[Blueberrybook]

God, I can't believe I'm writing this. I am still f***ing mixed. Is the "with mixed features" part of bipolar diagnosis permanent, or does that just mean mixed has happened to you?

I am starting to think I'm stuck being mixed. If I'm not mixed, I'm a little manic or a little depressed though I do recall having times of only one or the other (particularly full mania).

Can mixed or "the with mixed features" be a part of your bipolar norm? It's starting to feel that way for me.

Does anyone know how long mixed can last? Does it have a maximum time limit?

Yes. That's my base dx, though only because severe mixed episodes with psychosis have been my worst episodes leading to hospitalizations. I experience a lot more of milder episodes that are elated, but if they progress to full blown manic they usually always turn mixed in the end, at least eventually.

[Travelinglady]

I think so, but I still don't get what being "mixed," is about, even though I've been told I've had mixed episodes. I guess it could vary from person to person as far as time frame, but, of course, the ideal is to be stable--neither too high or too low. I take meds to help me stay that way.

[luvyrself]

I really feel that if you give it some time, with your husband starting his new job and the stress on you being less, that your symptoms are bound to lessen.
My ex and I (with our money for retirement managed by different parties) both just took gigantic losses in the stock market crash, and I feel like ____. I expect to be depressive or mixed for awhile, especially since my dear friend is out of town for a month.Blue and Bird , I will watch for your posts, as you are both so perceptive in expressing yourselves.

[Blueberrybook]

Thanks, everyone. I've been with this pdoc awhile now (9 months, I guess), but he worked with my retiring pdoc who gave him a summation that she thought I was heading toward mixed (paid astronomical fee for 10 yr of psych records), but he told me he talked over my case with her a couple of times (my first few months of treatment with him; I signed a release) as she scaled back to working part-time. She is very, very good, and among the area, my new pdoc has very high ratings and my PCP knows him (a plus there). He has been my old pdoc's colleague a long time; he has been at that clinic as long I have been going there, since early Jan. 2008, so they have been colleagues quite awhile. It may have been a diagnosis they both felt warranted it.

I am hoping once H is established in his new job, my daughter back in school, and all the medical insurance sorted out, I will be doing better. I hope so. My pdoc wants to swap out Cymbalta for Wellbutrin; I did decently on Cymbalta, especially in the beginning, shortly post-partum and it seems like a couple of years at least, and Cymbalta helped with fibro pain (fibro screamed when I stopped it), and if I get on Cymbalta, I may not need gabapentin any more (only take gabapentin for fibro). I know he also wants to get the Seroquel dosage lower in the long run, but, as said above, he felt the stress around the holidays, so much stress in my life in general needed to calm down a little before tinkering with meds. Hopefully, we can start working with the change to Cymbalta soon. I get forgetful for words on Wellbutrin.

Fingers crossed H's new job makes him happy and less exhausted (even with a long commute). And hopefully, it comes with better medical insurance than they give high school teachers.

[jaysmotogp]

Sorry to hear yoor still struggling with the mixed Blue, i know its been a while now.
Hang in there, it will break eventually👍

[BeyondtheRainbow]

It is mine. It is very rare that I'm not mixed to some degree. Until clozapine it was pretty much always moderate to severe; now it is more mild dipping into moderate. A few months ago I had a month that my diagnosis was mild or moderate (don't remember) hypomania and that was actually weird because I see that so rarely.

Since clozapine works for me I've learned that if I feel symptoms I need to get treatment immediately if I feel any change. In the summer I avoided a big mixed episode by asking to do a 4 day pulse of a higher dose of clozapine; generally in the summer I have a bad episode and this prevented it.

[Blueberrybook]

Originally Posted by BeyondtheRainbow

It is mine. It is very rare that I'm not mixed to some degree. Until clozapine it was pretty much always moderate to severe; now it is more mild dipping into moderate. A few months ago I had a month that my diagnosis was mild or moderate (don't remember) hypomania and that was actually weird because I see that so rarely.

Since clozapine works for me I've learned that if I feel symptoms I need to get treatment immediately if I feel any change. In the summer I avoided a big mixed episode by asking to do a 4 day pulse of a higher dose of clozapine; generally in the summer I have a bad episode and this prevented it.

Were you able to stop or lower the dosage of another med when you got on the clozapine? I don't want to add any more meds or go to the pdoc sounding drug seeking. My mixed is not horrible, I suppose, as I tend to have depression/hypomania together or very close in time to one another. Only rarely will I be fully hypomanic or fully depressed. I do know if I start sleeping less and less (particularly under 5 hr. for me), full mania follows very quickly, and I need to call the pdoc ASAP. But my sleep is OK for now, and neither manic nor depressive sides seem to have the upper hand. Though maybe besides being situational, the depressive stuff could be ED stuff as well; lines blur.

Did you get any side effects from clozapine?

[Blueberrybook]

Originally Posted by jaysmotogp

Sorry to hear yoor still struggling with the mixed Blue, i know its been a while now.
Hang in there, it will break eventually👍

Thanks. It sucks.

