I have been diagnosed as having a bipolar disease called hypothymia; that is, fluctuation between being depressed and severely depressed. what can you tell me about hypothymia. Is the treatment different than that for BPI, BPII, and hyperthymia? Should ECT be considered if drug resistant but not suicidal?


Hello Terry -- 
Sorry, I don't recognize "hypothymia".  There's hyperthymia, cyclothymia, dysthymia -- all commonly used; but hypothymia, not so.  Now somebody could have used the term, based on your description, as kind of the opposite of hyperthymia.  Hyperthymic people live "up" -- energized, active, boisterous, often loud in speech and action.  So I suppose one could use the term hypothymia to describe a person's life as "down", and use the term also to indicate a fluctuation in down (since all of these terms kind of belong in the realm of "bipolar", i.e. cyclic changes in mood and energy; even hyperthymia "belongs", because it is used commonly by one of the most prominent bipolar researchers studying mood and "temperament" -- but I've not heard him or his colleagues use the term hypothymic, even in contrast.  Maybe your doctor has.).  

In any case ALL of these lingo terms are used to describe mood fluctuations or mood states associated with bipolar phenomena.  And so far, ALL bipolar variations are treated the same way: rely on mood stabilizers, watch out for antidepressants (and ECT works, treats both manic and depressive symptoms, but leaves open the question as to how recurrence of symptoms, which is the norm in all this, will be prevented).

Perhaps a look around my site on bipolar variations (particularly "bipolar II", which is the only "officially recognized" version of bipolar disorder besides bipolar I, which is the classic "manic-depressive" pattern) would help clarify some of this -- I think it might.  I hope so.  

Dr. Phelps