Coming Soon to an Entrepreneur Near You - the Cyclothymic Personality

 When you’re too ready for prime time, not quite ready for lithium and then pity the poor spouse or COO who tries to keep you on the rails.

When you’re up (in the up or euphoric side of it), you’re incredibly productive and creative, but often overwhelm others with your energy, intensity and pushiness.  When you’re down, people have trouble pulling you out of bed or out of your down mood or convincing you of that truth that you really are in just a “mood” and it will pass. Welcome to Cyclothymia.

Despite the ups and downs and chaos you manage to have enough success to keep going and may even manage to hold onto a marriage, but it’s a wild ride and you never achieve lasting success in either your career or personal relationships

If you’re fortunate enough to have a spouse or COO to keep you centered, you will fight them tooth and nail and then after you’ve gone too far up or down, and you’re on an even keel you will earnestly and sincerely apologize to them and promise it won’t happen again.  And then, voila… it’s Groundhog Day.

Over time roughly one third of you will escalate to what’s referred to Bipolar 2 disorder, where you’re not actually psychotic or out of touch with reality, but it’s time to try a mood stabilizer such as lithium, valproate, carbamazepine, lamotrigine with or without some antipsychotics such as olanzapine, quetiapine, ziprasidone, or aripiprazole to rapidly bring you under control during a severe acute episode. 

Why do you avoid seeking treatment?  Anything or anyone besides yourself that threatens to muck around with your feeling like yourself (good, bad or otherwise) feels too threatening (although you often self-medicate with caffeine, alcohol, pot, cocaine, sleeping pills kidding yourself that you’re in control of all of those). That said, the mood stabilizers by taking away the highs (and lows) can cause you to feel that you lose your creative and productive edge.  As one cyclothymic patient told me, “When you’re up you feel not only powerful and productive, but you feel like somebody.  And after feeling like that, when you go back to feeling like anybody, it’s the same as feeling like nobody.”

Early on the hyperactivity can be confused with your having ADHD and if so you will often be placed on stimulants such as Ritalin, Dexedrine or Adderall.  But although these may sharpen your focus they will often increase your edginess, especially when you are coming off those drugs.

Cyclothymic Personality is characterized by a pervasive pattern of pronounced changes in mood, behavior, thinking, sleep, and energy levels, beginning by early adulthood and present in a variety of contexts, as indicated by seven (or more) of the following:

  • has depressive periods: depressed mood or loss of interest or pleasure in all, or almost all, activities and pastimes alternating with hypomanic periods: elevated, expansive, or irritable mood;
  • has a decreased need for sleep alternating with sleeping too much;
  • has shaky self-esteem with naive grandiose overconfidence alternating with lack of self-confidence;
  • has periods of sharpened and creative thinking alternating with periods of mental confusion and apathy;
  • displays marked unevenness in the quantity and quality of productivity, often associated with unusual working hours;
  • engages in uninhibited people-seeking (that may lead to hyper-sexuality) alternating with introverted self-absorption;
  • becomes excessively involved in pleasurable activities with lack of concern for the high potential of painful consequences alternating with restriction of involvement in pleasurable activities and guilt over past activities;
  • alternates between over-optimism or exaggeration of past achievement and a pessimistic attitude toward the future, or brooding about past events;
  • is more talkative than usual, with inappropriate laughing, joking, and punning, and then less talkative, with tearfulness or crying;
  • frequently shifts line of work, study, interest, or future plans;
  • engages in occasional financial extravagance;
  • makes frequent changes in residence or geographical location;
  • has a tendency toward promiscuity, with repeated conjugal or romantic failure;
  • may use alcohol or drugs to control moods or to augment excitement;

If the above applies to you, go see a psychiatrist who specializes in mood disorders to have it evaluated.  The more sophisticate and experienced clinicians work with many people like you and will also be able to come up with a treatment where you don’t lose your productive or creative edge, you just come back from having to live on the edge.

The people I know who have gone to be evaluated and receive treatment have usually had only one regret… that they didn’t do it sooner. 

One man I know started crying after he finally had it taken care of.  When I asked him what was wrong, he said: “Nothing is wrong.  I am crying with relief that I’m finally normal.  I thought normal was for everyone else and just not in the cards for me.  I just thought that I was fated to always be at war inside and outside and now the war is over.”

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