Your Mini-Guide to Understand Mixed Episode Bipolar Disorder

Last Update on April 1, 2024 : Published on April 1, 2024

Bipolar disorder is a serious mental health disorder that causes extreme mood swings. People living with bipolar disorder experience episodes of mania or hypomania alternating with depressive episodes. But what happens when the pendulum swings in both directions at once? This is the reality of bipolar mixed episodes. 

Today, I’m bringing you a know-all guide to understanding bipolar disorder with mixed features, its symptoms, what causes bipolar mixed episodes, and how you can find treatment for this perplexing disorder. 

Let’s get reading! 

What is Bipolar Mixed Disorder?

The mixed episode in bipolar disorder is a state wherein you experience symptoms of both mania (or hypomania) and depression simultaneously or in rapid succession. Unlike the distinct mood swings of typical bipolar disorder, mixed bipolar disorder blurs the lines, creating a confusing and often debilitating experience. 

Here’s an example; Imagine feeling on top of the world one moment, yet feeling crippled by hopelessness and fatigue the next. That’s the core of a mixed bipolar disorder. It’s a chaotic blend of emotional extremes that can be incredibly challenging to work through. 

The current diagnostic term, according to DSM-5, is “mixed features”. This specifier can be applied to both – bipolar I disorder and bipolar II disorder. 

On one hand, mixed bipolar disorder can be confused with rapid-cycling bipolar disorder. In rapid cycling, you experience four or more mood episodes within a year. However, these episodes are distinct and clear-cut with periods of normal mood in between. 

Bipolar mixed episodes, on the other hand, involve both mania and depressive symptoms within the same episodes or switching rapidly between them without a return to baseline mood. 

Symptoms of Bipolar Mixed Episodes 

The hallmark of mixed episodes is the coexistence of symptoms from both mania and depression. Here’s what symptoms of bipolar mixed episodes look like; 

Mania Symptoms; 

  • Racing thoughts 
  • Pressured speech 
  • Inflated sense of self-esteem 
  • Decreased need for sleep 
  • Poor judgment and impulsivity
  • Irritability and agitation 

Depression Symptoms; 

  • Increased sadness and emptiness
  • Loss of interest in once-enjoyable activities 
  • Changes in weight and appetite 
  • Increase in fatigue and loss of energy 
  • Feelings of worthlessness and guilt 
  • Difficulty concentrating 
  • Difficulty making decisions 
  • Recurring thoughts of death or suicide 

The specific combination of symptoms might vary from experience to experience or person to person. Some people might experience primarily manic symptoms with a dash of depression, while others might experience it in reverse. The unpredictable nature of bipolar mixed episodes adds more layers of difficulties to this condition. 

What Does a Bipolar Mixed Episode Feel Like? 

It’s a common concern; what does a bipolar mixed episode feel like? Well, imagine riding an emotional rollercoaster…blindfolded. One moment you’re exhilarated by the climb, full of energy. But then, a sharp turn throws you off, and you land in a pit of despair, feeling hopeless and drained. This is the disorienting reality of a mixed bipolar episode. 

People living with mixed bipolar often describe feeling out of control, like they are being pulled in two opposing directions. The mania can be exhausting, while the depression’s crushing weight makes it harder to live life to the fullest. 

The unpredictability of mixed episodes can cause distress. These emotional extremes can make it harder for you to plan ahead or feel safe. This uncertainty can even worsen anxiety and make it harder to cope with day-to-day stressors. 

What Causes Bipolar Mixed Episodes? 

The exact cause of bipolar mixed episodes isn’t known, but several factors are believed to contribute to this disorder. Bipolar disorder is thought to be linked to imbalances in brain chemicals like dopamine, serotonin, and norepinephrine, which regulate mood, sleep, and energy. Even genetics can play a role in contributing to bipolar disorder. 

Moreover, stressors in life can trigger mood episodes in bipolar disorder. It is also believed that certain medications such as antidepressants or stimulants can sometimes worsen bipolar symptoms or trigger mixed episodes. 

How Does Bipolar Mixed Episode Impact Well-Being?

Bipolar mixed episodes can influence almost every aspect of your life. Here’s how this disorder with mixed features might affect your well-being; 

1. Your Relationships:

The erratic mood swings and emotional volatility during mixed episodes can strain your relationships with family, friends, and even romantic partners. People with bipolar mixed features might struggle to maintain healthy communication and might withdraw from social circles because they feel a sense of shame.