[Blueberrybook]

Originally Posted by luvyrself

I really feel that if you give it some time, with your husband starting his new job and the stress on you being less, that your symptoms are bound to lessen.
My ex and I (with our money for retirement managed by different parties) both just took gigantic losses in the stock market crash, and I feel like ____. I expect to be depressive or mixed for awhile, especially since my dear friend is out of town for a month.Blue and Bird , I will watch for your posts, as you are both so perceptive in expressing yourselves.

I think you could be right. I really, really hope so.

[Blueberrybook]

Originally Posted by BirdDancer

Yes. That's my base dx, though only because severe mixed episodes with psychosis have been my worst episodes leading to hospitalizations. I experience a lot more of milder episodes that are elated, but if they progress to full blown manic they usually always turn mixed in the end, at least eventually.

I've only gotten psychosis once with mixed but full blown manic ends me up in the hospital or just avoiding it because I have H home to watch me. I suppose mine is mild or moderate at most, but that doesn't make it easier, going on so long.

[Blueberrybook]

Originally Posted by Travelinglady

I think so, but I still don't get what being "mixed," is about, even though I've been told I've had mixed episodes. I guess it could vary from person to person as far as time frame, but, of course, the ideal is to be stable--neither too high or too low. I take meds to help me stay that way.

I agree. And I think it might depend on the pdoc you have as well. Some might see mixed, others hypomanic or depressed, especially depressed, depending on when you go in. I don't know if I am the only one, but I tend to complain about symptoms more to the pdoc if I'm depressed or if I have a med side effect I don't like. Hypomania tends to feel good, so for me, it equals less symptom issues to tell the pdoc about.

[BeyondtheRainbow]

(please note there is an answer in dark green in the quote box as well as an answer in the white part of the reply. i didn't do that well.

Originally Posted by Blueberrybook

Were you able to stop or lower the dosage of another med when you got on the clozapine?

I went off very high dose (1200-1500 mg) Seroquel when I went on clozapine. I also had to increase my gabapentin dose quite a bit with that change. Later it went down and now that I'm going off clonazepam it is up more. I can't remember if there were other changes but I think not.



Did you get any side effects from clozapine?

Clozapine is pretty side effect heavy. Initially I gained weight although I've managed to lose that and about 20 more pounds with metformin, diet and exercise. It tends to have somewhat evil effects like severe drooling at night, bed wetting and lots of labs (weekly for 6 months, every other week for 6 months then monthly while on the med) to monitor for abnormal immune effects. It makes me very tired and I sleep a lot; on a lower dose I didn't feel nearly as good although I maybe slept less. I honestly don't care about any of those because it is the first drug that worked for me but it isn't fair to say it's a great drug without being honest about the downsides. It is supposed to be used as a last resort after all other reasonable meds have been tried and that is exactly how it was used for me. I knew for a long time that I might eventually need it and then for about 6 months that if nothing changed that I would need it and then I reached a point where I obviously needed it. I'm glad to have it; I've been on 40 plus meds and 70 plus combinations and had practiically given up on anything ever working as well as this does. It's not perfect but for me it's the best we can get and I'm grateful to have it.

[Blueberrybook]

Originally Posted by BeyondtheRainbow

(please note there is an answer in dark green in the quote box as well as an answer in the white part of the reply. i didn't do that well.


Clozapine is pretty side effect heavy. Initially I gained weight although I've managed to lose that and about 20 more pounds with metformin, diet and exercise. It tends to have somewhat evil effects like severe drooling at night, bed wetting and lots of labs (weekly for 6 months, every other week for 6 months then monthly while on the med) to monitor for abnormal immune effects. It makes me very tired and I sleep a lot; on a lower dose I didn't feel nearly as good although I maybe slept less. I honestly don't care about any of those because it is the first drug that worked for me but it isn't fair to say it's a great drug without being honest about the downsides. It is supposed to be used as a last resort after all other reasonable meds have been tried and that is exactly how it was used for me. I knew for a long time that I might eventually need it and then for about 6 months that if nothing changed that I would need it and then I reached a point where I obviously needed it. I'm glad to have it; I've been on 40 plus meds and 70 plus combinations and had practiically given up on anything ever working as well as this does. It's not perfect but for me it's the best we can get and I'm grateful to have it.

Ugh, those side effects do not sound great. I don't need added exhaustion between the BP, the meds side effects, and the fibro fatigue & brain fog. I can't even separate what is causing what. I am very lucky to not have issues other than fatigue on Seroquel, though I suspect it may be keeping me weight stable with the amount of exercise I do, eating pretty much normally. My weight is already bad enough, the pdoc nags, lectures, etc. but just enough to keep me out of the hospital and as it has more or less been stable several months now, the pdoc is less concerned. However, stupid ED thoughts make me want to lose weight and stop Seroquel cold turkey and see what happens (and yeah, I bet that would be mania).

I hope my daily life won't be so stressful this year. That ulcer thing alone made 2018 continue its rocky start, and now I have PTSD from the whole experience, not to mention paranoia and/or hypochondria every time I get pain on my sides or stomach. Ugh.