For me they vary somewhat, but typically combine severe insomnia, agitation, intrusive and racing thoughts, anxiety and very impulsive, risky behaviors, with suicidal ideation, crying episodes, paranoia and feelings of despair and being trapped. The grand finale is usually a psychotic break.

I'm not sure what my exact triggers are for mixed states, since it tends to feed on itself. Insomnia will be an initial symptom, for example, but the sleep deprivation also exacerbates everything and eventually brings on the psychosis, which means I sleep even less, and on and on.

I was never able to find relief outside of medication, most of my life has been quite the train wreck. I finally caved and tried Zyprexa this year after a bout of being homeless and psychotic for a while. So far the medication is working.