Understanding Cyclical Depression: Types, Treatments & Support

Cyclical depression describes recurring depressive symptoms that encompass conditions like cyclothymia, persistent depressive disorder, and seasonal affective disorder, with evidence-based therapeutic interventions providing effective treatment for managing these periodic mood episodes and their underlying patterns.

Ever feel like you're riding an emotional rollercoaster—good days followed by crushing lows, over and over? Cyclical depression affects millions of Americans, but understanding these patterns is the first step toward finding relief through therapy.

What Is Cyclical Depression? Types, Treatments, And Support

Cyclical depression is a term describing depressive symptoms that recur periodically throughout someone’s life. Also sometimes called recurrent depression or bipolar III disorder (as it represents a milder form of bipolar disorder), cyclical depression isn’t a formal diagnosis in itself but rather an umbrella term covering various mood and depressive disorders. These include cyclothymia, persistent depressive disorder (PDD), and seasonal affective disorder (SAD).

Living with any depressive disorder can significantly impact your daily life and functioning. However, it’s important to know that cyclical depression is treatable, and understanding more about this condition can help if you’re experiencing it.

What is cyclical depression?

The symptoms of cyclical depression vary due to the range of mood and depressive disorders that may follow cyclical patterns. If you’re living with cyclical depression, you might experience periods of profound sadness followed by days with elevated mood and energy levels. These mood swings are less severe than bipolar disorder, which can involve hypomania or mania episodes.

During periods of depressive symptoms, you might struggle with performing daily tasks. Cognitive difficulties or social withdrawal are also common. Research indicates connections between cyclical depression and other mental health conditions. For instance, those diagnosed with a depressive disorder may also experience anxiety-related disorders or post-traumatic stress disorder (PTSD).

Cyclical depression, physical illness, and PTSD

Many individuals diagnosed with PTSD also experience recurrent depression. One study examined people who lived through 9/11, including residents, rescue, and recovery workers of New York City. Researchers found that many participants were living with PTSD alongside co-occurring depression or generalized anxiety disorder.

Emotional reactions and symptoms of anxiety and depression may also accompany diagnoses of severe physical illnesses. People diagnosed with cancer, for example, often experience symptoms related to anxiety and depression regardless of whether their treatment leads to remission or is palliative. Whatever the reason for experiencing depression symptoms alongside other physical or mental health conditions, seeking support from loved ones or professional help through therapy is crucial.

Types of cyclical depressive disorders

According to the World Health Organization, over 280 million people worldwide live with a depressive disorder. While many people experience depression symptoms after a loss or traumatic change, those with cyclical depression experience symptoms that subside only to return in episodic periods.

Rather than being a diagnosis, cyclic depression encompasses several mood and depressive disorders, including:

• Cyclothymia
• Persistent depressive disorder (PDD)
• Seasonal Affective Disorder (SAD)

Though cyclical depression isn’t considered the most severe type of depression, it remains a serious condition. Below are symptoms of each depressive condition that may fall under this label.

Cyclothymia

Cyclothymia, or cyclothymic disorder, is a primary mood disorder categorized under the bipolar disorder category in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Cyclothymic disorder features the following depressive and hyperarousal symptoms:

• Restlessness and trouble concentrating
• Low mood, irritability, and crying
• Feelings of guilt or worthlessness
• Loss of hope
• Appetite changes
• Low self-esteem
• Social withdrawal or loneliness
• Elevated mood and high energy
• Impulsivity
• Grandiosity
• Racing thoughts
• Increased sociability
• Excessive physical activity
• Increased speech production

While considered a type of bipolar disorder, cyclothymia has milder symptoms that may arise more regularly. The highs are not as high as bipolar disorder I or II, nor are the lows as low.

However, treating symptoms is valuable to prevent worsening episodes. Other challenges, such as ADHD, sleep disorders, and substance use issues, often accompany cyclothymia.

