What is Mixed Mania and How Do We Treat It?

What is Mixed Mania and How Do We Treat It? The official term for mixed mania is bipolar disorder either 1 or 2 with mixed features. With bipolar 1 disorder, you have episodes of depression and episodes of mania. With bipolar 2, you have depression and episodes of hypomania.

Mixed features means you have a combination of depression symptoms and hypomanic symptoms occurring at the same time. Mixed mania is harder to treat than bipolar disorder without mixed features. In this video I discuss some of the treatment options including electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS).

Disclaimer: All of the information on this channel is for educational purposes and not intended to be specific/personal medical advice from me to you. Watching the videos or getting answers to comments/question, does not establish a doctor-patient relationship. If you have your own doctor, perhaps these videos can help prepare you for your discussion with your doctor.

[veerlon]

"If you don't want miss an episode.."

[joyjones]

I thought mania looked like: shopping sprees, sex sprees, no sleep, lots of energy and happiness. But it can also present as pure anger and irritability. Thank you!

[basakaybasakay]

“Hyped up sad negative person” i couldn’t express it like this before watching this video. Thank you, you made me realise im going through this episode and it’s time to get some help. I sincerely thank you from the bottom of my heart

[aroundtheworldgirl]

Mixed episodes are hell. A mixed state is what sent me to the hospital. Before that I was manic for about a month towards the end I went into psychosis. I thought I was crazy and then I went into a mixed episode. I have never feared myself as much as I scared myself during a mixed episode. My mind raced with horrible thoughts, depersonalized, saw demons, and in the end I tried to commit suicide because I felt the shell that I was living in didn't matter to me and was foreign. I wouldn't wish mixed episodes on anyone. Mania; I like, Depression; I can live with, but Mixed? Pure hell.

[GreenAndTheToe]

Mixed episodes are the WORST thing I have experiencing. You have strong anger, sudden anxiety and sadness. When you are depressed, all you can do is lay down but in mixed episodes, you have the ability to take your own life. I rather be depressed than being in a mixed episode like right now.

[gingerg]

I wish you were my doctor 👩‍⚕️.. So insightful..

[NickRyanBayon]

I went from hypomanis to mixed now, i honestly feel exhausted of this condition. I can't even stand looking at myself in the mirror anymore.

[confusinglyquestionable]

Psychiatrists don't talk to patients or about their diagnosis in my country, so no one has ever told me that i can be manic and depressive at the same time which made me question my diagnosis in the first place. Thanks you for yet again an amazing video♡

[luvforgs]

the "bipolar has ruined my future and ruined me" hit so hard I actually broke down

[donnahamilton]

This description brings back memories. I had a very severe mixed episode with mania and depression in 2005, and continued to struggle with my bipolar disorder for years afterward. I was hospitalized three times in three years for it. But there truly is hope for anyone dealing with this illness. Because I've not had a manic or severe depressed episode in a very long time. With faith in God, solid medical treatment, supportive people in my life, a good licensed counselor... Bipolar disorder doesn't have to ruin your life, although it is a force to be reckoned with.

[sallyjones]

I am struggling so hard to be “high functioning” but the entire 2020 year was a humongous trigger.

[leafyveins]

I am not a mental health trainer. I cannot advise you on what is best for YOU. This is just what has worked effectively and in a lasting way for me.

Things that have helped me cope with hypomania:
1. Drinking plenty of water to the point where I generally dont experience extreme thirst or dehydration at all anymore.

2. Preventing hypomanic episodes in the first place by having a plan in place for when I recognize an episode building.

3. Neutral affirmations. Example: "I feel very up and high right now, and that is caused by a chemical process in my brain." Or, "It feels like a good idea to move to Virginia with no plan, but what if I, instead, planned a camping trip there? It's not the immediate adrenaline hit my brain is craving, but it's an outlet for it." (I have to be in a stable or baseline base to be able to come up with an array of mental phrases I use to slow down the mania/hypomania/mixed mania.)

4. Yoga, slow stretching for at least 15 minutes, and walking slowly. These are methodical and flowing exercises. They are also not fast-paced, which for me can really ramp up my hypomania/mania/mixed mania.

5. Recognizing what "parts" of me I choose to define myself with. Figuring out what I like and not just what mania/hypomania/mixed mania "tells" me I like.

