Bipolar III Disorder or Cyclothymia

Causes, symptoms and treatment

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Bipolar III disorder is the unofficial term for cyclothymia, a mild form of bipolar disorder.


Cyclothymia, sometimes called cyclothymic disorder, is a long-term condition where your moods cycle between hypomania and depression, but they are not incapacitating or suicidal. Hypomania is a "high" that can be mild to fairly severe but does not include delusions, hallucinations or other psychotic features.

Cyclothymia is milder than bipolar I or bipolar II in that the depressive and hypomanic episodes are not as intense as those found in the other two disorders. In between the highs and lows, you may feel pretty normal. However, it's important to get help for cyclothymia since it can significantly impact your everyday functioning and affect your relationships at home and at work.

Who Gets Cyclothymia/Bipolar III Disorder?

Cyclothymia usually starts during the teen years or young adulthood and affects both males and females equally. It may be underdiagnosed because people who have it are sometimes erroneously diagnosed with other mental health conditions like depression or bipolar II disorder.

Many people with cyclothymia do not seek treatment either because their symptoms are not as debilitating as those seen in bipolar disorder.


As with every other mental health disorder, no one knows what causes cyclothymia. Certain factors, including family history, environmental stressors, and brain chemistry seem to play a role in developing cyclothymia.


Cyclothymia has similar symptoms to the other bipolar disorders, but not quite as extreme. It is characterized by emotional highs and lows that can be but aren't always disruptive to daily functioning. These emotional highs and lows are called hypomanic and depressive episodes.

Hypomanic Symptoms

In cyclothymia, when you are on an emotional high, you are experiencing a hypomanic episode, which is not as extreme as mania. Hypomanic symptoms occur for at least four days and may include:

  • Difficulty concentrating
  • Feeling restless
  • Feeling extremely happy or euphoric
  • Not needing as much sleep as normal
  • Irritability or agitation
  • Becoming more physically active, which may include fidgeting or pacing
  • Thinking very highly of yourself
  • Poor impulse control and/or judgment, which can lead to risky choices
  • Being more talkative than normal
  • Becoming distracted easily

Depressive Symptoms

In cyclothymia, when you are in a low place, you are probably experiencing a depressive episode, which also tends to not be as extreme as those found in bipolar I and bipolar II. These symptoms may include:

  • Isolation
  • Not experiencing pleasure in the things you used to enjoy
  • Excessive crying
  • Changes in eating habits and/or weight
  • Sleeping too much or too little
  • Difficulty concentrating
  • Feeling guilty, worthless, or hopeless
  • Irritability
  • Feeling tired or worn out
  • Thoughts of death or suicide


If you have symptoms of cyclothymia, you should see your doctor right away. Depending on your doctor's experience, she may refer you to a mental health professional for a diagnosis if no physical reasons for your symptoms can be found.

Cyclothymia is diagnosed when these factors are present:

  • Your stable moods, which are the times between mood episodes, last for less than two months.
  • You have had both hypomanic and depressive episodes for at least two years (one year for children and teens), and these highs and lows account for at least half of the time.
  • The symptoms you're having don't meet the diagnostic criteria for another illness, such as depression, bipolar I, or bipolar II disorder.
  • These mood episodes are negatively impacting your life and day-to-day functioning.
  • Your symptoms aren't a result of substance abuse or a physical illness.


An effective treatment plan can take time and patience in order to figure out the best combination for you. Treatment may include psychotherapy and/or medications to help keep your symptoms from interfering with your life.

There aren't any medications approved by the Food and Drug Administration (FDA) specifically for cyclothymia, but your doctor may use medications approved for bipolar disorder, like mood stabilizers or antidepressants, to help control your symptoms.

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Article Sources

  • American Psychiatric Association. (2013).Diagnostic and statistical manual of mental disorders (5th ed.).Washington, DC: American Psychiatric Publishing.
  • Tartakovsky M. (May 2016). Psych Central: Understanding & Coping with Cyclothymia. 
  • U.S. National Library of Medicine. (September 2014). Cyclothymic Disorder.