Persistent depressive disorder (PDD)

Persistent depressive disorder (PDD), previously called dysthymia, is a chronic state of depression lasting at least two years in adults and one year in children and adolescents. Symptoms include:

• Significant changes in weight
• Loss of enjoyment in daily life
• Mood changes
• Fatigue
• Insomnia
• Low self-esteem
• Poor concentration and decision making
• Feelings of hopelessness

Genetics may play a role in dysthymia, though further research is needed. PDD is also associated with other psychiatric comorbidities like anxiety, personality, and substance use disorders.

Seasonal affective disorder

Seasonal affective disorder is a form of cyclical depression that may be linked to a lack of natural sunlight and vitamin D. It’s more common in parts of the world with harsh winters and limited sunlight.

Due to these factors, seasonal affective disorder may have less to do with genetics and more with geographic location. Sunlight boosts vitamin D, and a lack of this vitamin can cause depression symptoms.

As sunlight diminishes and days shorten, you may experience challenging thoughts and depression symptoms. Common symptoms include prolonged low mood, anxiety, low energy, excessive sleeping, anger, appetite changes, irritability, loss of motivation, dread about the future, and unfounded guilt.

While these mental health conditions all fall under cyclical depression and share some symptoms, treatment approaches can vary. Only a qualified mental health professional can diagnose a depressive disorder. Contact a mental health professional for support if you experience any symptoms mentioned. You can also try the following coping strategies.

Avoiding self-medication and substance use

People with depressive disorders like clinical depression or cyclothymia sometimes try to alleviate their symptoms through substance use, known as self-medicating.

If you use alcohol to cope, it’s important to note that alcohol is a depressant that can cause long-term low moods. With consistent and heavy use, some people develop alcohol use disorder (AUD), which may require treatment. A diagnosis of a substance use disorder alongside a mental illness is called a dual diagnosis. Dual-diagnosis conditions can be more challenging to treat, but treatment is possible.

Treatment options for depressive disorders

There are many treatment approaches for depressive disorders, but the following are the most effective and widely used options.

Therapy

Various forms of therapy can be effective if you have cyclical depression. Many clients find talk therapy valuable in treating mood shifts and depressive episodes. However, treatment approaches may differ depending on your diagnosis. For example, seasonal affective disorder is linked to lack of sunlight, so one popular treatment method is taking Vitamin D supplements in conjunction with light therapy. Always consult your healthcare provider before trying a new therapy or taking new supplements.

If you’re unsure what to address in therapy, simply talking about your feelings can bring relief. Your therapist can guide you through activities, interactive assignments, and guided questions. With over 400 therapeutic modalities available, if one approach doesn’t work for you, another might be effective.

Prescription medication

Many people with chronic or cyclical depressive conditions find success through prescription medications. If you’re reluctant to use medication, consult a doctor or psychiatrist before starting, changing, or stopping any medication.

You may experience side effects that make continuing medication difficult. You and your doctor may need to experiment with dosages before finding what works best. When starting medication, maintain communication with your provider to report any side effects or symptoms. Never quit a medication without consulting your doctor, as some medications can cause dangerous side effects if stopped abruptly.

Counseling options

If you’re experiencing symptoms of cyclical or chronic depression, reaching out to a therapist for support can be beneficial. Many people find that telehealth therapy is an effective option for addressing depression symptoms, as sessions can be attended from home on days when symptoms are challenging.

Many people with depressive disorders struggle with tasks like setting up appointments and following up on phone calls. If you can relate to this difficulty, consider contacting a therapist through ReachLink’s telehealth platform. When you connect with a mental health professional online, you can choose between phone, video, or messaging sessions, depending on your needs and comfort level.

Research supports the effectiveness of telehealth therapy approaches. One recent study directly compared in-person and online therapy and found telehealth therapy equally as effective as face-to-face therapy. Additional advantages included cost-effectiveness and convenience.

Takeaway

Cyclical depression involves patterns of depressive episodes that may be followed by periods of energy or well-being. These patterns can be distressing and may require treatment. ReachLink’s licensed clinical social workers are trained to help you navigate these challenges through evidence-based therapeutic approaches. If you’re experiencing any depressive symptoms, contact a therapist for evaluation and support to help you manage your mental health more effectively.