6. Eating a healthy diet. With lots of fruits and vegetables. And probiotics to help with stomach issues caused by the anxiety/mania. And fish oil with omega-3's to help with the rage. Not eating processed sugar (this is a really hard one for me but an enormous help with the insomnia.) I drink tea instead of coffee and then switch to herbal tea/water/hot cocoa/homemade lemonade after 3:30PM.

7. Routine, Routine, Routine. I'm 28 and just now accepting this one. But it's been one of the most important parts about keeping myself feeling balanced.

Things That Have Helped Me with Depressive Epsiodes:

1. Setting 5 alarms with very gentle, nice music to wake me up at the same time every day.

2. Starting my day with tea (no enormous, debilitating crash like after coffee.) I still like coffee every once a blue moon. It just hurts my stomach.

3. Letting and allowing myself to be slow-moving and slower to wake up than when I was manic. Reminding myself that it feels even slower than what is actually reality, because of the contrast of the two episodes. And that's okay.

4. Singing my favorite songs even when my voice comes out in a monotone and the colors look grey. I'll cry-sing in the shower, in my room, in the kitchen. Anything to keep my voice going.

5. Medication. Talk to your doctor. If you don't have a doctor, gets doctor if you can. If you can't, make it a priority to try to see someone if you feel that is something you need.

6. Therapy, therapy, therapy. Talk therapy! Cognitive behavioral therapy! Any kind of mental health therapy! Make sure you give the person a chance, don't expect immediate results, and don't miss your appointments. Forgive yourself when or if you do miss one, and explain to them the REAL reason why you couldn't pick up the phone. You gotta be honest for therapy to be as effective as possible.

7. I know everybody hates this one, but forcing myself to do things when all I want to do is let sleep embrace me and give me an escape. I always feel worse after I take a depression nap. If I drink some extra tea and drag my body to do something, anything, wash my face, brush my teeth, it doesn't matter how long it takes. I always feel a tiny, tiny bit better afterwards. And then it makes it easier to keep on doing things.

8. Calmly and rationally (or sometimes, admittedly, not so calmly-which doesn't work as well) debating, reframing every single depressed thought I have. Asking it what it's intention with me is. Protecting myself from the harm they cause me.

[polarpalmwv]

I am starting to believe, at 48 years old, that THIS is what I have experienced almost continually since my earliest memories at age 4. The information from this video honestly frightens the heck out of me and I am glad that I am discussing this with my psychiatrist in a few days.

[lorieprice]

12 yrs on and i still have memory problems from ECT, i suggest intense research before allowing your brain to be fried. i was lead to belief side affects would be minimal and temporary. i'm my case they were not. there is verifiable research that proves there can be permanent damage.

[sarahlynch]

Currently in a mixed mania state. Feeling empty and depressed but so much energy and motivation to frantically search for things to make me feel happy.

[ellieclaire]

It’s hard to tell the difference in me between having a mixed episode or just having a depressive episode with irritability and extreme anger and needing to move around and full of nervous energy, and this being caused by a different comorbid disorder causing these symptoms like BPD or ADHD. Hopefully when I finally get to see a doctor they might consider that. I miss mania and feeling good, or even depression which I can control. I just feel this intensity but I don’t know in what emotion, and this need to move and racing thoughts

[masastefan]

Just got my meds adjusted for my first manic episode of the year, some of it thanks to you for helping me and educating me so I can identify my symptoms early on. It's the first time I catch it myself, thought it was never going to be possible and it always ruins my life in some way, but not this time. I'm grateful 💜

[topknotsdoubleshots]

Thank you so much for making these videos. After being diagnosed with Bipolar I disorder over 20 years ago, it’s been a long road to get to where I am today. I definitely feel heard watching your videos 😊

[tomcleverley]

Thanks again for your time and helpful information. Please anyone who believes that BP has ruined your life, continue to work with your Doctors and your loved ones to get better. GOD and your family love you and you can live well even with BP. I know how difficult it seems at times but it's possible to have a good life with BP in this day / age that we're living in now. GOD BLESS to all

[chocolatecurlsandswirls]

Thank you, I was diagnosed today with mixed episodes, I have Bipolar and it’s been very rough. Your explanation was on point! It has been suggested several times to try ECT to be better treated, today you’ve helped me understand why.