Loved one with cyclothymia

My wife has been diagnosed with cyclothymia, and possibly bipolar I. The problem is she hasn't really seen the psychiatrist that many times yet to get a full diagnosis. She's on buspar right now, but it seems to me it's more for the anxiety rather than cyclothymia proper.

Earlier, I posted in the other forum that I feel that I am in an abusive relationship. But now that I've read online about cyclothymia, it seems like it's the disease that's causing this behavior.

Unfortunately, it seems like she's in the manic phase now. Right now she's in relative good mood, which is a change from a couple of days ago. But I fear that it can change at the drop of the hat. Also, she seems to show some paranoid tendencies, albeit mild (nothing like "they're out to get me", but still). Does that fit the bill too?

Before the diagnosis, whenever she would be irritable, and we'd start a fight, I would try to apply logic to the fights, and convince her. It never worked. Maybe this is why.

Unfortunately, I have been diagnosed with depression. And now I think her cyclothymia may be if not the sole, at least a big reason for it. After we fight, I tend to brood on the fight and its reasons. But since the reasons don't appear to be logical, I have trouble dealing with it. And every day, I silently assess her mood. Any little sign of irritability, and I get depressed.

So. How do I get better? I want my wife to get better, to have the quality of life she deserves. But I have to take care of myself. I'm afraid living with someone who has cyclothymia is very draining, and the prospect doesn't look too good. Sometimes she has said that she doesn't think there's anything wrong with her, that I'm the one with the problems. And then I start to doubt myself. I start to think maybe she's right. My biggest fear is that she'll believe that treatment is not necessary.

And I feel guilty, but I like her better in her depressed mood. At least she's not as irritable then.

Dear Saaristonlapsi,
My heart goes out to you!! I have cyclothymia and just found out and got diagnosed last summer at 43 years of age. My poor husband has lived, just like you, with an undiagnosed and unmedicated woman with a disorder... whether it's cyclothymia, bipolar II or bipolar I... they are similar but vary in degree from mild (cyclothymia) being at the low side of the spectrum to BP II, then BP I. I honestly don't know how my husband endured 9 years of living with me... seriously, we don't have a clue that there is something going on biochemically, but all of the behaviors you've described sound very familiar! Our disorder ruins relationships, so bless your heart for hanging in there! The power of your love for her will help her see that she needs professional help. I have lived her behaviors and know exactly how her mind works at those times. When we are irritable, and we perceive that we are being criticized or judged, we lash out with a vengeance. Our moods can swing from enthusiastic, vibrant and jovial, to irritation, anger, and rage. Our hypomanic times can be times of great creativity, productivity and a more positive attitude, but we are also experiencing thoughts that race a mile a minute, hard time sleeping, loss of appetite, more irritable and edgy and more prone to doing things without care or regard for the consequences to others. We can be very self-absorbed and have perfectionistic tendencies. We have self-esteem issues... quite low due to past behaviors and impulsive choices. Financially we tend to go on shopping sprees and have awful credit (these are obvious generalizations and not everyone with cyclothymia fits this description - little clarifier there) - when we swing to depression, we lose our zest for life, former pasttimes or activities are no longer something we care to do... we have a hard time staying on a weight loss plan, exercise program because of this. We just want to sleep our days away and eat junk food and see nothing but gray skies. We also tend to self-medicate because our bodies don't have enough lithium, there are problems with seratonin, and what happens with our neuro-transmitters... bio chemical reasons for our condition.... I self-medicated with tequila, beer, pot and cigarettes. Almost needed them daily to literally relax my brain because my thoughts were so rapid all day long, I just needed to "chill"... the addictions also dulled the emotional pain, as well. Oh! and when we go to Vegas, we obsess over one machine, develop a relationship with it and will pour extreme amounts of money into it convinced that it will hit the jackpot! we can rally a crowd in the stadium like no other! We are extremely passionate and passionately extreme. Once I got diagnosed and met a wonderful psychiatrist who is actually a brilliant chemist, she prescribed four medications that have revolutionalized my life and the quality of my life with my husband!! I'm writing a mini novel here in hopes that you let her read it. It's a shock and difficult to accept that one has a condition called cyclothymia. But it can also be a relief because it explains the reasons for some of your bizarre behavior and why you are such an emotional beastie, at times! There is treatment for the symptoms, and you can live a relatively productive and peaceful life in balance within, not so extreme! My husband notices a night and day difference in me! Embrace the treatment! It will transform your life, too!

