[yellow_fleurs]

I am curious what has worked for people regarding mixed episodes, either preventing or treating. Thinking meds, but also other ways of dealing with them if you have a recommendation. I am working out meds in general with my pdoc right now, but just trying thinking of things to maybe ask about. I am feeling a little worried that maybe I will have a lot of issues with that at least in the near future. Thanks!

[ducky2030]

i feel I may be experiencing this but not sure so i can't help...im only on a low dose mood stabilizer. but i think most likely you need a mood stabilizer plus anti depressents. also diet and sleep is very important and should;l be apart of your plan

[BipolaRNurse]

I haven't had a mixed episode in years (knock on wood), but when I did my pdoc would bump up my antipsychotic. That always did the job. After I was stable for awhile he'd reduce the AP back down to my normal dose.

[cashart10]

Originally Posted by BipolaRNurse

I haven't had a mixed episode in years (knock on wood), but when I did my pdoc would bump up my antipsychotic. That always did the job. After I was stable for awhile he'd reduce the AP back down to my normal dose.

^^^^this^^^^

[*Laurie*]

Pdocs tell me that I have mixed episodes much of the time. I agree. I take a fairly low dose of Lamictal and Paxil. I've been taking a very low dose of Seroquel, but I don't think it does anything except make me very sleepy. Meditation and music are very helpful to me, as is keeping busy...I do art work and creative things, errands, chores. Sleep hygiene is essential. (My sleep has been screwed up due to the extreme heat and wildfires we're having and the odd sleep pattern is causing me to feel a bit too hypomanic...it's getting a little strange.)

Seroquel XR is my main episode fighter for just about everything, but unlike Laurie, I take a somewhat large dose of 600 mg. But a good thing is that like the posters before mentioned, my dose usually does get lowered a little a while after I stabilize. Seroquel XR helps me sleep, but is not that sedating during the day anymore. For some people, lower doses are more sedating than higher doses. Higher doses work more as moodstabilizers for most than lower doses.

The thing I've learned about mixed episodes is to not take a medication that gets rid of the elevation, but leaves depression, or vice versa.

[*Laurie*]

Originally Posted by BirdDancer

...
The thing I've learned about mixed episodes is to not take a medication that gets rid of the elevation, but leaves depression, or vice versa.

That is precisely the problem I have with mixed episodes. Losing the elevation, but winding up depressed and anxious. Enormously hard to treat. I'm glad you mentioned it, Birdie.

[yellow_fleurs]

Thanks everyone for the input! Maybe I need to talk to my pdoc about an AP (and definitely need to improve my sleep hygeine). I am just on Lamictal right now, and feel like I am either in a mixed episode or rapid cycling pretty much all the time recently (as in since taking Lexapro). I am starting to worry this won't ever end, even though I know that is not likely, it feels that way.

yellow fleur, I'm glad you will talk to your doctor. Though I know we are all unique, I will share that I would never be stable for long on Lamictal alone. It is very activating for me, like an antidepressant. Though I know it is some people's wonder drug, I can only take it in small doses and only with an antipsychotic and probably also with the other anticonvulsant moodstabilizer I take.

What goes up often comes down. In my case, activating meds will almost always make me manic, but also usually turns mixed, too. My worst mixed episodes were the ones I had as a result of taking activating meds without sufficient balancing medications. I, personally, can't take antidepressants at all, but the small dose of Lamictal (with my Seroquel XR and Tegretol XR) does have value in my mix.

[MoodyMountain]

I'm on lithium and latuda, and my one brief hypomania since starting latuda was euphoric, not irritable or mixed. I'll have to see about mixed episodes, I hope I don't have any.

Right after I got diagnosed I started depakote, and that provided some relief but lithium ended up being better. I'm weird, usually mixed episodes don't respond to lithium but to to anticonvulsants.

Mixing a mood stabilizer and and anti-psychotic is considered an effective treatment.

[yellow_fleurs]

Originally Posted by artsygirl88

i feel I may be experiencing this but not sure so i can't help...im only on a low dose mood stabilizer. but i think most likely you need a mood stabilizer plus anti depressents. also diet and sleep is very important and should;l be apart of your plan

Hope you feel better soon

[yellow_fleurs]

Originally Posted by BirdDancer

yellow fleur, I'm glad you will talk to your doctor. Though I know we are all unique, I will share that I would never be stable for long on Lamictal alone. It is very activating for me, like an antidepressant. Though I know it is some people's wonder drug, I can only take it in small doses and only with an antipsychotic and probably also with the other anticonvulsant moodstabilizer I take.

What goes up often comes down. In my case, activating meds will almost always make me manic, but also usually turns mixed, too. My worst mixed episodes were the ones I had as a result of taking activating meds without sufficient balancing medications. I, personally, can't take antidepressants at all, but the small dose of Lamictal (with my Seroquel XR and Tegretol XR) does have value in my mix.

Thank you, that's really helpful. I am starting to think this one is activating for me too, especially around my period since this is more intense on the higher dose. I am supposed to increase my dose from 100 mg to 200 mg tomorrow, which I hope will help, but I am honestly afraid I will get worse.

Keep in close contact with your psychiatrist if you notice any worsening of your mood yellow fleurs. I hope that instead it helps you.

[Nammu]

APs are what help. Prevention wise staying away from AD and activating OTC meds help.

[Pookyl]

The best Rx for my mixed moods are a combo of Lithium + Depakote. In terms of non meds treatment RBT works ok. I’ve found mindfulness exercises in particular to be helpful.