View Full Version : What's a mixed state?


Fuzzy12
01-08-13, 12:34 PM
Does it include:

Depression, weariness, suicidal ideation, frustration, anger, agitation, restlessness, desperation (as in the feeling that you can't bear it anymore but in an annoyed rather than sad way) and a general feeling that everything is just so, so wrong??

Oh and a strong urge to do something really stupid??

And a strong desire to cry but not being able to?

And does it usually really last for at least a week?

Or maybe I've just had too much coffee???????????????????????????????????????????? ?????????????????????????????????????????????????? ?????????????????????????????????????????????????? ?????????????????????????????????????????????????? ????????????????????????????????????

saturday
01-08-13, 12:48 PM
Mixed is refering to a mixture of euphoria and dysphoria all with in one episode.

The word episode can also be confusing. It seems that generally people think of Bipolar as up, down, up, down, up, down. However it is usually much more than just two distinct poles. A person can be super high, medium high, high, super low, super high super low, medium low, medium high, for example.

I dont think there is a time limit for episodes either.

ezridax
01-08-13, 12:51 PM
It's all so confusing, isn't it?

mrs. dobbs
01-08-13, 12:52 PM
I get what you describe Fuzzy. It's just before I do something impulsive or rash... I can't stand that nothing's gonna change or give.

Fuzzy12
01-08-13, 01:02 PM
Mixed is refering to a mixture of euphoria and dysphoria all with in one episode.

The word episode can also be confusing. It seems that generally people think of Bipolar and up, down, up, down, up, down. However it is usually much more than just two distinct poles. A person can be super high, medium high, high, super low, super high super low, medium low, medium high, for example.

I dont think there is a time limit for episodes either.

According to the DSM - IV there are lower bounds on the number of days that an episode has to last. For example, hypomania has to last for at least 4 days and from what I've read, a mixed episode has to last for at least one week.

I agree though that the actual episodes are very graded.

It's all so confusing, isn't it?

yes, it is. :mad:

I get what you describe Fuzzy. It's just before I do something impulsive or rash... I can't stand that nothing's gonna change or give.

Yup, that's exactly what it is Mrs D. I can't stand the feeling that nothing is ever going to change or give. It's driving me crazy. Actually crazy. I feel like a bull in a bull fighting ring. I'm getting more and more agitated. My nostrils aren't flaring yet but I keep punching the wall and exhaling heavily, like an angry sigh.

saturday
01-08-13, 01:12 PM
According to the DSM - IV there are lower bounds on the number of days that an episode has to last. For example, hypomania has to last for at least 4 days and from what I've read, a mixed episode has to last for at least one week.


What I've expiriences falls in line with these lower limits, but I wouldnt exclude symptoms that last less time just because the DSM has defined limits. There are gray areas, you know what I mean?

Fuzzy12
01-08-13, 01:17 PM
I know and I agree. I think the limits are quite arbitrarily defined as well. I remember reading a paper that mentioned that often cycling occurs much more rapidly than is commonly accepted. With me that's definitely the case. My psychiatrist explained it as my mood just being very volatile in general so apart from having episodes I can also go through the entire bipolar spectrum (except for psychosis) within a day (or sometimes within an hour). Or maybe like someone said on another thread of mine, these ultradian mood swings are more a sign of a mixed state.

ezridax
01-08-13, 01:43 PM
I get what you describe Fuzzy. It's just before I do something impulsive or rash... I can't stand that nothing's gonna change or give.

I get like this sometimes, or pretty darn close. I don't actually act on most of my impulses, but mostly because it just would take too much effort to follow through.

Like I get tired of the constant disarray of my house, so I start ranting about how I'm going to get a UHaul and fill it with our stuff and get rid of it. And I don't mean getting rid of actual junk; I mean getting rid of the bookshelves and the books and half our furniture and dishes and clothes...And we really don't even have that much to start with...

