Yes, Lex. I frequently get mixed episodes, even though my depression and mania are well under control with my current med regimen. They are difficult to medicate, therefore i've had to develop other coping skills to deal with them. I use Xanax for the extreme irritability and anxiety-like symptoms, isolation to decrease stimulation, and allow myself "time-out" from the activities of daily life like going a day without a shower, or spending more time in bed. Fortunately, they don't last long.They are such torture, though, that I deserve these concessions to my lifestyle. I've been able to get through them successfully using these techniques for about two years.