Do you think this is a mixed episode?

I haven't kept track, but I would say looking back for over a month I started out hypo-manic. This lasted for a few weeks. I then I think would drop into maybe a depression. I wasn't suicidal, but there was no energy or motivation, just blah. I had no energy but I wanted to work on projects around the house, very weird feeling. This would happen over night and would last for a few days and then I would climb back up to hypo-mania. One day I went from this type of depression I guess you would call it, to a complete rage in the evening where I thought I was going to punch someone. I was put back on Seroquel (300mg) back in July and it stabilized me and then my pdoc added Topamax 25mg at the beginning of September. This medication change was before this swinging back and forth started to happen. I noticed during the highs I was still waking up several times at night with all of the night meds I am on and when the so called depressions I would not. I will admit that I have been drinking a small RedBull at noon when I wake up because of all the night meds causing me to be just completely blah in the morning and I have to get my you know what in the shower and get to work, which is really my only goal for the day. So I drink the RedBull at noon, drink water the rest of the day and I go to bed at 1 am. My doctor had a fit, but I told him I didn't know what else to do. And don't get mad at my pdoc, I have literally tried everything and Seroquel seems to be the only one that has come the closest to keeping me from falling apart again. I know that we are not suppose to have caffeine, so don't give me the lecture please, and coffee upsets my stomach. So anyway a week ago he upped the Topamax to 50 mg and said if I swing back up again I need to bump the Seroquel to 400mg. Well guess what, I am back up in the tree tops again running my mouth at work waiting to get myself in trouble with HR.

My question is what is going on with me this back and forth? This last March he diagnosed me as BP1 mixed, but I really didn't pay attention to how I was feeling. Is this mixed? I thought mixed was depression and mania at the same time? See below because I am also on other medications that I have been on for quite some time. He told me the older I get the less I will swing back and forth. I'm just so tired of this up and down that happens so fast. I know you guys can't diagnose just looking for some info.

BP1/OCD/GAD

Lamictal 400mg
Xanax ER 1mg am and pm
Propranolol 10mg am and pm
Topomax 50mg
Seroquel 300mg

obviously your meds aren't working or you wouldn't be experiencing these mood fluctuations. I have never seen the sense of adding new meds to meds that aren't working or upping doses to meds that aren't working. if they were working you would see some relief at the lower dose. I drove my drs up the wall changing meds all the time but I got tired of being on six different meds that weren't working. so I tried one mood stabilizer at a time. if it didn't stabilize me or had negative side effects I moved on within a couple months. docs didn't think I was giving meds a chance but I wasn't going to waste my time with something that wasn't working. it took me a couple years and almost all the meds but we finally found one that took care of nearly all my symptoms. then we added a second to finish it off. no side effects total stability. it is possible. you just have to be really patient and advocate for yourself.

I was diagnosed 7 years ago and have been going round and round with medicines, which I understand is part of dealing with this illness. This is only my second doctor, I have been seeing him since March. There's two problems. One, so far I have had an allergic reaction to five meds, my throat closes up and I end up in the ER. Second, for some reason when I find a med it works for awhile and then things go bad. He originally put me on the Topomax because of the weight with the Seroquel. When I was off of the Seroquel before I lost a ton of weight from the Depakote that I had gained, and I knew once I went on the Seroquel like before I would stay at the same weight. So he decided to give it a try.

I can't say that is mixed, but I can assure you others have same fluctuations. Speaking from personal experiences. I think I have had mixed a few times, but can't explain it. It is kind of like feeling all the emotions at once. Not sure if that makes sense. Not comfortable. My mania the other night went to complete anger over nothing. Understand what you are saying. Think I even had some dissociation periods with it. Not sure this helping you, but that my thoughts. Best wishes.

If it is mixed, you're doing a good job controlling the energy. I was diagnosed as mixed because I was physically attacking people, throwing objects out of my car at other motorists, and catching stuff on fire when I got angry.

Mixed is having the depression and anger, and having the high ENERGY to follow through with your impulses. At least it is for me. I can't speak for everyone.

Mixed or not, you're having some issues and should see your pdoc. If your current pdoc can't help you, find another one.
Take care.

Chronic adminstration of caffeine and taurine (redbulls ingrediants) is only going to make things worse. If you really need the caffeine to help with fatigue steep loose green tea leaves, not bags, for 3-5 minutes. Talk to your pdoc about adding melatonin to your sleep meds as well as using light therapy. I think this provides a rather accurate set of instructions for using melatonin, although you may find benefit from a higher dosage than 150mcg due to the amount of stress you're under. I've also come to appreciate Darkness Therapy.

I think mixed episodes can present differently - some people experience a predominantly depressed phase with some features of hypomania whilst others experience the opposite. My mixed episodes have always presented as dysphoric mania. I tended not to swing back and forth but rather, for me, it was a constant feeling of depression with symptoms of mania popping through. There was no stability during this time. That's just my own personal experience. Others may present differently.

I agree, mixed episodes can be different for everyone, so it's great to see how some are effected by it here! I'm not sure if I get mixed or rapid cycling, but I can go from depressed to ecstatic, doesn't have to be hypomanic tho some times I guess it is. My depression is weird. I can feel really very low, alone, worthless, helpless, even suicidal one minute, and a few minutes later feel great. When ever I go down, it feels like a piercing knife in my stomach. Because I don't know how bad it will get. Some times it's followed by extreme anxiety. If I was not on meds, I would have explosive anger and rage. Even when I am pretty stable and around baseline, my moods vary more then average but not as bad without meds. Often I say to myself "I hate my life!" "I should just die!" and later on be totally happy. It sickens me to know I am like this.

I don't know if that's mixed or rapid cycling, either, but it sounds awful.
When I'm depressed I have absolutely no energy. I want to die, but I barely have the energy to get out of bed or eat, so suicide is not really on the agenda.

I hate being like this, too. It's very embarrassing at times to think about things I've done.

I have rapid cycling and for me when I'm cycling it's complete chaos. I go from mood to mood in no time and it's like I can't even keep up myself. And this occurs frequently!its horrible!

Occasionally once in a great while I do fall in a deep longer lasting depression just as you describe. Thankfully I can go years in between. But depression is never far for me. I can fall in a hole at any time. Even distracted I can fall in to it. Generally it's brief or at most days or weeks, usually just minutes to hours. It's embarrassing for me too. And also hurtful. I hate nothing worse then exploding on my children! I love them more then any thing.