2. Your Productivity & Performance:

The unpredictability of bipolar mixed episodes can make it harder to hold down a job or perform well in school. This disorder can cause trouble concentrating, fatigue, and impulsiveness – all of which can negatively impact your productivity and academic performance. 

3. Your Health:

Bipolar mixed episodes can take a toll on physical health as well. Sleep issues, changes in appetite, and risky behaviors can lead to changes in weight, malnutrition, and lower immunity. 

4. Thoughts of Suicide:

The presence of depression and mania can increase the risk of suicidal thoughts and behaviors. The combination of hopelessness, agitation, and impulsive behavior can create an impossible situation. It’s important to seek help if you or someone you know is experiencing suicidal or self-harm thoughts. 

How to Treat Bipolar Mixed Episode? 

Luckily, bipolar mixed episodes can be treated with a combination of medication and therapy. Here are some bipolar mixed episode treatment options; 

1. Mood Stabilizers 

Medications that help stabilize mood can be used as a way to treat bipolar disorder with mixed features. These medications can help regulate mood swings and prevent future episodes. 

2. Antidepressants 

Antidepressant medications can also be prescribed along with mood stabilizers to specifically target depressive symptoms during mixed episodes. However, it’s important to use these medications cautiously as they might trigger mania in bipolar disorder. 

3. Antipsychotics 

Atypical antipsychotics can also help manage psychotic symptoms that can occur during mixed episodes of bipolar disorder, such as hallucinations and delusions. 

4. Psychotherapy 

Psychotherapy plays an essential role in managing and treating bipolar disorder. Cognitive-behavioral therapy (CBT) can help you identify and replace negative thought patterns that contribute to mood swings with positive ones. Moreover, therapy can teach you coping skills to manage stress and improve communication. 

Coping Tips to Manage Bipolar Mixed Episode 

In addition to professional intervention and treatment, you can engage in self-management strategies to cope with bipolar mixed episodes. Here are some coping tips for you; 

1. Get quality sleep.

Don’t compromise on your sleep and aim to get at least 7–8 hours of quality sleep each night. Even when your mood is fluctuating, aim to get enough sleep. 

2. Develop a routine.

Try to stick to a regular schedule for your meals, exercise, and even relaxation techniques such as meditation, yoga, etc. 

3. Avoid substances.

Such as alcohol, drugs, and caffeine. Substances can worsen bipolar symptoms and make it harder for you to manage your mixed features and symptoms. 

4. Build a support system.

Surrounding yourself with supportive friends and family who understand your condition can help. Talk therapy or support groups can also offer support and a sense of belonging. 

5. Create a wellness plan.

Along with your doctor or psychiatrist, you can create a wellness plan to manage your bipolar mixed episodes symptoms. You can also include strategies for identifying warning signs of mixed episodes in the plan.

6. Take care of yourself.

Try to prioritize the activities that promote relaxation and reduce anxiety, such as yoga, outdoor therapy, or listening to music. 

7. Educate yourself about your condition.

Learning about bipolar disorder – and its types – can empower you to take charge of your well-being and mental health. 

Wrap Up…

Bipolar mixed episodes can be challenging to manage, but know that you’re not alone in this fight. With the right interventions, treatment plans, and self-help strategies, you can manage your mixed features and live a meaningful life. If you’re struggling with your bipolar disorder with mixed features, then don’t hesitate to ask for help from a professional. Know that early intervention is crucial to prevent further complications. 

For more information and help regarding bipolar mixed episodes, you can reach out to these resources; 

Remember, you’re not your diagnosis. With the right support and self-help, you can thrive and live a fulfilling life, even with bipolar disorder and its intricacies. 

Did we help with our article on understanding mixed episode bipolar disorder? Let us know your thoughts in the comments below. 

Take Care!

About The Author

Swarnakshi Sharma
Swarnakshi Sharma

Swarnakshi is a content writer at Calm sage, who believes in a healthier lifestyle for mind and body. A fighter and survivor of depression, she strives to reach and help spread awareness on ending the stigma surrounding mental health issues. A spiritual person at heart, she believes in destiny and the power of Self. She is an avid reader and writer and likes to spend her free time baking and learning about world cultures.

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