Dr. Carol Edelstein is a psychiatrist in private practice in Los Angeles, California, and has a particular interest in eating disorders. She describes a case below that falls in that vague hinterland between cyclothymia and bipolar disorder, type II.
"I saw a young man in his early 30's, married, with one child. He presented with brief periods of being engaged and active, but most of the time he was on the couch, reading and smoking, but without enough symptoms to ever meet criteria for major depression. During the evaluation, his wife told me that when she became pregnant, he announced that he was going to build a crib by himself, although he had no real carpentry experience. He went to the lumberyard , bought a bunch of tools, went to work enthusiastically for a couple of days, then retired to the couch. This pattern went on, and by the time he got the crib finished his daughter was walking and no longer needed the crib! I put him on Lamictal and Wellbutrin, and he improved to the point where his wife says it changed his life. So here's a man who clearly had cyclothymia by DSM-IV, and who responded to medication I often use for bipolar disorder. These types of patients convince me that we need to see more clinical trials focussing specifically on cyclothymia."