[WinterRose]

What's a mixed episode? How would you recognize it? I had a really bad end to a bad week last week. I think what I ended with was a mixed episode, but I'm not sure and I get confused because I have a dx of ADD as well as bi-polar. I don't think I've ever been manic, but possibly hypomanic (I think that's what it's called). I'm usually battling depression and this was not quite depression. It was like being tortured.

[Psychotic_Phil]

http://en.wikipedia.org/wiki/Mixed_episode

That should answer your question. If you've had a mixed episode it means you have Bipolar I, not II.

[WinterRose]

I don't know what bi-polar my Dr. has me down as. I wasn't sure if I really was because mostly I'm depressed and don't know if I'd recognize mania - I've certainly never been to that point where I feel superhuman. I start getting confused like I say - too many dx for one little person.

an exclusion criterion on depression and depressive disorders is past history of a 'mixed state'. a 'mixed state' is the presence of mania or hypomania. if there is a past history of mania or hypomania then you don't get a dx of depression (which is a uni-polar disorder - depression with no mania / hypomania) instead you get a dx of bi-polar or bi-polar II depending on the extent of the manic.

there is some controversy over bi-polar II. a way of turning an axis II into an axis I methinks ;-)

[January]

I found this for you, too.

LINK TO PC INFO

Hugs,

Jan

[darkeyes]

Sounds like Bipolar-II, I do not know what a "mixed episode", even though I thought I did, but former pdoc said I didn't fit the criteria, and may have just been getting use to the meds, which was all new to me. I personally would only go with the DX the pdoc feels is it.
Until I saw a pdoc, my gp would just keep writing scriptsd for AD's claiming I was depressed,refusing to address physical problems.
I was later DXed by a Psychiatrist who after an evaluation (GP's aren't qualified to do, though they think so) concluded I was Bipolar-II(mild) and ADD mild.
I take 200mgs of Lamictal daily and Concerta, 36mgs in AM
Other meds to us ONLY if needed, Ativan and/or Klonapin, I really do ONLY use when I really need them, so I do not abuse them.

Just my 2 cents.
I can count the times I may have been slightly hypomanic, in my entire life (I'm 50) on one hand.
and this was always at the times I was taking diet pills (amphetamines) other than those times I was considered "clinically" depressed, and wasn't DXed with Bipolar till 2000, and I was on Phenterimine at that time, so truth be known, I may not be Bipolar, but still more prone to depression.
Whenever I try to drop down 50mgs from Lamictal, with pdoc's supervision, I'm good for a few months and then depression begins, no hypomania at all, I wish there was, at least a smidgen of it.
Hope all works out for you, take care now.

[Direction]

I would discuss it with your p-doc some more...

[WinterRose]

I called him (pdoc). He was a little concerned because I used the word 'crazy.' Apparently I'm very eloquent so when I use words like dead or crazy etc he really takes notice. The T thought it was a mixed episode after I told her about it - she sees episodes of hypomania in me that I don't catch, I guess. The pdoc said that he thought he'd have me try adding in another drug temporarily to give me a break. Funny thing is - I'm feeling pretty normal this week.

Depression was my first dx with a previous pdoc and an independent pdoc for state disability, but my pdoc has it down as bipolar.

I may have caused my own problem because I experimented with not taking my Concerta for three days and day 2 was when I bottomed out although I had been struggling prior to that anyways. So connection or no connection - hard to tell.

What scares me though is that I called the elders from my church to come over and bless me. One called to check up on me yesterday (nice) and said he was afraid I was suicidal that night. I wasn't - I was too tormented to consider that although I almost took a second dose of my Lamictal just because I was desparate to make it go away. I'm glad he didn't turn me in. I'm so lucky. I once had an attack waiting in an office of a pdoc and was tearing up magazines to keep down the panic and he suggested to his receptionist that she call the police on me! I'm glad she didn't. I'm so lucky.