I don't think "mixed" is considered to be only the result of medication. My former "pdoc" kept telling me I was having mixed states. Interestingly, I've been with a new pdoc for over two years, and she hasn't seen any! She knows that I joke and laugh as a way of dealing with my physical and emotional pain....

My take on "mixed" is when someone is actually depressed but is at the same time active physically and overactive mentally. It doesn't make any sense to me either.

I have been known to be laughing one minute and crying the very next. Maybe I should enter the Grand Prix of cycling.

I never had any mania at all until I started taking anti-depressants, when I was in my forties.