Depression Childhood Depression Cyclothymia in Children and Adolescents Symptoms, Treatment, and Outcomes By Lauren DiMaria Lauren DiMaria LinkedIn Lauren DiMaria is a member of the Society of Clinical Research Associates and childhood psychology expert. Learn about our editorial process Updated on June 04, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Akeem Marsh, MD Medically reviewed by Akeem Marsh, MD LinkedIn Twitter Akeem Marsh, MD, is a board-certified child, adolescent, and adult psychiatrist who has dedicated his career to working with medically underserved communities. Learn about our Medical Review Board Print Image Source/Getty Images Table of Contents View All Table of Contents The Course of Cyclothymia Symptoms Treatment When to Seek Help Outcomes How Parents Can Help Cyclothymic disorder, or cyclothymia, is a mood disorder in which a child experiences alternating episodes of hypomania and depressive symptoms. Cyclothymia is considered to be part of the bipolar disorder spectrum, with mild but chronic symptoms. This article discusses the course that cyclothymia takes, including its onset and potential for developing into bipolar disorder. It also explores the symptoms of the condition, treatments that are available, and steps that parents and caregivers can take to help their child. The Course of Cyclothymia Cyclothymic disorder involves periods of depressive symptoms alternating with periods of hypomania, which is an elevated mood state. In order to receive a diagnosis of cyclothymia, a child must experience symptoms for at least one year, with no more than two months free of symptoms. The onset of cyclothymia typically begins in adolescence, although it may begin as early as childhood. A family history of bipolar or cyclothymic disorder is a risk factor for developing cyclothymia. Some research suggests that cyclothymia is a risk factor for developing bipolar II disorder. The rates of cyclothymia and other bipolar disorders in children and adolescents are not well established. Estimates of the condition's prevalence in children range from 1.8% to 3.9%, but one 2021 analysis concluded that bipolar disorder in pre-adolescent children was very rare. Symptoms of Cyclothymia Symptoms of cyclothymia are considered to be mild enough to function. However, a child often experiences significant impairment in important areas of daily functioning. Symptoms of cyclothymia may include: Difficulty completing a task Easily distracted Engaging in excessive reckless behavior, such as fast driving, overspending, substance abuse, etc. Fast speech Irritability Lack of concentration Overly joyful Racing thoughts Recurring thoughts of death or suicide Short or quick temper Very little or no sleep, but not feeling tired Children or teens with cyclothymia may be described as unreliable, moody, or temperamental because of unpredictable or irritable moods. For a diagnosis of cyclothymia, the depressive symptoms must not meet the criteria for a major depressive episode, and the hypomanic symptoms must not meet the criteria for mania. Additionally, symptoms must not be better explained by substance use or another psychiatric or medical illness. Research suggests that childhood bipolar conditions also co-occur with other mental health conditions, including attention-deficit hyperactivity disorder (ADHD). Co-occurring conditions may sometimes complicate the diagnosis process or contribute to misdiagnosis. Treatment Options for Cyclothymia Once a child is evaluated and diagnosed, their physician will consider all factors of their situation and determine the most appropriate treatment for them. There is no cure for cyclothymia in children and teens, but there are treatments that can help manage symptoms. Medications Medications are often the first-line treatment for bipolar disorder in both children and adults. Such medications work by helping to stabilize moods. Mood stabilizing medications, like lithium and mood-stabilizing anticonvulsants, are known to be effective for bipolar disorder in children and adolescents. Such medications are often effective but may have potential side effects that you should discuss with your child's doctor. Antidepressant medications may be prescribed, but need to be used cautiously in children and adolescents with a family history of bipolar disorder, as they can potentially contribute to manic episodes or increased mood cycling. All antidepressants carry an FDA black-box warning about an increased risk of suicidal thinking in children and young adults. Because of this potential risk, children should be carefully monitored by their parents and doctors to watch for warning signs of suicide. Psychotherapy Psychotherapy has also been shown to be an effective accompanying treatment. Therapy can help children learn to recognize the signs that are experiencing symptoms of depressive or manic episodes. Children can also work on developing coping skills that will help them better manage symptoms. Cognitive behavioral therapy (CBT) is a type of therapy that can help children and teens with cyclothymia learn to recognize unhelpful or negative thought patterns and behaviors that might contribute to mood episodes. Therapy can be helpful, but it is often most effective when used in conjunction with medication. When to Seek Help If you are concerned about symptoms or behaviors that your child is exhibiting, talk to their pediatrician for further evaluation. Changes in mood, activity levels, behaviors, academic performance, social behavior, and sleep patterns can all be cause for concern. Talk to their pediatrician or a mental health professional if your child or adolescent has symptoms of cyclothymia or another bipolar disorder. Cyclothymia is a serious medical illness that requires treatment. Treatment can significantly reduce the severity of symptoms and potentially prevent future episodes. Outcomes of Cyclothymia Even though cyclothymia is considered to be a chronic disorder, appropriate treatment can significantly help manage symptoms. Without treatment, however, short- and long-term consequences associated with cyclothymia are: Academic decline Increased risk for suicide attempt Interpersonal relationship difficulties Low self-esteem Substance use and abuse Less than half of people with cyclothymia end up developing bipolar disorder and in some people, cyclothymia actually disappears with time. How Parents Can Help Children With Cyclothymia If your child has been diagnosed with cyclothymia or another mental health condition, there are steps you can take to offer support and help your child manage their symptoms. Some actions you can take: Be patient and understanding with your child. Encourage them to talk to you about what they are experiencing.Pay attention to your child's moods and behaviors to watch for changes that might indicate a mood episode.Recognize your child's triggers and take steps to manage changes in mood.Help your child adhere to their treatment plan. It takes time for therapy and medication to work, so consistency is important. Help your child manage stress. Stress can make symptoms worse and more difficult to manage, so minimizing sources of stress and relying on relaxation strategies can be helpful. If you or a loved one are struggling with cyclothymia, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. 7 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Van Meter AR, Youngstrom EA. Cyclothymic disorder in youth: why is it overlooked, what do we know and where is the field headed? Neuropsychiatry (London). 2012;2(6):509-519. doi:10.2217/npy.12.64 Parry P, Allison S, Bastiampillai T. ‘Pediatric Bipolar Disorder’ rates are still lower than claimed: a re-examination of eight epidemiological surveys used by an updated meta-analysis. Int J Bipolar Disord. 2021;9(1):21. doi:10.1186/s40345-021-00225-5 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC; 2013. Tatsiopoulou P, Porfyri GN, Bonti E, Diakogiannis I. Childhood ADHD and early-onset bipolar disorder comorbidity: A case report. Brain Sci. 2020;10(11):883. doi:10.3390/brainsci10110883 Fornaro M, Anastasia A, Valchera A, et al. The FDA "black box" warning on antidepressant suicide risk in young adults: More harm than benefits? Front Psychiatry. 2019;10:294. doi:10.3389/fpsyt.2019.00294 World Health Organization. ICD-10: Chapter V. National Institute of Mental Health. Bipolar disorder in children and teens. By Lauren DiMaria Lauren DiMaria is a member of the Society of Clinical Research Associates and childhood psychology expert. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Depression Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.