Understanding the Anxiety and Depression Types—Type 6: Cyclic Anxiety/Depression

Anxiety and Depression Types—Type 6: Cyclic Anxiety/Depression

The hallmark of Type 6: Cyclic Anxiety/Depression is a cyclic pattern of low moods or anxiousness. People with this type tend to experience major mood swings, their depression or anxiety comes and goes, or it increases and decreases in severity. Cyclical disorders, such as bipolar disorder, cyclothymia, premenstrual dysphoric disorder (PDD), and panic attacks are part of this category because they are episodic and unpredictable. Seasonal affective disorder (SAD), which is associated with winter blues, is a variant of this type.

Type 6: Cyclic Anxiety/Depression is a spectrum disorder, which means you can have a very mild form or a very severe form, or anything in between. A person can have a mild form of premenstrual syndrome (PMS) or a mild cyclic mood disorder, or the problems can be so severe that they are debilitating or even life-threatening.

Cyclic Anxiety/Depression must be closely and skillfully monitored, especially at critical times in the course of the disorder, such as when a person is experiencing intense stress, going through a hormonal transition, or changing medications.

The hallmark of Type 6: Cyclic Anxiety/Depression is a cyclic pattern of low moods or anxiousness. Click To Tweet


People with this type generally have 4 symptoms from Pure Anxiety (Type 1) and/or Pure Depression (Type 2) in addition to at least 4 “cyclic” symptoms.

Anxiety symptoms include:

  • Frequent feelings of nervousness or anxiety
  • Panic attacks
  • Avoidance of people or places due to a fear of having anxiety or panic attacks
  • Symptoms of heightened muscle tension (headaches, sore muscles, hand tremor)
  • Periods of heart-pounding, nausea, or dizziness
  • The tendency to predict the worst
  • Multiple persistent fears or phobias (such as dying or doing something crazy)
  • Conflict avoidance
  • Excessive fear of being judged or scrutinized by others
  • Being easily startled or a tendency to freeze in anxiety-provoking or intense situations
  • Shyness, timidity, and getting easily embarrassed
  • Biting fingernails or picking skin

Depression symptoms include:

  • Persistent sad or “empty” mood
  • Loss of interest or pleasure in activities that are usually fun, including sex
  • Restlessness, irritability, or excessive crying
  • Feelings of guilt, worthlessness, helplessness, hopelessness, pessimism
  • Sleeping too much or too little, early-morning awakening
  • Loss of appetite and/or weight loss, or overeating and weight gain
  • Decreased energy fatigue, feeling “slowed down”
  • Thoughts of death or suicide, or suicide attempts
  • Difficulty concentrating, remembering, or making decisions
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
  • Persistent negativity or chronic low self-esteem
  • Persistent feeling of dissatisfaction or boredom

Cyclic Symptoms

  • Abnormally elevated, depressed, or anxious mood
  • Decreased need for sleep, feeling energetic on dramatically less sleep than usual
  • Grandiose notions, ideas, or plans
  • Increased talking or pressured speech
  • Racing thoughts
  • Markedly increased energy
  • Poor judgment leading to risk-taking behavior (departure from usual behavior)
  • Inappropriate social behavior
  • Irritability or aggression
  • Delusional or psychotic thinking


Type 6: Cyclic Anxiety/Depression is associated with extremely high activity in the brain’s basal ganglia and/or deep limbic system. These areas of excessive activity act like “emotional seizures” as the emotional centers hijack the brain for periods of time in a cyclical pattern. Not surprisingly, SPECT scan findings for this type vary depending on the phase of the disorder.

For example, a woman with severe premenstrual syndrome may show only increased focal deep limbic activity during the unaffected time of her cycle. However, during the worst time of her cycle, her scans may show not only increased focal deep limbic activity but also decreased activity in the prefrontal cortex (associated with trouble concentrating and impulsivity) and increased activity in the anterior cingulate gyrus (associated with getting stuck on thoughts or behaviors).


In some cases, people with cyclic mood disorders or anxiety may require medication to stabilize moods. This needs to be monitored very closely. There are other natural solutions that may be beneficial, including:

  • Diet: Consuming foods that are high in omega-3 fatty acids—such as salmon, tuna, avocados, and walnuts—promotes healthier moods.
  • Supplements: Taking supplements, such as omega-3 fatty acids, GABA, saffron, or SAMe, may be helpful.
  • ANT therapy: Learning to challenge the ANTs (automatic negative thoughts) that infest your mind can help create a more positive mood.
  • Psychotherapy: Therapy and other psychological interventions can help you learn how to decrease the stressors that may trigger an episode of the disorder.

Depression, anxiety, bipolar disorder, mood swings, and other mental health issues can’t wait. During these uncertain times, your mental well-being is more important than ever and waiting until life gets back to “normal” is likely to make your symptoms worsen over time.

At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.


