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First Responder Cyclothymia (Bipolar III) Disorder Treatment at After Action
Understanding Cyclothymia in First Responders
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Cyclothymia, often referred to as Bipolar III disorder, is a mild but persistent mood disorder that presents unique challenges for first responders. Characterized by fluctuating periods of hypomanic and depressive episodes, cyclothymia’s subtler symptoms can still significantly impact the effectiveness and well-being of those in high-stress public service roles.

Cyclothymia is a long-term condition that involves less intense mood swings than those found in Bipolar I or II disorders but can be equally disruptive to daily life and work. For first responders, the unpredictability of cyclothymic episodes can complicate the demands of their duties, affecting decision-making, energy levels, and emotional resilience.

Unlike Bipolar I and II disorders, which include severe manic or major depressive episodes, cyclothymia’s symptoms are milder, making them harder to recognize and address. Hypomanic episodes may manifest as brief periods of heightened energy and optimism, which can be misconstrued as positive attributes in a high-pressure job. However, these are followed by episodes of mild to moderate depression, marked by low energy, sadness, and disinterest in daily activities—symptoms that can undermine a first responder’s ability to perform their duties effectively.

Diagnosis involves a comprehensive evaluation against DSM-5 criteria, considering the unique lifestyle and stressors of first responders. It’s crucial to differentiate cyclothymia from the more intense mood swings of Bipolar I and II disorders, as well as from the normal stress responses associated with emergency service work.

At After Action, we recognize the importance of a nuanced approach to treating cyclothymia in first responders. Our treatment plans are designed to manage the mild yet persistent mood swings of cyclothymia through:

Psychotherapy: Techniques like cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT) help develop coping strategies and healthier behavior patterns, addressing the root causes of emotional instability.


Medication Management: Mood stabilizers, antidepressants, or low-dose antipsychotics may be prescribed to help regulate mood swings, tailored to each individual’s response to treatment.


Ongoing Support: Recognizing cyclothymia as a chronic condition, we emphasize the importance of ongoing care and support, including therapy and medication management, to prevent the disorder from escalating into more severe bipolar disorder.

At After Action, we are dedicated to supporting first responders through their journey with cyclothymia. Understanding the unique pressures of emergency service roles, we aim to provide treatment that not only addresses the symptoms but also strengthens resilience and coping mechanisms in the face of stress.

For first responders navigating the challenges of cyclothymia, After Action offers specialized, compassionate care tailored to your specific needs. If cyclothymia is affecting your life and work, reach out to us. Early intervention and consistent treatment are key to managing this condition effectively, allowing you to continue your vital work in the community with confidence and stability.

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Siri Sat Khalsa, MD, Medical Director
Clinically Reviewed By
Siri Sat Khalsa, MD
Dr. Siri Sat Khalsa is a board certified Addictionologist with over a decade of experience as a specialist in detoxing and treating patients with alcohol and substance use disorders. As a graduate of USC medical school and Harbor UCLA residency, she spent 10 years a Family Practitioner before discovering her passion for caring for patients struggling with addictions. Her approach is to safely detox patients as comfortably as possible and to then focus on caring for the anxiety and depression and other mental health issues that typically accompany substance use disorders while simultaneously crafting plans to sustain long term sobriety.

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