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Personality disorders are deeply ingrained maladaptive patterns of behaviors,
often present throughout life.
Personality disorders are characterized by behavior patterns (perfectionism, suspicion,
emotionally) rather than by symptoms such as anxiety or depression which typifies
so many of the disorders.
The severity of the behavior patterns fits on a spectrum going from a few examples
of a particular trait to a full-blown disorder.
Having a few traits is normal but when individuals have enough of the traits to impair
their functioning significantly year after year, they have a personality disorder.
Probably everyone has some of the traits characteristic of these personality disorder.
Few individuals have enough of the traits to be regarded as having a personality disorder.
Behavior Patterns
A Cyclothymic personality disorder is similar to a manic-depressive psychosis
but much less severe.
Throughout life such individuals are "high" and elated for a period of time,
then thoroughly depressed for a period of time.
Or they may remain mostly elated throughout life or mostly depressed throughout life.
In other words, they can, throughout their lives, the high or low, or can alternate
between the two extremes.
When Cyclothymic individuals are related, their warm, ambitious, buoyant, optimistic,
enthusiastic, outgoing, and likable.
In severe cases, they may seem hypomanic or persistently euphoric.
They may talk so much and so fast that they actually become hoarse, racing logically
from one topic to another as though unable to keep their minds on a single train of thought.
Their speech is generally cheerful and effervescent, full of contagious humor
until some frustration produces a flash of anger that turns the humor into hostile sarcasm.
Wrapped up in their achievements, they can be very insensitive to others,
using religious jargon or making embarrassing comments.
Since they have a tendency to blame others and possess little true self-awareness,
their behavior can be exasperating to family and other associates.
Uninhibited by self-criticism, they may show poor judgment in their impulsiveness
and self-confident drive.
They may plunge into extravagant enterprises in attempting to acquire needless possessions.
Some act like exhibitionists, going nude or posturing seductively.
Their tendency to maneuver or exploit others without compassion can create
interpersonal havoc within a family.
They have a conquering superego when "high."
When depressed, the same Cyclothymic person is sad, hopeless, helpless,
and dependent – performing at a low energy level.
The recurring periods of high and low sometimes fluctuate rapidly,
sometimes for weeks and months.
The periods of depression are marked by reduced motor activity, pessimism,
social withdrawal, guilt, depression, and anxiety.
Hpochondriacal feelings may exist, such as diminished appetite, insomnia,
or decreased sexual desire.
Occasionally ideals of suicide occur.
Cyclothymic individuals continue to function during periods of depression,
but only marginally.
The manic-like highs are commonly prized by Cyclothymic individuals
because they "feel so good," but dreaded by family, friends, and associates.
Conversely, low periods, disliked by Cyclothymic individuals, provide welcome relief
for family and acquaintances, since the Cyclothymic persons become less pushy
and cease dominating conversations as they slow down to a mild to moderate depression.
The elated periods are characterized by an enhanced sense of well-being.
Optimistic and self-assured, Cyclothymic individuals frequently make a number
of commitments and may even complete them all.
They may be viewed by others as being capable and creative.
With their increased motor activity, only a few hours of sleep seem to be adequate.
During their high periods the individuals make expensive plans and can be successful
in financial or professional achievement.
Problems arise when those plans are thwarted.
Becoming irritable and suspicious these individuals may react in a socially inappropriate
manner by being antisocial, impulsive, or explosive.
Sexual or alcoholic excess may occur during that stage.
Causes
Cyclothymic disorder seem to develop when a conflict arises between a severe,
punishing superego and powerful, primitive, unconscious impulses.
Often an early childhood trauma such as desertion causes hostility,
which is turned inward and later manifests itself in depression.
Or depression may arise when a personality problem caused by an early childhood loss
is reactivated by a similar conflict at the adult level.
Diagnosis of a Cyclothymic disorder is almost never applied to a child
and only infrequently to adolescents.
Treatment
With help, many Cyclothymic individuals can identify the maladaptive behavior
that accompanies their "mood swings."
Recognizing the goals of their behavior, they can learn better ways to attain them.
Often the individuals come to realize that their moods are ineffective ways
to get along with people.
In such individuals the mood may be more apparent than real anxiety.
People sometimes appear or pretend to be hypomanic if they perceive that the only way
to be accepted is to be "the life of the party."
They may appear to be depressed if they see sorrow as a means of
obtaining attention and affection.
Many times hypomanic hyperactivity is a cover-up
for true depressive unconscious feelings.
By staying excessively busy, Cyclothymic individuals do not have time to look
at their true feelings, such as repressed anger.
A significant step in therapy, therefore, is to have Cyclothymic individuals get in touch
with her anger and other emotions.
They must learn to verbalize without being ashamed of them.
They must also forgive those who wrong them.
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