[JonB]

Can someone tell me (in a non-textbook description) what it really feels like to be experiencing a mixed state? My doc says he thinks I'm between hypomania and depression and that my irritability indicates a mixed state. He read me the description but I didn't see the connection. I have bad insomnia like I do when I'm hypomanic, but not the usual great mood and flood of brilliant ideas - just wide awake and moody. What is this? Is a crash imminent? I don't take any meds right now except sleeping pills which I'm taking regularly but are having no effect whatsoever.

[Taipans]

Wish I could help, that sounds interesting though. I suppose a mixed state just means your on a boarder line manic and depressive episode, so your kind of between? No idea, what do I know.... lol, someone might though!

Mark

[Yehuda]

I can tell you about what it is like for me. I had a recent episode and I am not completely over it yet.

It starts as a deep depression. It gets to a point where my mind can't deal with it anymore. It sort of feels like a light switch in my head. The switch gets flicked and my mind starts racing. Unfortunately, it is racing with the depressive thoughts that I have been experiencing. It is defintely a mania. all of the symptoms are there...racing thoughts, excess energy etc. Unfortunately, there is no joy or fun, just repetitve depressing thoughts and feelings. It seems to go away fairly quickly, usually within a day or so. Then it often falls back into simple depression.

I don't know if this is what you and your therapist are talking about It is just my personal experience. I hope that this is some help for you.

[darkeyes]

I see you said you are not on meds., have you been treated for Bipolar? I think a mood stabilizer may help with this, I'm surprised being Dxed with Bipolar that your doc isn't working on treatment with one of them.
I often wonder with myself, if in the past, before my DX and treament plan, if I had mixed states, I can't put into words what I felt, but it wasn't pleasant, sort of like PMS to the max., the other states, depression and hypomania were always more obvious.
I wish I had something to reply with, but when I read your post this is what came to my mind.
I could appreciate you asking for a non "text book" description. So often it is a big help to listen to real life experiences, from real people, not reading or being quoted to you from the professional.
I wish you luck with this.
DE

I was diagnosed with bp I when I was in a mixed state. I was very depressed & very agitated. I was crying & pacing a lot. My thoughts were repetitive, negative, delusional-- especially about myself & how other people thought I was really an awful person & wanted me to kill myself. I had a hard time sitting down or concentrating. The dark thoughts were consuming me. I can't remember if I was sleeping or not. It has been about 5 yrs. since I had that. It is not a good place to be. I was put on medication immediately.

Hope you find the correct diagnosis & some relief.--Suzy

[JonB]

Thanks for the help everyone. I'm supposed to start meds soon. I took them several years ago but have been off for awhile. I've never gotten a firm dx. One doc said bipolar, another said no, this new one says who cares lets see what drugs will work. Years ago, things were pretty clearly divided I was either depressed or manic, but these days not so much. The mixed state thing never came up in the past so I wasn't sure what to look out for. Now I've got a much better idea - thanks everyone.

[darkeyes]

I think your doc has a good idea, may even save time and money, trying not to concentrate on if it's either or, at this point, it's not like it's new, you said you had tried other meds for years. Not knowingly, many years, and time lost, for me was due to my Internest/GP treating me for "clinical depression" which didn't do the trick, after all the years a therapist detected the true DX and referred me to a pdoc for proper meds and treatment for mild Bipolar, it worked.
Okay not everyday is a walk through "Mr. Roger's neighborhood," but life happens, and I can handle things in a better way compared to the non DXed version, years ago.
Lots of luck, and always feel free to come here, update us, or just a little old "chit chat".
Take care,
DE
I'd say give it a try, the doc has a good point

[lonelychick]

I am new to the site (just joined today) but I can try to describe what a mixed state is like for me. I think I spend most of my time in a mixed state. I actually didn't know there was a name for it until very recently. But for me, it's like outside I'm manic. You know, talking too fast and too much, not sleeping, trying to do everything. But inside I'm so depressed I can't care about anything. My outside actions won't match my inside feelings and I don't know why. I've heard that mood stabilizers help but I'm still searching for the right one. Hope this helps. Sorry, I'm not very good with words.

[bizi]

Dear Jon,
I don't know if you saw this or not...but the anxiety and agitation fits in.....
bizi

mixed state ....dysphoric mania

--------------------------------------------------------------------------------

Mixed state
Main article: Mixed state (psychiatry)
In the context of bipolar disorder, a mixed state is a condition during which symptoms of mania (or hypomania) and clinical depression occur simultaneously (for example, agitation, anxiety, fatigue, guilt, impulsiveness, insomnia, disturbances appetite, irritability, morbid and/or suicidal ideation, panic, paranoia, psychosis, pressured speech, indecisiveness and rage). [5]

In at least 1/3 of persons with bipolar disorders, the entire attack--or a succession of attacks--occurs as a mixed episode.

Mixed states can be the most dangerous period of mood disorders, during which panic attacks, substance abuse, and suicide attempts increase greatly.

A dysphoric mania consists of a manic episode with depressive symptoms. Increased energy and some form of anger, from irritability to full blown rage, are the most common symptoms. Symptoms may also include auditory hallucinations, confusion, insomnia, persecutory delusions, racing thoughts, restlessness, and suicidal ideation.

Alcohol, drugs of abuse, and antidepressant drugs may trigger or aggravate dysphoric mania in susceptible individuals.

[JonB]

Thanks bizi - very helpful indeed

[maureen]

Jon, I apologize if I do sound a little text booky, but I apparently BP1 consists of the mixed states compared to BPII. BP 1 is a several depressive episodes, several manaic episode but most of the the bipolar is in a mixed state.
Recently, a pdoc asked me in a hospital setting what state was I in. Depessed or Manic; I replied that I was in a mixed state because I was aware of the fact that I wa talking double the speed limit per minute but I was full of depression inside and only trying to verbalize it. When I'm depressed, (unless severly) people can't tell because of my manic actions. But if only they knew my inner soul how much pain I am truly in.
Maureen

[Pughead]

For me, I believe I am in a mixed state right now or ultra-ultra rapid cycling.
Especially last month, before I was put on depakote.

I would generally feel lethargic and hopeless, but then sometimes get wildly enthusiastic about something, even if it wasn't that exciting. I would be extremely volatile. I would boil over without hardly any provocation and the resulting behavior is extremely scary, things get destroyed, fortunately just objects and doors and walls....and of course, after settling down (many hours later) I would feel extremely horrible, depressed, and suicidal. I had two horrible panic attacks that occurred last month: one seemingly unprovoked, and the other as a result of having an intense paranoia of my own condition.

It felt like a constant clashing of good and bad/up and down, which I often translated to good and evil (sometimes I get delusional in the religious sense)...

I felt like one minute I was doing great and the next minute in the deepest pits of hell. It's like living in constant fear of yourself. And the whole thing is just a cycle. The negative thought patterns just perpetuate everything into a downward spiral. That's kinda how I feel about it anyway.

I know that I DON'T ever want to get that bad again.

The depakote IS helping.