20-year chronobiologic study of a middle-aged cyclothymic male subject

1. Cyclothymia is characterized by pronounced but not debilitating shifts of moods often lasting approximately two to nine weeks. 2. It can be classified as a psychopathologic mood disorder on a continuum to Bipolar II, or as a chronobiologic rhythm similar to the circadian except on an infradian time scale. 3. A male subject diagnosed cyclothymic agreed to daily chart moods and emotions, record dreams and monitor physical states. He kept track of hypomania-depression, high-low energy, high-low tension, dream affect and sleep parameters. 4. In the 1,006 affective cycles recorded between 1977 and 1996, four affective phases appeared sequentially: being comparable to early hypomania (I, PA), late hypomania (II, PD), early depression (III, ND) and late depression (IV, NA). 5. During the experiment lasting 20 years, the frequency of the four-phase affective cycle increased intermittently from 30.3 days (1977) to 28.0 days (1980), 24.7 days (1983), 19.0 days (1986), 17.8 days (1989), 12.1 days (1992), and 1.3 days (1995). 6. These findings of a four-phase variable infradian rhythm may have utility in determining fine structure and time course of rhythms in cyclothymics, both medicated and non-medicated, studied outside the clinical laboratory.