When many people think, discuss, or read about Bipolar Disorder, they often associate it with the ups and the downs, the highs and the lows, and the activity juxtaposed with the inactivity. Many people who live with the Disorder or are close to those who do not know that mixed episodes exist.
Yet, for many people with Bipolar Disorder, the mixed episodes are a substantial part of their struggle. People sometimes ignore mixed episodes, so in this article, information regarding mixed episodes will be broken down into common questions and answers.
What is a Mixed Episode?
First, we answer the most basic and straightforward question: What is a Mixed Episode? This definition is much simpler than you might think.
Mixed episodes are Bipolar episodes in which the symptoms and criteria of both manic and depressive episodes are present daily for at least a week.
The fifth and most current edition of the Diagnostic and Statistical Manual of Mental Disorders (used to diagnose mental health issues) uses the term “mixed features” to be applied to depression, hypomania, and mania.
This helped open up diagnosing mixed episodes by removing the restrictive criteria used in previous manual editions.
A mixed episode is not a separate disorder. It describes how Bipolar Disorder can manifest. Like mania and depression, mixed episodes have to be severe enough to cause distress or impairment in areas such as the home, friends, education, work, or some other important area of life such as the church. In addition, the Disorder is not attributable to different physical conditions, general medical conditions, or substance use such as alcohol, medication, or drugs.
Simply put, mixed episodes are complicated when a person with Bipolar Disorder’s mood changes rapidly. They show a variety of symptoms, and they are struggling with mania and depression at the same time. It can be a daunting emotional roller coaster for those involved because the symptoms are vast and varied and can be damaging.
The best, and the only way, to describe mixed episodes are to list the symptoms of mania and depression. To be diagnosed with mania or depression, a person needs several symptoms lasting over several days. For a mixed episode, many symptoms of both must be present.
Mania symptoms include:
- Elevated, expansive, or irritable mood.
- Increased energy and agitation.
- Lessened need for sleep. Energy levels stay similar or are raised despite the lack of sleep in mania.
- Forced speech. (Not being able to stop talking.)
- Uncontrollable, racing thoughts.
- Unable to focus.
- Impulsivity
Depression symptoms include:
- Depressed mood. This can be defined as a general sadness or emptiness.
- This is a loss of interest and pleasure from previously enjoyable activities.
- Weight loss. This does not include deliberate weight loss.
- Sleep problems. This can consist of insomnia and hypersomnia.
- Loss of energy.
- Loss of concentration.
- Suicidal thoughts.
When these symptoms overlap enough, someone with Bipolar can have mixed episodes. Mixed episodes come with their issues, such as being tiring, emotionally confusing, and difficulty stabilizing their mood.
Furthermore, if these symptoms feel familiar, you can always take a diagnostic test at Mind Diagnostics. If both signs connect with you, a mixed episode is possible. Here’s a link to visit: https://www.mind-diagnostics.org/bipolar_disorder-test.
How Long Do Bipolar Episodes Last?
This question has no good answer because it depends on each situation. It could last anywhere from days to weeks to months. It depends on several tours, such as the severity, the medical treatment, and the actions of the person with Bipolar Disorder.
To officially diagnose mania, a particular set of symptoms must be established for one week (or the patient is severely manic and hospitalized within a few days). To officially diagnose depression under the DSM-5, severe symptoms must be present for two weeks. To formally diagnose a mixed episode, significant signs of both mania and depression must be present for a week.
There is no telling how long a mixed episode could last. With exacerbating conditions and without pursuing treatment, a mixed episode could go on for a long time. The most important thing is to seek help from a medical professional; you will be better off and on your way to a sound recovery. Even when the episode is treatment-resistant, there is still reason to hope.
How Difficult are Mixed Episodes?
There is no good answer to this question. Suffice it to say mixed episodes can be challenging. However, there is no way of telling whether a mixed episode will be worse than a depressive or manic episode.
Bipolar Disorder is a challenging condition to live with. Mixed, manic, or depressed episodes can be brutal and even dangerous over time. This is why it is crucial to seek help.
Who Gets Mixed Episodes?
It is estimated that around 2.6% of people have Bipolar Disorder. Any of those millions of people can have a mixed episode because mixed episodes are common manifestations of Bipolar Disorder. Bipolar Disorder typically starts in the late teens or mid-20s. It is uncommon first to manifest itself after the age of 50.
What are the Risks of Mixed Episodes?
The risks of mixed episodes are substantially high. They are similar to the dangers of depressive and manic episodes; mixed episodes combine the risk factors. With mixed episodes, someone may miss work by sleeping through their alarm, which would be a depressive episode, and later in the day, they may go on an online spending spree, which would be a symptom of mania/hypomania.
There is a controversial discussion regarding suicide and mixed episodes. An article published by the National Institute of Health found no evidence of increased risk for hybrid attacks over depressive or manic episodes. Yet, a competing paper found the risk doubled in adolescents for mixed episodes over depressive episodes. Suicide was 5.67 times higher than manic/hypomanic episodes in mixed episodes in adolescents.
There is no consensus on the link between suicide and mixed episodes. Still, there is enough controversy over the danger that people with Bipolar Disorder and their loved ones should be aware of its risk factors. If you have been experiencing any thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255. The Lifeline is available 24 hours a day, seven days a week.
How Do I Get Out of a Mixed Episode?
A mixed state is dangerous, as was previously mentioned. It must be a top priority to stabilize a person with mixed Bipolar Disorder immediately.
A doctor needs to be involved in stabilizing a full-blown mixed-state patient. Some of the most common medications include atypical antipsychotics and different mood stabilizers. With medication compliance, a less stressful environment, and self-care, a person with Bipolar in a mixed state can more quickly stabilize.
How Do I Avoid Mixed Episodes in the Future?
People who deal with mixed episodes need to know how to prevent them. People with Bipolar Disorder need to work with a doctor, watch out for stress and other triggers, and practice self-care, which can come from therapists, friends, entertainment, exercise, diet, and other healthy habits.
Conclusion
Mixed episodes are one of the least understood aspects of Bipolar Disorder. Since they are extremely risky, patients, doctors, and loved ones need to be aware of this combination of up and down. They are comparable to hypo/manic and depressive episodes relative to treatment and lifestyle. With the right tools and commitment to treatment, it is possible to enjoy a healthy, fulfilling lifestyle while on the bipolar spectrum.