Thanks for the encouraging words! Of course my biggest fear is that she will decide that there is nothing wrong with her, and thus not continue with treatment. And there's still that nagging feeling in the back of my head saying that maybe I'm wrong. Maybe it is just me and not her. And if so, what right do I have to expect her to go to treatment?

I've been trying to understand the disease. If you, or someone could shed a little light on one issue that I have trouble understanding, that would be great. When you say you're on a high phase, if you're that happy, why do you feel irritable? I realize that it really has to do with chemistry more than logic, but that's the part that kind of eludes me... So do you feel irritable also during the down phase?

Before I had even heard of cyclothymia, I just (ignorantly) assumed that bipolar people switch between feeling extremely sad, and extremely happy. But now I've learned that it's so much more complex than that.

You're welcome : ) if you can get her to a psychiatrist, there is a test that I took before my first session. It's called the MMPI - the Minnesota Multiphasic Personality Inventory. There's a long series of yes no questions to be answered honestly. Takes two to three hours to complete and can even be done at home. When the two of you sit together with the pdoc to read the results, you both will know whether she is or isn't and if she is, you'll both know where in the spectrum of bipolar she is : ). It is a very effective assessment and was quite revealing and accurate about how I perceived myself. Graphics very interesting and I was able accept in black and white what I didn't want to believe.

About why in the hypomanic phase high irritability is also a characteristic... That would be a great question for the pdoc. My only guess based on personal experience is that, when I'm hypomanic, everything's in overdrive... Racing thoughts, speech is slurred at times because my mouth can't keep up with my mind. I get in a creative zone, hyper, restless, no appetite, insomnia (everyone's irritable without enough sleep) so little things can irritate. I have a four year old, and when he bangs something repetitively I feel like I'm gonna lose it! The senses seem more heigtened to me... something that would normally bug me, really gets under my skin and I react, often explosively. There's also a possibility, if she is bipolar, that she goes through a magnification of symptoms mid way through her cycle, "day 14"... Once / if she's diagnosed, help her keep an emotional journal as well as a hormonal one. That's how my husband works with me and knows when I'm more prone to unleash the Cracken!! Haha! Hope this helps!

Well she missed the last psychiatrist appointment because our son was sick. But I did go instead, and had a great talk with the psychiatrist. I wish there was more traffic in this forum... I found a local support group for manic depressive people, I think I'll go there to try to learn more about the disease.

Actually, I was going to go today, but instead my wife wanted to go out to the park with our son. It sounded like a great idea, and a great excuse since my social anxiety kind of interferes with me joining a support group. But little did I know that the park visit wouldn't happen. Should have gone to the meeting instead. I have a feeling she's in the hypomanic stage again...

Also funny how while my wife does recognize that she's been diagnosed with cyclothymia, she refuses to accept that she might actually ever show symptoms of it.

Dear Sarristonlapsi,
I too wish there were more people in this forum. I post more frequently in the bipolar forum because there are more active contributors, and our disorders are similar just different on the spectrum of bipolar. Her arguments with you... You can't win nor can you help her see the "logic" of your side... "emotions govern her moods and responses which are mostly "illogical," don't you think? Life with a cyclothymic is draining, you're right! My husband fell "out of love" with me because I was quite difficult to love! It created a vicious cycle, and we both gave In to resignation and despair. That's the crappiest place to be for both of you, and since cyclothymics blow things out of proportion exponentially, any change in your pursuit of her will be received as rejection which she will internalize and reawaken old wounds from her past. Glad to hear that you're getting help for YOU. My pdoc said that my husband suffered from post traumatic stress disorder and that antidepressants would be very helpful for a season. I personally take three different antidepressants and they help me, big time! If you are not getting through to her verbally with your plead, (this is just my personal opinion)... Try the drastic ultimatum route. Shake her up with how unbearable life is with her though you know it's the biochemical condition she has that is causing these crazy mood swings, and her unwillingness to seek professional help leaves you no choice (don't use mental illness) it's a wild label to accept. I must allow you to do the research yourself and stop denying that you have a disorder. Once you begin the process with an open mind and seek professional and allow the psychiatrist to treat you effectively with medication, then I will return home. Your disorder has taken an enormous toll on my own well-being, so I need to do what is necessary for me to heal, as well. Assure her that you're not leaving her, but that you are forcing her to choose: acceptance that something's not quite right, or continued denial that she's fine and you're the one with the problem. It's a huge risk and a gamble, but it just may be the wake up call that forces her to look within. Just my two "extreme" cents, but if nothing else has worked thus far... It would wake ME up! Hoping for the best!!

