Cyclical depression, or “recurrent depression,” can occur, abate and reoccur throughout the span of a person’s life. It can be difficult to self-diagnose, since emotions fluctuate. Cyclical depression often overlaps other forms of depression and anxiety, including premenstrual syndrome and seasonal affective disorder (SAD); therefore, it requires careful monitoring and attention to various co-occurring emotional experiences.
Research also suggests a correlation between cyclical depression and several mental disorders. Obsessive-compulsive disorder (OCD) and panic attacks, for example, can impact an individual’s capacity to think clearly and perform daily tasks, initiating and reinforcing recurrent depressive episodes.
Post-traumatic stress disorder (PTSD) also leads to cyclical depression. The National Institute of Mental Health reports that approximately 40 percent of people with PTSD also struggle with symptoms of depression in recurring patterns. Physical illnesses such as cancer and aneurysms may have ties to cyclical depression, as well.
Depression is not only hard for the person suffering, but also for those around him or her. It takes a toll and can ruin lives and relationships. Therefore, it is best to identify the symptoms early. Depression does not have to be total despair.
There are different levels and types of depression, and it is important to note that the symptoms are not the same for everyone. Without further ado, here’s a look at some of the lesser-known depressive disorders:
What Is Cyclical Depression? First Type: Cyclothymia
Cyclothymia is a rare mood disorder with some of the same characteristics as bipolar disorder. However, cyclothymia is a milder form that appears on a more chronic basis. The typical symptoms include highs and lows for at least two years or more.
The lows are more like a mild form of depression, different than a full-blown case of depression, while the highs are not as high as a full mania, but classified as hypomania. In between the highs and the lows, the baseline feels normal.
What Makes Cyclothymia Different than Bipolar Disorder?
Cyclothymia is different than bipolar disorder in that the feelings of mania and depression are not as strong. But, cyclothymia can become more intense over time, and the highs and lows will start to interrupt daily life on a regular basis.
It is important to seek treatment before this type of depression becomes too disruptive for a normal life. Those with cyclothymia are also more likely to suffer from attention deficit disorder, substance abuse and sleep disorders.
Whom Does Cyclothymia Affect?
Cyclothymia affects both men and women equally; however, women are more likely to seek treatment. It is rare in the general population, with only 0.4 to 1 percent who get diagnosed with this condition. Typical onset occurs during adolescence, but overlooking the symptoms is easy because they are hard to identify.
Symptoms of Cyclothymia
According to the American Psychiatric Association, you must exhibit all these symptoms:
- Multiple periods of hypomania and multiple periods of depressive episodes over a span of two years.
- Symptoms of hypomania and depression are active for at least half of the two-year span, not meeting criteria for a major depression or mania.
- Other mental disorders are not a contributing factor to the episodes.
- The symptoms are not related to drug abuse or other medication use
- The hypomania and depression symptoms disrupt normal life.
Signs of cyclothymia can include:
- Feelings of sadness
- Loss of hope
- Sleep disturbances
- Feelings of worthlessness or guilt
- Concentration problems
- Suicidal thoughts
- Loss of interest in favorite activities
- Weight changes
- Loss of motivation
- Impaired judgment and problem-solving skills
- Low self-esteem
- Loneliness or social withdrawal
- Difficulty handling conflict and finding meaning in life
What Is Dysthymia?
Dysthymia is a milder form of depression. It is still a chronic condition, but has fewer symptoms than major depression. Dysthymia is also known as chronic depression or persistent depressive disorder (PDD).
The symptoms can linger, often for years, making it hard to know what is normal anymore. While suffering from dysthymia, there can also be periods of major depression overlapping the symptoms.
Whom Does Dysthymia Affect?
The National Institute of Mental Health estimates that dysthymia affects about 1.5 percent of American adults. It is not as disabling as a full-blown depression, but the symptoms can often continue for years, hence the name persistent depressive disorder.
Dysthymia typically starts in childhood, sometimes going undiagnosed for years. As with cyclothymia, women typically seek treatment for this condition more frequently than men do. Major life stressors can set off an episode, or abnormal pathways in the brain. Genetics could play a role, but science does not yet fully understand the part that genes play.
Symptoms of Dysthymia
The potential symptoms of dysthymia include:
- Feeling sad and depressed most of the day
- Loss of enjoyment
- Major change in weight
- Changes in sleep patterns
- Feeling physically run down
- Feelings of hopelessness
- Problems with concentration
- Struggling with decision making
- Recurring thoughts of death and/or suicide
What Is Seasonal Affective Disorder?
Natural sunlight has a huge effect on the human body. Specifically, it produces vitamin D, an important vitamin for mental health. Without it, people can develop depression symptoms and other physical and mental symptoms known as seasonal affective disorder (SAD).
Those affected by SAD experience depression symptoms as the days get shorter and the sunlight disappears. Thus, it can feel like depression that coincides with the change of the seasons.
Symptoms of SAD
Symptoms of SAD can include:
- Low energy
- Excessive sleep
- Changes in appetite
- Changes in relationships
- Loss of interest
- Feelings of guilt
- Dread about the future
- Loss of motivation
Living with Depression
The symptoms of depressive disorders can be disruptive to everyday life, making it difficult to keep up with work, family life and other obligations. However, they can be more manageable with help from therapy or various coping strategies.
Many people with cyclical forms of depression say that they can feel a depressive episode coming on, like a migraine, or a storm. This can take the form of feeling distracted, losing focus, or feeling more tired than usual. If possible, it may be helpful to alter schedules and obligations to accommodate the depressive period and its symptoms.
In an interview with NPR, popular MSNBC host Rachel Maddow openly discussed her history of cyclical depression. Maddow said she can feel her depression coming, and tries to make allowances in her work schedule for it. She noted that she can often read a whole book in a day, especially when interviewing authors for her show, but this pace slows down during a depressive episode, due to a lack of focus.
Dual Diagnosis Treatment for Depression and Substance Abuse
Dealing with depressive disorders, no matter the degree, can be a difficult subject. If you or a loved one is experiencing symptoms, it may be time to talk to a doctor.
Depression often goes together with substance abuse. If you or a loved one think you are experiencing one of the lesser-known depressive disorders in conjunction with substance abuse, it is not only possible, but necessary, to get help for both at the same time. This is known as dual diagnosis treatment. Reach out to Maryland Recovery to discover programs specifically designed to deal with both disorders.
Dr. Bhalavat is Board Certified in General Psychiatry and Addiction Medicine, and provides inpatient evaluation and consultation services at the University of Maryland Upper Chesapeake Medical Center, University of Maryland Harford Memorial Hospital, Maryland Recovery Partners, and Citizens Care & Rehabilitation Center. Dr. Bhalavat’s background includes treatment of depression, anxiety disorders, schizophrenia spectrum disorders, bipolar disorder, substance abuse and dementia.