Cyclothymia?

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I've had some difficulty with my moods for a little over a year now, and I always just thought it was normal, but lately it's been getting worse so I've been looking more into any disorder I might have (in addition to ASD). I had ruled out bipolar disorder quite some time ago because my periods of heightened or depressed moods don't last for weeks on end most of the time, and they have always seemed to cycle too quickly for true bipolar, not to mention that neither my heightened nor depressed moods are as extreme as those experienced by those with full bipolar. Most of the time I've been in depressed moods, often with no actual reason, so I thought that I might just have depression, but as I said earlier, things have been getting worse. I suppose I should just put it more directly: For the past month or so my moods have been cycling erratically, far more quickly than anything I've experienced before. There have been days where I have woken up bursting with energy and motivation, only to suddenly have to leave one of my college classes in tears five hours later. For the past four or so days I've been in a heightened mood, and I can't even remember what it was like to have just a normal mood I wasn't suspicious of just a little (aside from dismissing the idea of being in a heightened mood because I feel too good to possibly have a mood disorder...until I feel so terrible that I must have a mood disorder). I'm considering seeking professional help in exploring the possibility of having Cyclothymia, which seems similar to what I've been experiencing based upon what I've read. What I haven't read much about is first hand accounts, though, which I would like to get before I seek help, just in case I'm just being overly suspicious of myself. My moods cycle sometimes once a week or sometimes four times in one day, and most of the time I don't think I hit any sort of middle ground in the transition (I have literally felt the shift from heightened mood to badly depressed mood in a span of a few seconds). If anyone else around here knows anything about Cyclothymia, or something else that might explain my experiences with mood, I'd appreciate some input telling me about other experiences with it. Does the pace of my mood cycling make any sense? Is it too fast? Most of what I've read seems to suggest that multiple shifts in a day can occur, but it's very vague about it. I'm still in an elevated mood right now, but I can't guarantee how much longer it will be until I feel depressed again, which is the one constant I'm certain of. If this gets any replies I can only hope that I'm motivated enough to respond back.

Heard of 'rapid cycling bipolar' or 'ultra rapid cycling' or 'ultra-ultra rapid cycling'? I'm not sure of the exact diagnostic requirements but worth checking it out.

Thank you for responding. Yeah, that was something I looked into pretty early on. It sounded like it could be what I have, but the 'rapid cycling' for that disorder means having 'four or more' episodes a year, which seems to be setting the number of shifts fairly low for what I've experienced. Rapid cycling bipolar also still induces full states of either heightened or depressed moods, and I'm not sure if I can say that I have episodes that are so extreme in either case. Cyclothymia seems to fit my experiences better as the moods experienced with Cyclothymia are said to be less extreme but still noticeable. There's just some lack of information about how often a person with cyclothymia can experience mood shifts.

The following excerpt from the Wikipedia article on Bipolar disorder. It describes both cyclothymia and rapid cycling. As you can see 'rapid cycling' can be applied to any type of bipolar disorder including cyclothymia. So 'rapid cycling' is not a type of bipolar disorder, like type 1, type 2, cyclothymia etc., it is an add-on description. It is possible that someone could be 'ultra rapid cyclothymia' for example.

Even though rapid cycling is four or more episodes per year, the article describes ultra-ultra rapid and ultradian cycling which are much more frequent, even up to one per day.

When it comes to diagnosis, it is best done with a psychiatrist. There are so many different variables that someone online can't really tell what your symptoms are and even if the symptoms are clear then someone online can't diagnose you.


"Criteria and subtypes
There is no clear consensus as to how many types of bipolar disorder exist.[70] In DSM-IV-TR and ICD-10, bipolar disorder is conceptualized as a spectrum of disorders occurring on a continuum. The DSM-IV-TR lists three specific subtypes and one for non-specified:[71][72]
Bipolar I disorder: One or more manic episodes. Subcategories specify whether there has been more than one episode, and the type of the most recent episode.[73] A depressive or hypomanic episode is not required for diagnosis, but it frequently occurs.
Bipolar II disorder: No manic episodes, but one or more hypomanic episodes and one or more major depressive episode.[74] Hypomanic episodes do not go to the full extremes of mania (i.e., do not usually cause severe social or occupational impairment, and are without psychosis), and this can make bipolar II more difficult to diagnose, since the hypomanic episodes may simply appear as a period of successful high productivity and is reported less frequently than a distressing, crippling depression.
Cyclothymia: A history of hypomanic episodes with periods of depression that do not meet criteria for major depressive episodes.[75] There is a low-grade cycling of mood which appears to the observer as a personality trait, and interferes with functioning.
Bipolar disorder NOS (not otherwise specified): This is a catchall category, diagnosed when the disorder does not fall within a specific subtype.[76] Bipolar NOS can still significantly impair and adversely affect the quality of life of the patient.
The bipolar I and II categories have specifiers that indicate the presentation and course of the disorder. For example, the "with full interepisode recovery" specifier applies if there was full remission between the two most recent episodes.[77]
Rapid cycling
Most people who meet criteria for bipolar disorder experience a number of episodes, on average 0.4 to 0.7 per year, lasting three to six months.[78] Rapid cycling, however, is a course specifier that may be applied to any of the above subtypes. It is defined as having four or more episodes per year and is found in a significant proportion of individuals with bipolar disorder. The definition of rapid cycling most frequently cited in the literature (including the DSM) is that of Dunner and Fieve: at least four major depressive, manic, hypomanic or mixed episodes are required to have occurred during a 12-month period.[79] Ultra-rapid (days) and ultra-ultra rapid or ultradian (within a day) cycling have also been described.[80] The literature examining the pharmacological treatment of rapid cycling is sparse and there is no clear consensus with respect to its optimal pharmacological management.[81]

You're stepping into an area with a lot of controversy. When you seek out a mental health professional, I would make sure the mental health professional takes a full history and does a full psychosocial assessment (perhaps even interviewing those who know you), along with assessing your signs and symptoms (while watching how they develop over time). Do not accept a diagnosis without that.

I'm Bipolar 2, but tend to attribute daily ups and downs to autism, and the fact that I'm emotionally sensitive. Any little thing can make me feel ridiculously happy for a few hours (somebody being nice to me, something exciting happening, or just drinking caffeine) – but what goes up must come down, so after a few hours I crash into a depression. And then something else happens, and the cycle repeats.

But on top of that, I have longer-lasting hypomanic and depressive phases, that generally last anywhere from a few weeks to a few months, and I fit the classic pattern for Bipolar 2.

It could very well be that you have Cyclothymia, and since you feel that the symptoms describe you perfectly, it's definitely worth getting checked out! But as to your question about the daily ups and downs, my own belief is that autism explains that kind of emotional sensitivity.

I found this interesting:

"The DSM-IV-TR notes that the mood disturbance must be not severe enough to constitute a full fledged manic or major Depressive episodes. The diagnosis requires that there be periods of both hypomania and depression and periods of normal mood not last longer than 2 months.

The DSM-IV-TR also notes that some clinicians believe that borderline personality disorder is really cyclothymic disorder in disguise."

I've read in other sources that episodes of cyclothymia have a maximum duration of 2 months, but no minimum duration. It's also interesting that some people consider it a form of borderline personality disorder, as BPD is characterized by very rapid changes in mood that can happen several times a day.

There are also "unspecified" mood disorders, and AS can definitely contribute to mood swings. Honestly, I wouldn't be surprised if this is one of those things where the diagnosis will vary from doctor to doctor. Psychology is not a very precise science. I'm not trying to discourage you from getting help though--I would just try to find a very experienced doctor who is willing to do a thorough evaluation.