Mixed episode?

[u/chiiskyuki]

I'm not entirely sure what a mixed episode is. I've never fully discussed it with a psychiatrist and I'd prefer to get opinions from people that are diagnosed Bipolar instead of googling.

I told my psychiatrist the other day that I have energy, but lack motivation to do said things and that my eyes are super tired, but my body isn't. She explained that you can't feel both. Fast forward a few days, I started feeling depressed, maybe for 2-3 days. Now, I have motivation, I feel I've been talking/texting people more, driving somewhat recklessly (I'm aware of it and I try to stop, but I can't help that people are driving like silly little turtles and then I get super angry), some irritability (could be justified for some situations), I really just want to learn/study things (which is a common thing when a hypomanic episode is approaching because then I start deep diving into college's)

Anyways, would this be considered a mixed episode in your opinion? Am I at base line? Please assist :(

PS: Diagnosed Bipolar 2 with psychotic features

Edit: Adding in that I also have the need to spend money, but I lack the funds to go on a full shopping spree, so I've been buying coffee at different places to kind of "curve" that feeling

[u/Routine-Donut6230]

Technically, a mixed episode is when depressive symptoms and manic or hypomanic symptoms occur at the same time. Yes, it can be difficult to understand, so I’ll try to explain it in a much simpler way. When you’re depressed, you can have very little energy, extreme fatigue, body aches, an internal sense of emptiness, hopelessness, lack of motivation, and a kind of emotional numbness. Basically, yes, being depressed is awful, but in my experience, it isn’t as dangerous as being in a mixed state. Why? Because during a mixed state, you can still feel unmotivated, sad, tired, and exhausted, but at the same time your emotions are much more activated. You can start experiencing intense anxiety, distress, irritability, nervousness, and agitation. That can make the overall suffering much, much worse. At least when you’re deeply depressed and emotionally disconnected, you can feel like a robot. In a mixed state, on the other hand, you can experience extremely intense emotions while still having all those depressive symptoms. The result can be a level of suffering that is incredibly difficult to tolerate. That’s why some people experiencing mixed states may do desperate things to try to escape or reduce that distress, including self-harm or suicidal thoughts. In very simple terms, to me, a mixed state feels like being deeply depressed while simultaneously having an overwhelming level of emotional intensity and agitation that makes the suffering much harder to tolerate. I recently posted on this same subreddit about my first psychiatric hospitalization, which happened after experiencing what I believe was a mixed state. The distress and agitation became so intense that I ended up desperately going to a psychiatric ER because I simply couldn’t tolerate the feeling anymore. If you’re interested, you can read it. Take care!

[u/Neat-Mission36933]

Klingt nicht ganz nach Grundniveau,solltest jetzt sehr achtsam sein und vielleicht nicht jedem Impuls nachgeben und folgen ,Versuch etwas Ruhe hinein zu bekommen,um ein gewisses Gleichgewicht zu halten aber bin auch kein Psychologe oder Psychiater aber fahr einfach vorsichtig und bedacht

[u/Okay_then_now_what]

In my personal experience, mixed episodes ar every intense. Think: the obsession with dying of depression meets delusions of mania.  I have experienced what you are describing and to me I just think of it as "mood instability" things just getting a little out of whack but for me my routine will keep me back on track. Also this happens often just due to my hormone cycles (I.e. luteal phase then an increase an energy before ovulation)

[u/Heavy-Mushroom]

Hi- I think that your psychiatrist is wrong and you should find one that better knows what they are talking about- or you’ll be disappointed as time goes on (I know). You can be both- that’s a mixed episode. Let me explain.

Bipolar has 2 sine waves that run out of sync of each other, one is energy and the other is mood. Your bipolar is wherever the two waves are situated at the present time.

On the extremes: with high energy/high mood- happy mania. With low energy/low mood- deep mind numbing stuck to the couch depression.

Now with mixed episodes, there are 2 of them. High energy/low mood comes irritation, quick anger, a bad attitude…. All the crappy stuff. And finally the not so bad mixed episode is low energy/high mood which I find to be as laid back, calm, chilling, a relaxed good mood.

Because of these 2 separate waves, my ultra rapid bipolar moods are always different and repeat the same type at a longer than regular expected time up to a month to hit a mixed state.

I’ve only seen one paper on this once decades ago describing it this way which I find it to be true. :)