Or I start thinking about how I'm tired of taking care of babies and toddlers and can't stand to do it for the rest of my life. DH and I are taking ample measures to prevent me getting pregnant again (hopefully), but I still get stressed thinking about the possibility of that "surprise." And I know DH doesn't want a vasectomy, so I start grumping around and threatening to go get my tubes tied even though it's major surgery and waaaay expensive...Then DH will say something like "Fine, then! Just go get the scissors and castrate me already." lol We're so dramatic sometimes...I can laugh at it right now, but in the moment it's not real pleasant. Even in my normal state of mind I'm pretty positive I can't handle another kid.

ebullient
01-21-13, 01:38 PM
Fuzzy,

I am new here, but I have mixed state ultradian rapid cycling bipolar. Ultradian is the word for moods going through the spectrum in as little as a day as you described above. I love words - finding words that describe something I'm experience and I was happy to find that word. So, if you haven't known it till now, maybe you will like it too.

The DSM is grand and all, and it's always nice to go back and reference, but if it helps I've had many psychiatrists at incredibly good hospitals tell me that no case is quite like another. I think I knew that, but again, having it said was helpful to me somehow. So, you can always go to the DSM and look up a mixed state, but I can try to describe what it's like for me.

In my life with bipolar, I have had less than a handful of pure mania's. The most memorable was the breaking mania that sort of shot me from this weirdly depressed "hypomanic" (as even then I was mixed) anxious little thing, to full blown raging bipolar. The mania felt as though someone had taken the top off of me, and I was happy, finally happy. Now, mania can also be this sort of anger right? but it's so certain so pure. It's hard to describe to someone who hasn't been there, and I'm not doing the best job, but I think you may get me. Like I said, pure mania is foreign to me.

Mixed is always tinged. When I was pure manic, I had this relief from this depression that I hadn't had in 7-8 years? In a mixed state, it goes up and down, but the mania never goes, and the depression never goes. Does that makes sense? So, personally I characterize anger with my mania, but I can get a very low depression and add a freakish anger on top of it, or a rapid thought, but I can't focus on anything because my brain isn't working from the down side. you take little parts from each and mash them together. So what you described could easily be a mixed state.

The meds are different sometimes for mixed bipolars- so follow your instinct.

I hope this helps. I know it isn't all official, just my personal experience. If you have any questions though --- it's always nice to talk to someone who is going through the same thing

keliza
01-21-13, 04:19 PM
If you imagine the bipolar mood spectrum as occurring on a line, with mania at one end and depression on the other, a mixed state would be picking up the two ends of that line and bringing them together. Mixed states are sometimes called "agitated depressions", "dark manias", or something else to the effect to indicate that symptoms of both mania and depression are occurring simultaneously.

Mixed episodes include symptoms of depression like sadness, hopelessness, and feelings of suicide, as well as symptoms associated with mania, like difficulty sleeping, agitation, feeling as if run by a motor, impulsive decisions, etc. Mixed states are considered the most dangerous mood state in bipolar disorder because a person has the overwhelming depressive feelings, plus the energy and impulsivity of mania to carry out actions they might not otherwise engage in during a typical depressive episode. Mixed episodes are also more likely than depressive episodes to have a psychotic component, like mania.

Technically in the DSM, mixed states can only occur in bipolar I disorder, since it is the only form of bipolar disorder with true manias. But in reality the lines are much blurrier, and some people with bipolar II disorder can have what look like mixed episodes too, just not as severe as a true mixed episode in bipolar I. Sometimes a mixed episode is a step closer to full-blown mania in a person who originally looked to have bipolar II disorder but actually has the beginning of bipolar I. Sometimes it's not a true mixed state because it does not last long enough and is not severe enough - that doesn't make it any less horrible to experience, just for diagnostic sake, it's not a mixed episode.

I have only had a handful of mixed episodes, and they were truly nightmares. All of my suicide attempts have been during mixed episodes. Most of my psychotic episodes were during mixed episodes. It feels like your brain ripping itself in half, like everything inside of you is ripping in half, like you're screaming from your brain cells, from your bones, from your blood. Everything inside you is screaming. That is what a mixed episode feels like, to me.

