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What does depression look like in a person with cyclothymic disorder?

People want to know what the difference is between a normal low mood, clinical depression, bipolar depression and cyclothymic depression. So I'm sharing my own experience of what depressive symptoms look and feel like as part of cyclothymic disorder.

If you don't already know, cyclothymic disorder is characterised by fluctuations in mood, consisting of what some health professionals like to call 'mild symptoms of depression' and 'mild symptoms of hypomania'.

(Find out more about what cyclothymia is, and my argument about why cyclothymia shouldn't be called 'bipolar light')

What is the bipolar mood scale?

Try to think of mood disorders existing on a scale between two poles – with depression down one end, mania up the other, and normal balanced mood directly in the middle.

If you have normal mental health then you hover around the middle of the scale – this is the realm of normal mood ...

Ups and downs exist but they aren't extreme or consistent enough to be classed as an illness or disorder. Your moods can be affected by hormones, what you eat and drink, interactions with people, external events, stress and many other things that are all part of the human experience.

If you are clinically depressed you'll spend your time down one end of the scale. Depression is also sometimes called 'unipolar depression', referring to 'one' pole.

There are a set of symptoms that health professionals observe to work out your diagnosis, and you have to be stuck down that end of the scale for at least two weeks with consistent symptoms in order to be diagnosed with depression.

A person diagnosed with 'bipolar disorder' on the other hand – travels up and down the scale, swinging back and forth between both poles.

They'll have episodes of both depression and mania (or hypomania, which is a milder form of mania), plus extended periods of normal mood in between.

The main difference for people diagnosed with cyclothymia is that we aren't supposed to have actual 'episodes'.

As we've seen, a depressive episode consists of consistent symptoms for at least two weeks. a hypomanic episode is consistent symptoms for at least four days.

Instead we cycle back and forth along the scale much more frequently, experiencing 'symptoms' of both depression and hypomania intermittently, or sometimes mixed together, that are unpredictable and inconsistent.

This means the symptoms don't last long enough to meet the medical criteria required to diagnose an actual episode. If they did then the overall diagnosis would most probably be changed to bipolar 1 or 2, or something else entirely.

What are the symptoms of depression in cyclothymia?

Remember, with cyclothymia, you experience 'symptoms' of depression, and not actual episodes ...

A depressive episode requires several symptoms of depression to be present consistently for longer than 2 weeks, and for them to impact your ability to function in everyday life.

According to the NHS there are psychological, physical and social symptoms of clinical depression, with severity ranging from mild to moderate and severe.

The difference between grief and depression is also described, as well as other types of depression like postnatal depression, bipolar depression and seasonal affective disorder or 'winter depression' (SAD).

As you can tell, depression can be complicated, so I won't go into all of that here. You can go and read about it on the NHS website, but make sure you come back, because I share some of my personal experiences of depression further on!

Cyclothymic depression is far more unpredictable and inconsistent than the depressive episodes that occur in people diagnosed with clinical depression or bipolar disorder.

Sometimes it comes on heavy and feels terrible.

When this happens to me I find it near impossible to physically and mentally function, which technically isn't a feature of depressive symptoms in cyclothymia, according to the pros ...

They say it shouldn't affect your ability to function in life, but I beg to differ, because in my own experience, my depressive symptoms have been crippling.

Thankfully my heavy depressive waves don't stick around like that for too long.

Other times it can just feel like a general gloom or flat feeling that taints my experiences but doesn't necessarily stop me from living my life normally.

Depression isn't that straightforward though. There are many aspects that make up the symptoms of depression, such as fatigue, irritability, negative thought-spirals and suicidal ideation, and even anxiety – just to mention a few.

I personally find that when I am being affected by symptoms of mild depression, the way I perceive everything changes, and this is what I find most difficult to deal with ...

Seeing everything in a negative light creates a lot of inconsistency. It messes with my sense of self, as I find myself questioning everything – my thoughts, feelings, decisions, interests, passions, dreams, career, people and relationships.

It's insidious too. It'll creep up on you and you even won't realise it's there, sneaking its way into your life and affecting your mind ...

Before you know it you've quit your job, broken up with your partner, or deleted your half-completed novel. Yes, I've done all of these things as a result of depression and its devious nature. Cyclothymic depression can be fleeting, lasting for just a couple of hours, a couple of days, or longer. It can be punctuated with periods of time where your mood seems to level off or rise up higher, only to plummet back down again not long afterwards.

Sometimes you may experience more depressive symptoms clumped together all at once, and other times there may just be one or two that stand out. If you have many symptoms of depression consistently for longer than two weeks you should speak to your doctor and ask for a reassessment. You might feel like you know why you are feeling low, but a lot of the time your mood may just dip for seemingly no reason at all. We all have our triggers and red flags, but sometimes a depressed state just comes out of nowhere and seems to disappear without a cause too.

People who do not suffer from a mental illness probably experience similar highs and lows. The main differences are the intensity and the fact that there's no mood cycling.

An example of my experience of cyclothymic depression

I came out of a severely depressed state that lasted beginning to end about 6 days. The first 2-3 days were more of a build-up. The final 3-4 days were far from 'mild'.

It was the kind of depression that completely wipes you off your feet once it sets in. I lost all track of time that week, and it felt like much longer. We're not just talking about a low mood, although it started off like that ...

