Like what most are saying here, it really is hell on Earth. Although sometimes I just get "mixed symptoms," a full-blown mixed manic episode is the worst thing I ever experienced. For me, I get extremely high anxiety, racing thoughts, cannot sleep, hearing things late at night, hypervigilence/looking over my shoulder constantly, some paranoia, agitation, depression, hopelessness, being stuck in a maze you feel you can never get out of, never getting a moment of peace. On meds, I'll get these episodes anywhere from a few weeks to 1.5 months. Without meds, I had one that lasted for a few months straight.