Uncover the clinical secret of mood temperaments—why hyperthymia, dysthymia and cyclothymia are missed, and how low‑dose mood stabilizers can change outcomes.

Dr. Nassir Ghaemi explains that mood temperaments are mild, lifelong mood patterns genetically linked to bipolar illness. Hyperthymia describes a constantly upbeat, energetic personality; dysthymia a persistently low mood; and cyclothymia a continual swing between the two. These traits are not listed in DSM, so they are often overlooked and mistaken for ADHD, GAD or major depression, leading to unnecessary polypharmacy.

Clinical experience and observational studies suggest that low‑dose lithium (300‑600 mg) or valproate (250‑500 mg) can target the underlying temperament, reducing the secondary symptoms of anxiety, attention problems and depressive episodes. The TEMPS questionnaire (50‑item self‑report) is available at psychiatryletter.com for clinicians and patients.

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