What is cyclical depression? Types, treatments, and support

Medically reviewed by Laura Angers Maddox
Updated March 18, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention substance use-related topics that could be triggering to the reader. If you or someone you love is struggling with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357). Support is available 24/7. Please see our Get Help Now page for more immediate resources.

Cyclical depression is a term to describe depressive symptoms that recur periodically throughout someone’s life. It is also sometimes referred to as a recurrent depression. Rather than being a DSM-5 diagnosis, it is considered an umbrella term encompassing a range of mood and depressive disorders. These include cyclothymia, persistent depressive disorder (PDD), and seasonal affective disorder (SAD).

Any depressive disorder can be a severe impediment in a person’s life, and if you are an individual living with one, you may understand how challenging it can be. However, cyclical depression is treatable, and a few aspects of this condition may be beneficial to learn about if you’re experiencing it.

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You don’t have to navigate depression on your own

What is cyclical depression? 

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

An individual who has cyclical depression might have difficulty performing daily tasks during periods of depressive symptoms. They might also experience cognitive difficulties or social withdrawal. Some research indicates a connection between cyclical depression and other mental health conditions. For instance, those diagnosed with a depressive disorder may also have anxiety-related disorders or post-traumatic stress disorder (PTSD). 

Cyclical depression, physical illness, and PTSD

Many individuals who have been diagnosed with PTSD also have recurrent depression. One study examined people who lived through 9/11, including residents, rescue, and recovery workers of New York City, about their mental health. Researchers concluded that many of their participants were living with PTSD with co-occurrent depression or generalized anxiety disorder. 

Emotional reactions and symptoms of anxiety and depression may also accompany any diagnosis of a severe physical illness (like cancer). People diagnosed with cancer often experience symptoms related to anxiety and depression regardless of whether their treatment leads to remission or is palliative. No matter the reason for experiencing symptoms of depression alongside other physical or mental health conditions seek support from loved ones or a professional healthcare provider like a therapist.

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Types of cyclical depressive disorders

According to the World Health Organization, over 280 million people live with a depressive disorder. While it can be expected for many people to experience depression symptoms after a loss or traumatic change, many people experience these symptoms on a cycle. For some, the symptoms of depression subside, only to return in episodic periods. This pattern is known as recurrent, cyclic, or cyclical depression.

Rather than being a diagnosis, cyclic depression is a broad term used to describe a range of mood and depressive disorders. These include:

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

Cyclical depression is not considered the most severe type of depression, though that does not mean it isn’t serious. Below are symptoms of each depressive condition that may fall under this label.  

Cyclothymia

Cyclothymia, or cyclothymic disorder, is a primary mood disorder categorized by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) under the bipolar disorder category. 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 this condition is 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 bipolar disorder II, nor are the lows as low.

However, it can be valuable to ensure symptoms are treated to prevent a worsening episode. Other challenges, such as ADHD, sleep disorders, and substance use challenges, often accompany cyclothymia.

Persistent depressive disorder (PDD) 

Persistent depressive disorder (PDD), previously referred to as dysthymia, is a chronic state of depression that lasts for at least two years in adults and one year in children and adolescents. Symptoms of persistent depressive disorder include the following: 

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

Genetics might also play a role with dysthymia, but its significance may require further study. Dysthymic disorder 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. In parts of the world where the winter is harsh and the sun is not present as often, SAD may be more common.  

Due to these inciting factors, SAD may have less to do with genetics and more with what part of the country or the world people live in. Sunlight boosts vitamin D, and a lack of this vitamin can cause symptoms of depression. 

As the sunlight disappears and the days get shorter, you may experience challenging thoughts and symptoms of depression. Common symptoms of SAD can include a prolonged low mood, anxiety, low energy, excessive sleeping, anger, changes in appetite, irritability, loss of motivation, dread about the future, and feelings of unfounded guilt.

The above conditions may all be considered a type of cyclical depression, and they have a few symptoms in common. However, treatment for each condition can vary. Only a qualified medical professional can diagnose a depressive disorder. Contact a mental health professional for further support if you have any symptoms mentioned. You can also partake in the following coping tips.  

Avoiding self-medication and substance use 

People with depressive disorders like clinical depression or cyclothymia may sometimes seek to alleviate their severe symptoms via substance use. This act might be known as self-medicating. 

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

Treatment options for depressive disorders

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

Therapy

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

If you aren’t sure what to address in therapy, talking about your feelings may be a relief. Your therapist can guide you through activities, interactive assignments, and guided questions if it helps you. In addition, there are over 400 therapeutic modalities that clients can try, so if one doesn’t work for you, there may be another that is effective. 

Prescription medication 

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

You may experience side effects that make it difficult to continue your medication. You and your doctor may try experimentation with the dosage before you find one that works best for you. When tapering up on medication, keep in communication with your provider to report any side effects or symptoms you’re experiencing. In addition, try not to quit a medication without consulting your doctor, as some medications can have dangerous side effects if you quit them without tapering off. 

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You don’t have to navigate depression on your own

Counseling options 

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

In addition, 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 a platform like BetterHelp. When you contact a mental health professional online, you can choose between phone, video, or live chat sessions, depending on your needs. 

If you decide that online therapy is an option you are interested in, you can start by looking at studies showcasing the effectiveness of these methods. One recent study directly compared in-person and online therapy and found online therapy equally as effective as face-to-face therapy. Other advantages included cost-effectiveness and convenience.

Here are some reviews by recent users with similar backgrounds about their BetterHelp counselors:

“Mary Ballard has been an amazing counselor to me. She has devoted her time to making my life better. She really cares about her patients and clients. She genuinely listens with no judgment or assumptions. She has compassion and empathy. She knows how to teach someone the tools they need in order to gain self-confidence. Because of the worksheets and her well-thought-out conversation paragraphs after our sessions, I now have the tools to deal with my personal issues. I’d say she’s more than capable, she’s an expert at knowing how to deal with stress, anxiety, relationship issues, grief, self-esteem, depression, and hoarding. She is well versed in OCD cases as well. I’d like to continue to hire her but feel as though she has helped me out so much that I no longer need as much counseling. I fully recommend her as a counselor. Thank you, Mary.” Read more on Mary Ballard.

“Valerie had been a great therapist for me so far, I struggle with anxiety and depression and her techniques/counseling have helped me a lot. She seems supportive and understanding, a lot more so than therapists I have had in the past. She gives me realistic solutions and coping strategies that I can incorporate into day to day life and makes herself available at times convenient for me.” Read more on Valerie Giannavola.

Takeaway

Cyclical depression involves patterns of depressive episodes that may be followed by periods of energy or well-being. Often, these patterns can be distressing and may require treatment. If you’re experiencing any depressive symptoms, contact a therapist for evaluation and further support.
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