherapy has been noted as effective in several meta-analysis studies, each child and their situation is different. A sense of trust between the child and their therapist is crucial to working together and receiving the benefits of psychotherapy. Psychotherapy is often used in combination with medication to treat mental health conditions. Combining therapy with antipsychotic drugs is a common treatment among those with mental illness, but some researchers aren’t in favor of this mix. This is best explained by three researchers who performed a meta-analysis on psychotherapy and medication prescriptions among adolescents, “The need to examine psychotherapy effects is underscored not only by evidence on the extent, impact, and sequelae of youth depression but also by recent debate over medication risks. Selective serotonin reuptake inhibitors (SSRIs) have become a widely used treatment for depressed youths, but concerns over possible risks, including suicidal ideation and suicide attempts have led regulatory agencies to hold hearings, issue safety warnings, and classify SSRIs as “contraindicated” for pediatric use.” (Weisz, J.R., McCarty, C.A., & Valeri, S.M., 2006, para. 3.). In some circumstances antipsychotic medication can be extremely useful, and in other patients psychotherapy may be the most effective option. While many people who experience troubling mental illness, combining medication and psychotherapy treatment is better than either alone.
While drugs can play an important role in combating many bacterial problems, antipsychotic drugs are used primarily for brain control. Antipsychotic drugs are essentially used to control an emotional imbalance or mental health issue in adults and children, “Use of second-generation antipsychotics among youths has increased in the United States, in contrast to a constant or even declining use of first-generation antipsychotics.” (Kalverdijk, L. J., Tobi, H., Berg, P. B., Buiskool, J., Wagenaar, L., Minderaa, R. B., & Lolkje T. W. De Jong-Van Den Berg., 2008, para. 2.). Antipsychotic drugs do not cure these conditions but are used to help eliminate the symptoms and improve the quality of life. While antipsychotics are still considered a treatment option for adolescents in the United States, there is “no clinically significant superiority in efficacy has been demonstrated for any specific antipsychotic, including both first- and second-generation agents, in children and adolescents.” (Vitiello, B., Correll, C., Van Zwieten-Boot, B., Zuddas, A., Parellada, M., & Arango, C.,2009, para. 1.). During beginning stages of treatment of antipsychotic drugs, some symptoms such as heartburn and hallucinations, are often gone in the early days of an antipsychotic treatment. Diseases, such as cyclothymic disorder, often go away within weeks, but the full treatment results are apparent in a little over a month.
Cyclothymic disorders have generated a great amount of interest within the last decade due to the growing acknowledgement of their clinical importance considering genuine identification and treatment. This paper reviewed possible symptoms of cyclothymic disorder along with various treatments, how genetics and gender can play a factor, and the suicide and substance abuse rates among youth diagnosed with this disorder. In addition, the paper touched on how bipolar disorders I and II are similar to cyclothymic disorder, and how cyclothymic disorder can be misdiagnosed as bipolar disorder. Even though cyclothymic disorder symptoms are similar to those of bipolar disorder, the condition is diverse in a clinical setting. In conclusion, the scarcity of research is also discussed, but with the amount of research collected, the future of studies on mental health is promising.
