A new and quite extraordinary, indeed unprecedented, scientific study of cyclothymia has shown that it can be cured using a powerful combination of two different forms of psychotherapy.
WHAT IS CYCLOTHYMIA?
Most people are aware of manic depression, often refered to as bi-polar disorder, in which the sufferer experiences substantial mood swings from a period of substantial depression to one of manic activity. Most recently, Catherine Zeta-Jones has been treated for this disorder (http://www.the-confidant.info/2011/zeta-jones-is-one-of-many-creatives-to-be-diagnosed-with-bipolar-disorder-but-what-is-it/). Treatment for bipolar disorder has historically involved a combination of drug therapy and generic psychotherapy.
Less widely diagnosed, though probably far more common is a specific form known as cyclothymia. In this condition, the swings are often less debilitating going from a sense of overall cheerfulness and warmth to one of being ‘blue’ and irritable. The swings happen over a few hours and attempts by sufferers to obtain help are often met with a lack of sympathy with some general practitioners even maintaining that this is a question of temperament. their view is supported by the absence of any sense of ‘normality’ among sufferers as their swings happen too quickly and too frequently for them to feel ‘just right’ for very long.
In a recent article, I wrote about the propensity of people in creative fields especially to suffer from such disorders (http://www.the-confidant.info/2011/zeta-jones-bipolar-and-other-high-performance-disorders/) and also about the prevalence of them in society generally (http://www.the-confidant.info/2011/just-how-common-are-mental-health-problems/).
THE LATEST DISCOVERY
In the current issue of Psychotherapy and Psychosomatics, a group of Italian investigators headed by Giovanni Fava (from the University of Bologna) have published a randomized controlled trial on the psychotherapeutic treatment of cyclothymic disorder. Professor Fava explains; “This is a neglected disorder since there is no approved drug treatment for it.” The condition is frequently seen in ‘troubled’ adolescents and, in my experience, is also not uncommon among senior executives in volatile markets.
“We discovered that cyclothymic disorder is essentially an abnormal reactivity to environmental stimuli. By decreasing the level of anxiety and tension and by increasing psychological well-being these mood swings may fade away” concluded Professor Fava.
WHAT WAS SO EXTRAORDINARY ABOUT THIS WORK?
Apart from the application of rigourous scientific controls on the experiments, of which there are very few other examples, Fava and his colleagues were concerned not just with relatively quick responses to treatment, but also to longer-term impacts (over one and two years).
They, very unusually, provided a psychotherapeutic regimen that stuck clearly to two different approaches – cognitive behavioural therapy and well-being therapy – alternating between them. The rationale for this was that the former addresses the tendency to swing in mood, while the latter addresses the depressive phases specifically. Most psychotherapists would be able to adapt their approach to suit this approach, however many follow a fairly eclectic approach which makes it difficult to identify precisely what impact their interventions are having.
Our classification and accurate diagnosis of many such disorders is improving dramatically and, as we do there’s a pressure on researchers to be sufficiently organised that their results can withstand the changing palette of disorders. This study was a case-book example of how it should be done.
In this way, the researchers discovered that patients treated with ten, 45 minute sessions at fortnightly intervals, not only recovered, but maintained that recovery for over two years.