Fireandrain, Wow. Your descriptions and examples of how you feel with cyclothymia are EXACTLY how I feel. There's not a thing you mentioned that I didn't totally identify with. Over the years, I've tried and researched everything, but just recently stumbled upon cyclothymia. I always knew Bipolar sounded too extreme for my condition, but I also knew that how I am cannot possibly be normal. Thank you so much for your post. It's such a relief to see your suffering put into words and understood by someone else.

I just had another stupid "nothing" blow up with bf this morning. He's again puzzled by what my problem was and I am to the point now where I don't even know why I reacted that way! Story of my life. Well, I do kinda know now at least. I have an appointment in July to see a psych. I am hoping we can make things better!

Hi jferf!!
Wow!! I'm so glad that my anonymous spilling of my guts resonated with you... To read about another person dealing with the same symptoms and say, omg! This is ME! You hopefully can feel relieved knowing that you have a biochemical condition called cyclothymia ... This isn't "just the way you are!" that alone can do such a number on our already low self esteem. You have an appointment with a pdoc in July!! You're well on your way!! And letting your bf know everything will open his eyes and he'll have greater compassion when the moods swing! The more he learns and understands, he'll walk through it WITH you : ) I personally take lithium 1 in the am, 1 in the afternoon, and 2 at night. Then intake wellbutrin, an antidepressant, (the lithium balances oit the antidepressant or you could be launched into a hypomanic state until your head feels like it can't go on! 1 in the am and 1 in the afternoon...I take Xanax light dosage of 1mg pills morning, noon and night for anxiety I was on lamictal which is a really good drug, but I've experienced weight gain on it, Plus mid cycle when I ovulate day 13 and 14 I am a Hormonal beastie! My four year old said mommy, you look like the incredible hulk as I was just about to shatter the tv in front of them. I have been searching for the special holy grail for a cure ever since. When I become a cyberchondriac, I search high and low on the Internet. Found an article that said that nefazadone aka serazone is best for premenstrual magnification For some manic depressives, this condition is very real and it happens at ovulation. Some who take it and write on this forum told me that it has sedating effects, so I take 100mg at bedtime, And 100mg of the lamictal/lamotrigine in the am. Then I'll increase to 150 day 11-16. Pure guinea pig stage! You will truly feel like a different person... I couldn't believe how I felt... Way more even keel, not zombies out like some people say, still have my creativity! Best of everything to you as you take the plunge! You won't regret it! Keep us posted on how you're doing, okay?!

Whew that is a lot of meds! But the number of meds doesn't matter to me like it used to—the outcome does! It's amazing how many years people (I'm 38...I think you said you're 43?) can go on like this...suffering...feeling like they're just "moody"...or this is just "their personality." I swear I have read every self help book, watched shows, read articles, seen doctors and therapits (though not a psych), kept a gratitude journal, ate well, ate poorly, exercised, not exercised, concentrated on a positive attitude—now I finally know why none of that ever works! And I can stop feeling like a failure for it. I finally realize it's not any cirumstances in my life (maybe it's my job...no...maybe it's my marriage...no...maybe it's my mom dying...no...maybe it's...), that is chemical and I can't just positive think it away!

The extremes and end of the world nature of everything....the push and pull/love & hate in relationships...all of it can finally be understood. People have always been like "well i feel down sometimes" or "I think it's natural to feel overwhelmed" or "you've always been kinda moody" ...blah blah blah. I always wanted to scream NO! You don't understand! but I never wanted to seem nuts or like I couldn't handle life so I always just figured they were right and I blamed myself.

I hope more people post. I think it helps when we come on here and ramble—people can see themselves in us and it's a huge relief. We'll all stay in touch.

