Hello @cool09. I'm sorry to read that you've been hospitalized so many times. I also fully know what mixed states bipolar disorder is all about, and mixed states are indeed part of bipolar disorder for a large number of people. And they suck!

One should not expect that manic or hypomanic elation must be present for a bipolar diagnosis. Though mixed states don't usually feel like an "elated" state, they do have some of the symptoms in the hypomania/mania list. I suppose it is definitely possible to have never felt elated with bipolar mixed states, or maybe if elation was felt briefly or early in the episode, there could be lack of insight to it. Believe me on this. I know at least in my case.

I hope you will talk to your psychiatrist about any doubts or confusion about your diagnosis. It's a learning process and often an acceptance one, too.