  1. My daughter, Leaha who is 18 is experiencing severe anxiety and I would like to learn more about your tele health services and what type of insurance you take or if you provide discounts for sessions.
    Thank you,

    Comment by Marie Cady — January 18, 2021 @ 3:29 AM

  2. Does “Type 6” refer to brain type 6? Or a 6th type of anxiety? Thank you?

    Comment by Traci — January 18, 2021 @ 4:54 AM

  3. Thank you for another great article.

    Comment by Timothy Lee — January 18, 2021 @ 4:58 AM

  4. Dr. Amen, I know , you are expert in brain, but I would like to bring a few things to your attention. Dr. Wayne Dyer in his book, ” Your Sacred Self ” says that you are NOT the one who get depressed. You have depressing THOUGHTS. As soon as you DETACH yourself from those thoughts and look at yourself as a compassionate observer, you are not depressed any longer. I agree with him. He also has a great Quote, saying ” Enlightened people stay away from confrontation ” I agree with him. I know very well that there are a lot of people with narcissistic and psychopathic personality who are very aggressive and enjoy arguing with people.

    You already know me. Please contact me for any questions. Thank you and have a wonderful day. Dr. Marie Blair

    Comment by Marie Blai — January 18, 2021 @ 6:56 AM

  5. A relatively SNAP review of the potential or existing, forms of depression, is significantly pressed on many Military Combat Veterans, and some Active Military Members, and more especially those of Military Service, that have borne the Physical and mental Wounds, as a result of Military Combat Service. It is important to note that the Combat Veteran, especially those that bore Combat related wounds and injuries, …
    A., Experiences, a UNALTERABLE Mental Video, of their dire experience, of the before, during, and after, effects of their Combat role. ….
    B,. That same “Mental Video, incites, a mind-sight in CONSTANT REPLAY, of that dire event, that caused the Physical and or connected Mental strain, and impact on the well-being of the Veteran, to his or her, self, their family, their friends, their occupation(s), and even in their retirement should they continue to survive, the Combat Military Trauma, they experienced. …
    C., The worst case scenario, of a unwanted Instant Replay, of that Traumatic Military Combat Video, is when it is mentally, ‘”Switched On”, by a person or persons of ill-repute, that never had the privilege to Serve in the Military, in the form of, private and PUBLIC, harassment, with laughs, jeers, sneers, and verbal comments of dis-respect, of the Combat Veterans, presence, their appearance, (Observable, Physical-Disability, their Hat(s), and clothing, etc.).
    The conditions described in A., B,. C., above, are just some of the spikes and nails , that create many pangs, and a myriad of forms of depression, anxiety, conditions , upon the Military Combat Veteran, (Clinical and otherwise.),
    In closing, this now 76 year old, Vietnam 1967-1968, Combat Wounded Veteran, (Only one of many.), recall the constant slow, and at times with rather RAPID, incidents of ” Type 6: Cyclic Anxiety/Depression.” that with all my heart and soul, for, “Only by the Blessings, Goodness and Grace, of Our Father which art in Heaven,.. Am I Privileged to enjoy each new day HE’ provides…. and that I survived my endless bouts with Type 6: Cyclic Anxiety/Depression.

    Comment by Robert David Hummel — January 18, 2021 @ 11:00 AM

  6. Great article thank you. Many years ago I heard you speak on the ANTS on PBS . I took notes that day and have applied the lesson to my life for the last 20 years. And have encouraged others with the lesson also. It made a big difference in my life. Thank you.

    Comment by Annette Melton — January 18, 2021 @ 12:03 PM

  7. Great information!! Thank you.

    Comment by Valrie Johnson — January 18, 2021 @ 2:39 PM

  8. Dr Amen, there is massive amounts of data showing that there is neuroinflammation in depression, anxiety, Bipolar disorder, Borderline Personality, PTSD, ADHD, Autism/Aspergers, OCD addiction and suicide. It is also a FACT that neuroinflammation causes addiction and relapse and there is a high rate of addiction in all those conditions. Yet, you don’t even mention inflammation. There is also DOPAMINE deficiency in all of those conditions (look up Reward Deficiency Syndrome, notice that ALL of the behaviors in RDS are EXACTLY the same as in BPD). BPD, Bipolar disorder, PTSD and Autism are frequently diagnosed together and often doctors have trouble telling them apart. That’s probably because they all have Reward Deficiency Syndrome. Makes sense to me. What doesn’t make sense to me is leaving the inflammation untreated. If you visit a suicide survivors group, you’ll see that many of the suicide victims and their family members had/have the conditions I mentioned so they had untreated inflammation and dopamine deficiency causes pain/fear to be felt deeper and longer.

    Comment by Silvia Hinojosa — January 18, 2021 @ 4:52 PM

  9. I’m very interested in learning more about neuroinflammation. Is is connected to the kids of inflammation caused by poor diet?

    Comment by Joan Ottley — January 18, 2021 @ 8:15 PM

  10. I just need help. I’m in a bad place. Can find no help. The system does not help. Only traumatized by the system.

    Comment by Martha Marti — January 18, 2021 @ 10:20 PM

  11. Seems to me the “cyclic” symptoms could all be caused by drug use.

    Comment by Silvia Hinojosa — January 19, 2021 @ 1:47 AM

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