Diagnostic Criteria for Cyclothymic Disorder

Distressed man with his hands covering his face

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Cyclothymia, or cyclothymic disorder, is a condition that involves moods cycling between hypomania and depression. Though milder than bipolar disorder, cyclothymia is sometimes a precursor for bipolar I or II disorder.

How Cyclothymic Disorder Is Diagnosed

Criterion A from the Diagnostic and Statistical Handbook of Mental Disorders, Fifth Edition (DSM-5) defines cyclomania as: “For at least two years (at least one year in children and adolescents) there have been numerous periods with hypomanic symptoms that do not meet criteria for a hypomanic episode and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode."

Additional criteria for cyclothymic disorder in the DSM-5 are:

  • B. During the above two-year period (one year in children and adolescents), the hypomanic and depressive periods have been present for at least half the time and the individual has not been without the symptoms for more than two months at a time.
  • C. Criteria for a major depressive, manic, or hypomanic episode have never been met. [If such episodes appear later, the diagnosis would be changed to bipolar I or bipolar II disorder, as appropriate.]
  • D. The symptoms aren’t better explained by another mental disorder.
  • E. The symptoms aren’t caused by a substance (i.e., medication or drug of abuse) or another medical condition.
  • F. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The specifier “with anxious distress” may be added to a diagnosis of cyclothymic disorder where anxiety is a significant factor.

Other Considerations

Cyclothymic disorder usually first appears in adolescents and young adults, and there’s a 15-50% risk that such an individual will develop full-fledged bipolar I or II disorder later.

A genetic component has been found that increases the risk of developing cyclothymia, especially in first-degree relatives of individuals having mood disorders.

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  1. Baldessarini RJ, Vázquez G, Tondo L. Treatment of cyclothymic disorder: commentary. Psychother Psychosom. 2011;80(3):131-5. doi: 10.1159/000322234 

Additional Reading
  • Diagnostic and Statistical Handbook of Mental Disorders, Fifth Edition (DSM-5). American Psychiatric Association; 2013.