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What are the symptoms of a mixed features bipolar episode?

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Mixed episodes are when symptoms of mania and depression happen at the same time or right after each other with no break in between.

Mania with mixed features usually involves irritability, high energy, racing thoughts and speech, and overactivity or agitation.

Depression during mixed episodes involves the same symptoms as regular depression -- feelings of sadness, loss of interest in activities, low energy, feelings of guilt and worthlessness, and thoughts of suicide.

This may seem impossible. How can someone be manic and depressed at the same time? The high energy of mania with the despair of depression are not mutually exclusive symptoms, and their co-occurrence may be much more common than people realize.

For example, a person in an episode with mixed features could be crying uncontrollably while announcing they have never felt better in their life. Or they could be exuberantly happy, only to suddenly collapse in misery. A short while later they might suddenly return to an ecstatic state.

Mood episodes with mixed features can last from days to weeks or sometimes months if untreated. They may recur ,and recovery can be slower than during episodes of "pure" bipolar depression or "pure" mania or hypomania.

SOURCES: National Institute of Mental Health web site, "Bipolar Disorder." Benazzi, F. March 17, 2007. Mick, E. 2003. McElroy, S. January 1997. McElroy, S. December 1992. Medical News Today: "Study Identifies Predictors of Bipolar Disorder Risk." WebMD Medical Reference from Healthwise: "Bipolar Disorder: What Increases Your Risk." Moore, D. and Jefferson, J. , Mosby, 2004. Goodwin, F. Sept. 17, 2003. Conway, K. February 2006. Medscape Psychiatry & Mental Health: "Substance Abuse and Bipolar Disorder."










Lancet,Journal of Child and Adolescent Psychopharmacology,American Journal of Psychiatry,American Journal of Psychiatry,Handbook of Medical PsychiatryThe Journal of the American Medical Association,Journal of Clinical Psychiatry,

Reviewed by Smitha Bhandari on June 20, 2019

SOURCES: National Institute of Mental Health web site, "Bipolar Disorder." Benazzi, F. March 17, 2007. Mick, E. 2003. McElroy, S. January 1997. McElroy, S. December 1992. Medical News Today: "Study Identifies Predictors of Bipolar Disorder Risk." WebMD Medical Reference from Healthwise: "Bipolar Disorder: What Increases Your Risk." Moore, D. and Jefferson, J. , Mosby, 2004. Goodwin, F. Sept. 17, 2003. Conway, K. February 2006. Medscape Psychiatry & Mental Health: "Substance Abuse and Bipolar Disorder."










Lancet,Journal of Child and Adolescent Psychopharmacology,American Journal of Psychiatry,American Journal of Psychiatry,Handbook of Medical PsychiatryThe Journal of the American Medical Association,Journal of Clinical Psychiatry,

Reviewed by Smitha Bhandari on June 20, 2019

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What are the risks of mixed features during mood episodes of bipolar disorder?

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