Mostly Mixed Symptoms... Anyone else?

Okay so I A) rapid cycle and B) mostly get episodes with mixed features. either agitated depression, or dysphoric mania... It's terrible, it's like I am constantly living in hell. Last time I was on a high I was up for 5 days straight after several previous nights of getting only hours of sleep, I was suicidal and had depressive delusions (ie believing I was dead, in hell and, therefore can't die), also had some derealization going on. it was like nothing around me was real or actually happening, like life was like a movie and I was just a camera lens. I finally got some sleep when I heard a voice repeating the phrase "go to bed" over and over and over. This episode went on for about three and a half months.

that was about 14 months ago, now I'm severely depressed with racing thoughts and high levels of irritability, impulsivity, and self harm. And it feels like it just wont end.

Both of these episodes went on for months intersperse with a high day here or there where it was like I was maybe hypomanic... its weird..

Anyone else have an oddly meshed collection of symptoms like this? I feel like the more text book diagnosis would be preferable to this, because no matter what end I'm on its a terrible experience for me both during and after.

I rapid cycle, too, and often get mixed episodes. Mine are (thankfully) short-lived and not that severe because I have Bipolar 2 (and OCD) and I'm mostly stable on meds (I still struggle with my moods and worries, though). I keep very close tabs with my p-doc and I insist on going in to be seen sooner as needed. I'm very sensitive to any changes in my mood and I try to stay on top of seeing my p-doc if I think I need an adjustment.

Does your p-doc know about all these symptoms? Does your p-doc know about the self-harm? It sounds like you might need a medication adjustment.

I take Latuda, also. I take a higher dose, and I found that Latuda has helped the most with my anxiety out of any other bipolar medication I take. I hope you get some relief soon!

Lithium XR 900 mg
Trileptal 1500 mg
Latuda 120 mg
Risperdal 1 mg
Xanax XR 0.5 (2x a day)
Xanax 0.5 PRN for anxiety attacks

I'm rapid cycling and I get agitated depression or dysphoric mania.

Right now I get an episode every 6 weeks and they typically last about 2 weeks, but my episodes used to last several months. I don't know... my medication seems to have caused rapid cycling. (I wasn't rapid cycling before I started medication.)

But yeah, I don't think I experience textbook depression. It's always agitated or dysphoric, but usually agitated. I get the severe rage, irritability, impulsivity, agitation etc.. In fact, I'm usually pretty destructive. Like, I literally destroy things. For example, I intentionally smashed my phone in February of this year when I was in an agitated depression. I did it out of rage. Then I started kicking things and smashing them because I went on a rampage!

I also rapidly cycle and have mostly mixed episodes with agitated depression and sometimes dysphoric mania. I've been rapidly cycling for the past two years and its been absolute hell. I haven't been stable since I was diagnosed 2 years ago and I've been on over 10-15 different medications and I even had ECT which didn't help. I definitely also have an issue with rage as well, I'm always angry or agitated. But I also suffer with suicidal ideation and its gotten worse over the years as well.

Rapidly cycling here as well and my episodes are also mainly mixed. I used to complain about this because my behavior was inconsistent and sporadic during my mixed episodes, then I experienced a purely depressive episode earlier this year and I literally prayed for my mixed episodes to return.

At the moment, I'm in a mixed episode and it feels amazing compared to what I experienced over the winter.

thanks for the responses guys, I was beginning to feel like I was alone being dysphoric the majority of the time. I know rapid cycling is more common. but I've only ever met a couple other people that have mixed states in person.

You sound much like me. I've been very hard to treat because of those features and frequent instability. I'm mixed so much more than anything else that mood charting is a disaster because I can't mark it accurately when I feel both poles at once and am rapid cycling.

Ditto to like everything that's been said by everyone on this thread. Mixed sucks, I'm never really sure if I am infact mixed but just wholly unstable as a person, reading this makes me feel like I'm not the only one at least.

I thought I was mixed but compared to you guys, mine is a mild mixture. I really feel bad for y'all. How do u you make it when meds, pdoc and therapy don't put a dent in it?

I have this same problem with mood charting. I think a different chart with values for mood/energy/anxiety/irritability works better with mixed sx & rapid cycling but it's so time consuming. Also unless I do the multiple variables chart my pdoc seems to not take much information from it because it doesn't follow typical patterns & so doesn't stand out as clearly bipolar.

I have used a charting app and somehow adjusted what the scales meant to show some of it but it mostly just showed I was agitated. I've always found mood charting nearly impossible although it was a bit easier with the app than paper and pencil. I did it for a few months last year until it became clear it wasn't helping anyone very much, although it certainly showed dysphoria. But we knew about that already.

My charts do look bipolar because they spike constantly but I think the only reason that was "acceptable" was that my pdoc and therapist already know what cycling is like for me.

Antipsychotics really helped with going from mixed to textbook rapid cycling, for me. Atypicals keep a balance. Any meds working just for depression may jeopardise that balance. You can get sudden, strong anxiety by lack of anxiety.

Then (very short) mania will decrease that anxiety and you might get strong anxiety again, causing (short) depression, which decreases the anxiety, being further reduced by the med, causing strong, sudden anxiety from lack of anxiety. Could be that. Hypervigilance. Growing fear for mood fluctuations.

For me, panic attacks help: they stop the cycling for some time. So maybe a little or very much anxiety is best for mixed. And more stable perception due to antipsychotics.