Saaristonlapsi,
Hey there! Was reading this thread and wanted to chime in with what someone else said about the irritability. I'm 42 years old and I've been misdiagnosed for years (decades) with depression and generalized anxiety disorder and taken virtually every anti-depressant and anti-anxiety med out there with no real relief. about a month ago my pdoc put me, for the first time in my life, on a mood stabilizer. Within 3 hours of my first dose the cloud that had choked me my whole life lifted. Pretty telling.

As the mood stabilizer began to work and my mind gradually, over days became clearer and clearer, I began to wonder why it took 42 years for someone to finally hit upon the right med and possibly the right diagnosis (cyclothymia). I never EVER experienced the "euphoric" highs generally associated with BP. For me, it's been a lifetime of moderate depression with dips into severe depression and periods of EXTREME irritability and racing thoughts. I've seen countless therapists and psychiatrists throughout my adulthood and even been hospitalized for 14 days during a severe bout of depression, and no one EVER mentioned BP (or cyclothymia) as a possible diagnosis. I think it may be easier to diagnose BP (and milder forms of it) when the "euphoria" component is there. When irritability is the issue, I think it is much more easy for it to be attributed to other diagnoses (ie- GAD). It was not until I was speaking with my therapist about a week into taking this mood stabilizer that she told me that extreme irritability is also considered one of those BP "highs." I never EVER knew that. What I never realized was that the major difference between irritability associated with an anxiety disorder and irritability associated with forms of BP is the severity/extremity of the irritability (not that anxiety does not cause severe irritability... but the extremity of the BP irritability is almost irrationally extreme). So I just wanted to share with you that I'm one of those that never ever has had the "euphoria," but rather, extreme extreme irritability.

Also, medications are such a personal thing... since no two humans have the exact same chemistry, each person has to spend time (in my case, decades) trying to hit upon a combination of medications that works for them. I consider myself lucky to have finally found that for myself. Having been through such a long journey and having finally hit upon a medication that seems to finally have provided some relief, I also had to stop and think about this whole situation and its impact on the rest of my life. For me, I have come to terms that I very well may be BPII or Cyclothymic. I cannot overlook the fact that my mood stabilizer worked, so there obviously is a mood-impacting chemical imbalance that my med is, indeed, correcting. I'm not ashamed that I may have a condition with a name to it. Hell, I'm GLAD it might finally have a name! I also realize that I have a condition that must (MUST) be managed for the rest of my life. Part of managing it is staying on medications and being careful to notice any changes in the effects of the meds. I, too, was one of those who ditched my anti-depressants out of disgust when they didn't really work. This situation is different. I'm dealing with a medication that DOES work, so I have accepted the fact that now that I feel "better" (relatively speaking), this does not mean CURED. In other words, my brain chemicals were obviously out of whack for 42 years, so now that they are more balanced, I CANNOT EVER discontinue medications that are correcting this imbalance. I guess it's just an acceptance thing.

From what I've gathered from your postings, you wife is not in the same place that I am at. I'm not going to promise that she'll ever get to this place of acceptance that I have, but what I wanted to tell you is that there IS hope. It is obvious that she probably hasn't hit upon the meds combo that would bring her to a place where she could most effectively manage this condition. Every person has a threshold for emotional pain, and I'm definitely not telling you to hang in there to endure endless amounts of emotional abuse... not at all. But I DO want to convey that, as a person with the disorder, that it is a long and arduous battle. I'm SO happy that I've found relief and at the same time, so sad for what I've put loved ones through. Thoughts of what they endured with my emotional swings makes me cringe. But I'm grateful to the small handful of loved ones that hung in there for me and strive to, each day, be a positive, not draining, presence in their lives now.

Whether you decide to hang in there for the duration is a personal decision. You DO need to think of yourself, too, and ensure that you are taking care of yourself. I've really had to come to terms with the fact that I did drive some out of my life. I don't fault them for wanting or needing to go... it was probably for the best, as I wasn't the same person I am today.

I'm sorry if this is a bit rambling, and maybe my points are a bit cloudy. Just wanted to share my own experience with you so that you could hear the words of a person who has been in a place where your wife currently is, and had people in my life who probably felt very much as you do right now.

I wish you all the best in this difficult journey... my heart really goes out to you.

-Koshka