Cyclothymia

Proma, 26, is a stylist with a studio in Lalmatia, and this week she is magnificent. She restyles a bride’s entire holud look at midnight, orders three katan saris on her own card, and texts her assistant ideas until two. A fortnight from now she will not answer the client at all.

“Apu, two weeks ago you were dressing the whole of Dhaka,” Jhumur says, holding a garland of marigolds. “This week you won’t pick up the phone.” At Friday lunch, Proma’s Nanu pats her hand. “Our Proma is like Chaitra weather. Sun, then a storm, then sun.” Proma laughs with her. Later, alone, she types into her notes: My moods change faster than the Dhaka sky.

An illustration drawn from common experience. The person is invented; the pattern is not.

Understanding cyclothymia

Cyclothymia, or cyclothymic disorder, is a long-lasting pattern of mood instability: for at least two years, many periods of raised mood and many periods of low mood, with the ups never reaching full hypomania and the downs never reaching a major depressive episode, and with few stretches of steady mood in between. It sits on the bipolar spectrum in both ICD-11 and DSM-5-TR. It is easy to mistake for personality, “just how she is”, and people around the person often give it a weather name.

How common is cyclothymia?

A 2012 review in Clinical Psychology Review describes cyclothymia as rarely diagnosed, despite evidence that it may be the most common form of bipolar disorder, and as highly impairing. The same review notes that its course varies, from settling down to developing into a fuller mood disorder, which is a reason to take it seriously.

Signs and symptoms of cyclothymia

• Moods that swing every few days or weeks, for years
• High spells of energy, confidence, spending or little sleep
• Low spells of tiredness, doubt and withdrawal
• Relationships and work that follow the moods up and down
• People describing you as unpredictable, when you feel it too

Treatment for cyclothymia

Assessment looks for bipolar I or II, depression, thyroid problems, alcohol or other substances, and conditions that can look similar, such as ADHD or personality difficulties. Research on treating cyclothymia specifically is limited, and the 2012 review calls it largely neglected. Care therefore draws on what is recommended across the bipolar spectrum: UK guidelines for bipolar disorder recommend structured psychological therapy that includes mood self-monitoring, attention to how thoughts and behaviour affect mood, and a plan for early warning signs. Regular sleep and routine help many people. Whether medication has a place is decided individually, with care about medicines that can lift mood too far.

What getting better can look like

Proma’s steadier weeks might include a mood chart beside her sketchbook, a rule to sleep on any purchase over a set amount, and a quiet word with Jhumur so the studio keeps running on the low weeks.

Common questions about cyclothymia

Is cyclothymia a type of bipolar disorder?

Yes. Cyclothymia is classified on the bipolar spectrum, with mood swings that are milder than mania or major depression but last for years. It deserves assessment, because in some people it later develops into bipolar I or II disorder.

Is it just a moody personality?

Everyone has moods, but cyclothymia is a persistent pattern of highs and lows that causes real problems in work, money or relationships. A psychiatrist can help tell the difference and suggest ways to steady things.

When to see a psychiatrist

If your moods have swung up and down for years and are costing you work, money or relationships, it is worth an assessment. If a low ever brings thoughts of suicide, call 999.

Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.

Sources

• Van Meter et al., Clinical Psychology Review, 2012 (PMID 22459786)
• NICE guideline CG185, Bipolar disorder: assessment and management (last reviewed 2 September 2025)