The question bank is the fastest way to start, but PMHNP Helper also includes board-review planning, student resources, and plain-English guidance for psychiatric nurse practitioner students who are still learning the exam landscape.
intermediatecyclothymic disorderbipolar spectrumsubthreshold cyclingbipolar II differentialPDD differentialDSM-5 criteria
A 42-year-old female reports 3 years of mood fluctuations. She describes periods lasting 1-2 weeks of feeling "up" — increased energy, decreased need for sleep, and increased talkativeness — alternating with periods of low mood, fatigue, and hopelessness lasting 2-3 weeks. During the "up" periods, she does not meet full hypomanic criteria (fewer than 3 additional symptoms, no unequivocal change in functioning observed by others). She has never had a period meeting full criteria for a major depressive episode or a hypomanic episode. She has not been symptom-free for more than 2 months at a time. What is the MOST likely diagnosis?
Explanation
Cyclothymic disorder involves chronic mood cycling where neither the "up" nor "down" periods meet full criteria for hypomania or MDE. The cycling must persist for ≥2 years without a symptom-free period >2 months. If full hypomania or MDE criteria are ever met, the diagnosis is reclassified.
Key Takeaway
Cyclothymia = ≥2 years of cycling hypomanic and depressive symptoms that NEVER meet full criteria for hypomania, mania, or MDE. No symptom-free period >2 months. If full criteria are ever met for hypomania or MDE, reclassify to bipolar II.