Well being
By Patti Carmalt-Vener 06/19/2008
Dear Patti,
My name is Lauren and I am a senior in high school and live in North Carolina with my parents. I have been accepted at Caltech for next year. I am very excited. My aunt lives in Pasadena and the plan has been to live with her while I am going to school. Three weeks ago, I came out on spring break to stay with my aunt and see what it is like. Pasadena is great; in fact I am love with Southern California. What I didn’t expect was how difficult it was to stay with my aunt. She would get in different moods and I wasn’t sure what I was supposed to do. Recently, her family doctor referred her to a psychiatrist and the psychiatrist diagnosed her with cyclothymia. What is cyclothymia? I feel guilty, but I think I want to stay in the dorm at school. What should I do?
—Lauren
Dear Lauren,
Congratulations on being accepted to Caltech. That’s quite an accomplishment! This is a special time in your life and there’s nothing wrong with wanting to be with your peers and experience college to its fullest. Stay where you’re going to feel the most comfortable: you have nothing to be guilty about. You can still spend time with your aunt and support her without losing your dream of a fantastic academic experience.
In answer to your question, cyclothymia is a milder form of bipolar disorder and brings about mood changes that alternate between depression and mania. It’s not as severe as bipolar disorder, and patients who suffer from it usually don’t need inpatient care or experience psychotic symptoms. Your aunt isn’t alone. The American Psychiatric Association estimates that cyclothymic disorder affects between 1.2 million and 3 million Americans. Treatments for cyclothymia include psychotherapy with a trained professional specializing in treating mood disorders, medications referred to as “mood stabilizers,” or a combination of psychotherapy and medication.
As your aunt has probably experienced, cycling from one mood to the other can happen suddenly and sporadically and last for hours, sometimes days. At first she might feel downcast and empty to the point that life seems hopeless and bleak; then a rapid shift of mood occurs that might cause her to feel euphoric, energized and even wanting to engage in impulsive behavior with difficult consequences. People struggling with cyclothymic disorder can come across as moody, dramatic and unpredictable, and this can be very difficult for their loved ones.
Encourage your aunt to keep daily records as a way of monitoring her mood swings, activities and interactions with others. Charting can help identify warning signs that come right before a manic or depressive episode and — with the help of a therapist — she’ll be able to recognize what types of social and interpersonal interactions contribute to her difficulties with mood. A plan can then be developed to avert the escalation of her symptoms.
It’s important to remember that your aunt can’t control her mood swings by simply willing them to go away. Nor is it effective for family members or friends to scold her and tell her to “snap out of it.” The more you learn about cyclothymia, the better you’ll be able to understand what she’s going through. Have as much patience and empathy as you possibly can — but don’t lose your own sense of self in the process.
Patti Carmalt-Vener, a faculty member with the Southern California Society for Intensive Short Term Psychotherapy, has been a psychotherapist in private practice for 23 years and has offices in Pasadena, Santa Monica and Canoga Park. Contact her at patticarmalt-vener.com or call (626) 584-8582.
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