27 March Aidan talks Bipolar III

We are increasingly hearing of Bipolar III. This is also known as Cyclothymia. It is a mood disorder and a relative of Bipolar Type I or II. Let’s look at Bipolar III today and make it clearer as diagnosis rates are on the rise in Ireland, and Europe.

For the purpose of this article, I will call Cyclothymia – Bipolar III

Bipolar III is often confused or misdiagnosed as clinical depression and not readily distinguished from Bipolar 1 and 2. Bipolar III causes involuntary mood swings as in bipolar 1 and 2. However, the main difference is the manic highs in Bipolar III are not as severe as in Bipolar 1, and the depressive state is milder than in Bipolar 2.That is the way I find it easiest to explain. Between the two opposing states, there is stability and a sense of calm.

Bipolar III does not have the infamous name of Bipolar 1 or 2, however it is a serious illness that can interfere with family and work. It’s sometimes dismissed by those who are not in the know, but it is a recognized condition and a persistent condition.

The Diagnostic and Statistical Manual, features Bipolar III and talks about the duration of the mood swings, and its impact on daily life. It can be diagnosed if you have had numerous periods of hypomania and many depressive episodes for at least 2 years. The periods of stable moods usually last less than 2 months. Additionally there must be no other mental illness that is responsible for these mood swings, and these symptoms are not the result of drugs, alcohol or a medical condition. (

Let’s get clinical: specific criteria

For at least 2 years (1 year in children and adolescents), the presence of numerous periods with hypomanic symptoms and numerous periods with depressive symptoms that do not meet criteria for a Major Depressive Disorder

During the above period, the person has not been without the symptoms in the above for more than 2 months in the 2-year period

No Major Depressive Episode, Manic Episode or Mixed Episode has been present during the first 2 years of the disturbance.

The symptoms in the first piece of descriptive text are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia etc..

The symptoms are not due to the direct physiological effects of a substance (e.g. drug abuse, a medication) or a general medical condition

The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

One of the challenges for individuals with Bipolar III is the ability to identify hypomania. In a hypomanic phase, individuals often experience a sense of euphoria. The feelings can be a sense of energy and hyper productivity. These emotional highs may also include feelings of inflated self-worth, rapid speech and racing thoughts, decreased need for sleep, poor judgment, increased sex drive, aggression and hostility, impulsive decision-making, lack of concentration, and irritability.

The peril of mania occurs when the inflated sense of self leads to reckless choices and irresponsible behavior, with little regard for consequences. This is where family and close friends can provide critical support.

Patients that are struggling with the dark or depressive phase of Bipolar III are far more likely to seek treatment. The depressive symptoms include feelings of hopelessness, anxiety, sleep and appetite problems, decreased sex drive, fatigue, loss of interest in activities of enjoyment, irritability, and suicidal thoughts or behaviors.

Again, there is a danger that patients with Bipolar 3 who are treated with SSRI anti-depressants have the risk for increased mania.

Treatment and education is critical for those with Cyclothymia and their families. Firstly, the clinician will have to be very careful in evaluation of Bipolar III. It is probably best done by a Consultant Psychiatrist. This illness can present many challenges for individuals who may feel paralyzed by a lack of control over the timing, duration or severity of their mood swings. They may have difficulty trusting their everyday moods from a manic or depressive phase, and lack confidence in making decisions. And, since there is far less information about Bipolar III, there is the danger of clients and families dismissing grandiose and irrational behavior as personality quirks, and only seek treatment for depressed mood.

In terms of when it might appear in your life

Bipolar III usually starts during the late teen years or young adulthood and affects both males and females equally disorder. Many people with Bipolar III do not seek treatment either because their symptoms are not as debilitating as those seen in bipolar disorder the stigma .

In terms of Meds – You will typically see the same meds as Bipolar I or II, such as Seroquel XR, Risperidone, Lamictal, Zyprexa,. Lithium Carbonate would typically be the first choice

There is hope with Bipolar 3, but it’s important to get under the care of a good Psychiatrist and be open and honest with your family and friends

I am trying to keep a few pieces with a shorter length, 2000-1000 words. I think you’ll agree Bipolar III is not something that can be diagnosed speedily. It’s for a Psych and with the clinical criteria above, it’s very difficult to disgnose. I have a small number of friends with this. Good luck with your condition

AOC