By Saturday evening I had realised that my mood was not what it was that morning. I felt flat and a bit despondent. I had less enthusiasm for things like watching my favourite program or reading my book. I felt a bit tired. On Sunday I wasn't ready to admit that my mood was dipping and so I willed myself to keep living life normally – I took my dog for an extra-long walk, but I knew that my mood wasn't in a good place because I felt a bit lost, unappreciative, and disconnected from the beauty around me.

I couldn't find the usual pleasure and enjoyment I usually get from taking my dog to the woods and being surrounded by nature. It wasn't relaxing like it should have been. Instead, certain things were irritating me, like how many other people were also walking their dogs in the woods that day.

On Monday morning I woke up hopeful, with good intentions to stick to my routine and have a productive start to the week, but when I came to sit down at my desk and start work I realised with a sense of impending doom that I wasn't able to.

I tried to fight it, but the depression just washed over me. I sat in my chair stubbornly for as long as I could (about 20 minutes), staring at my computer screen until I had to surrender and find my way back to bed because suddenly I was exhausted.

I told myself that I just needed to get a little more sleep and that I could try to start my day again. Alas, I wasn't able to start my week the way I had wanted to, despite many similar attempts throughout the day. The stress and anxiety attached to not being able to function the way I wanted to, made me very emotional. Crying, although it's usually a therapeutic release of tension, just wore me out even more.

Any attempts I made to do anything at all over the next three days were thwarted with extreme heavy waves of depression that swept over me, bringing me back to bed.

The only thing I was capable of doing during this time was sleeping, and then using pockets of time in between sleep to do the things that I needed to do, like walk my dog up the road and back, go to the toilet, make a cup of tea and answer the phone when my sister rang. Along with the heavy depression came intense irritability, mainly generated by my cat's incessant meowing. There's nothing worse when you are feeling so heavy with depression than someone or something needing your attention.

The sound of my cat's vocals vibrated through my whole body, which was so extremely sensitive to noise that with every meow I actually experienced a kind of painful buzzing in my head and across my chest. My cat was physically hurting me without even touching me.

This lead to several meltdowns in which I lashed out, screaming at my poor cat to be quiet and leave me alone, which in turn lead to feelings of guilt and remorse, only making me want to bury myself deeper underneath the duvet. By day 2 of the severely depressed state I was unable to hold a conversation on the phone with my mother.

It was so utterly draining just to listen to her talk, never mind me actually attempt to contribute to the conversation. The longer I stayed on the phone the more irritable I felt until I was sitting with my head in my hands holding back tears and desperately praying that she would go away.

Sometimes I would sleep for too long so that it was physically painful to stay in bed because my body ached and hurt like it was a corpse and rigor mortis was setting in. I couldn't bring myself to move though, until my phone rang, and I knew it was my sister.

Her phone calls really helped me during those torturous days. Perhaps this was because she suffers from depression and talking with her about it helped to validate what I was going through.

Sometimes after some sleep I'd feel a little lighter and be able to do something vaguely enjoyable, like make a cup of tea and try to watch something on my phone, but not for very long. Other times I functioned only out of necessity, zombie-fashion.

There was no showering, no changing of clothes, any food that I managed to eat tasted of nothing, even my tea didn't hit the spot like it usually does. I walked my dog around the block each day, bought chocolate from the corner shop for the sugar boost, and then came home and crashed. It was four days of hell.

I have a book with a section that lists strategies for lifting a depressed mood. During my four days of hell, reading a textbook was the last thing on my mind. Looking through it later I almost felt insulted by the list, like it was suggesting I hadn't tried hard enough, and that my four days of hell was my own fault because I didn't try to 'feed bread crumbs to birds' or 'surf the internet for interesting topics'.

When you're truly in the throes of severe depression, even if it only lasts for 4 days, willing yourself to lift your body up off the bed because you're bursting for a wee is about the height of achievement.

The only thing I was able to do for myself that counted as self-care during my three days of hell was rest and not beat myself up about it. I knew that the depression would lift eventually and that I would feel more able to do things again, but during those four days, it would have been a waste of time and energy. It may even have prolonged the depression. It's difficult when you suspect that others think that you can do more to help yourself. I find myself switching into defence mode in my head - Do you really think that I want to feel like this? That I want to go without showering, without eating properly, without watching my favourite program or reading the new book I downloaded onto my Kindle? If I was able to make it go away by 'writing a poem about a pleasant time' don't you think I'd do that? Depression is just horrible, and not many people get it. The weirdest thing is that one of the side effects of cyclothymia is that once your mood shifts and you feel good again, it's kind of difficult to remember or fully relate to your own experience of feeling so low ...

I'm writing about it now, but I can't quite get my head around the fact that it was actually only two days ago that I could barely drag myself out of bed to feed my pets their dinner. In fact, this morning I was singing with the same cat I previously wanted to strangle. Yes, singing.

Share your experiences of depression

Sometimes hearing other people's experiences of what you go through is therapeutic. Maybe that's why you're reading this post?

Discovering that you're not the only one who has gone through something awful and that it really is as awful as you say it was, can be so validating, and help to convince us that we are not completely crazy. So please feel free to write in the comments below about your own experiences of cyclothymic depression, bipolar depression, unipolar depression, or even your normal low mood experiences for those of you who don't suffer from a diagnosable illness.

How long does yours last? What does it feel like? Do you have your own ways of coping that work? Do you also feel detached from your experiences of depression when it's all over? I look forward to hearing your stories.

Find out what hypomania looks like in a person with cyclothymic disorder

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