If you're feeling really agitated and impulsive, I would strongly recommend you call your psychiatrist ASAP. Talk about what needs to be done as far as meds or hospital for stabilization. If you are a true risk to yourself, you need to do whatever is necessary to keep yourself safe until the episode is over.

ebullient
01-21-13, 09:42 PM
I have only had a handful of mixed episodes, and they were truly nightmares. All of my suicide attempts have been during mixed episodes. Most of my psychotic episodes were during mixed episodes. It feels like your brain ripping itself in half, like everything inside of you is ripping in half, like you're screaming from your brain cells, from your bones, from your blood. Everything inside you is screaming. That is what a mixed episode feels like, to me.

If you're feeling really agitated and impulsive, I would strongly recommend you call your psychiatrist ASAP.

That.
Very well described I think. I know I'm very deep in one when actually begin to feel something crawl inside my brain. It embarassing to admit when I am perfectly happy and well sitting here eating an orange waiting for my huband to come home with my kiddos upstairs that I will try to erradicate said thing by whapping myself on the forehead over and over.
Although I always have a mixed component. The intensity of what keliza described is interesting There is a certain compulsive mix where my suicidal tendencies live. My mania swoops in and repeats to me over and over a simple, sociopathic rational voice - like a broken record that I can't get out of my head and my depression lends the feeling that it will never change, that it has always and will always be this way. It's a complete break with reality, but like I said it's not this aw shux moment like some suicidal feeling can be, but a never ending repetitive - hit you own freaking head- almost OCD. not sad, apathetic and committed.
I think I really understood I was bipolar when I got to the hospital and met a lot of unipolar depressed people. They have their own hell, but it's not mine. They felt sad. I feel sad, but it's different it's like they seemed to feel sad about things. I don't know how to describe it.


Anyway, good job describing it keliza as well as many other gems of facts. Perfect. I love that.

Fuzzy12
01-24-13, 06:07 AM
I think I really understood I was bipolar when I got to the hospital and met a lot of unipolar depressed people. They have their own hell, but it's not mine. They felt sad. I feel sad, but it's different it's like they seemed to feel sad about things. I don't know how to describe it.
.

This really struck a chord with me. I'm not always sad about things either. At times, I am and I've got a lifetime of sad events to fall back on when I want to be depressed (which I do) but at times things are going well and then suddenly BAM, I crash. it drives me crazy. I keep screaming in my head that life is good, everything is fine, there is no reason to get upset, but my brain doesn't care and there's no arguing with it. This is one of the reasons why I find it so difficult to avoid swinging back into depression. I can feel the depression coming on, but there's very little I seem to be able to do that might stop it.

sarahsweets
01-24-13, 07:35 AM
One of the many agonies of BP is feeling so sad,so low,so down when the rest of the world is all sunshine and rainbows. Its like being the last one in on the joke. Even worse is you feel guilty for being sad. How f**ked up is that?

ebullient
01-24-13, 06:33 PM
One of the many agonies of BP is feeling so sad,so low,so down when the rest of the world is all sunshine and rainbows. Its like being the last one in on the joke. Even worse is you feel guilty for being sad. How f**ked up is that?


Yeah Sarahsweets you sing my song haha. Being the last one in on the joke. No matter what mood it is, whether it's depression or mania or a weird delusional thought pattern- everyone knows it before you.

I was trying to describe to my husband when it first was happening and I was understanding that people knew I was crazy, why it was so embarrassing. Forgive me for the analogy, it's gross. It's like sh**ing yourself in public and you either not knowing right off or knowing instantly. Everyone can smell something is off, or see discoloration -haha- But everyone gets to take their little bag of crazy to this nice contained room and be completely private about it. Then when they have a break up or something that breaks them, they call in sick, eat nice things and then go to the room.

But for us, it usually starts out dancing around with crap in our pants.

Worst analogy ever. So gross. Totally described my hatred of my horrible mania ( I think I came u with it while I was manic- figures)


But yeah. there's always that moment of realization of -oh s***, I left reality again, I didn't think I did while I was doing it, and dealing with all of that.

Special-Ks
01-26-13, 04:22 PM
Hmm.... how would I describe it.

It's sort of like your mind is racing to complete a persuasive essay about why you should feel sad.

Or feeling so exhausted that you lay down, only to find that your bed seems to have an electric current running through it. On one hand you feel exhausted and want to relax, but you also have energy flowing through you and can't keep still.