Mixed Moods in Bipolar Disorder and Depression in the DSM-V

Posted by Natasha Tracy | Aug 16, 2011

The Diagnostic and Statistical Manual of Mental Disorders (DSM), the manual that defines all mental illness in the US, is being revised and a new version is due out in 2013. One of the proposed changes to the DSM is to the diagnosis of mixed moods. This change is being proposed by a mood disorders workgroup. It aims to reflect clinical practice where doctors already refer to a “mixed” mood that doesn’t officially meet the DSM criteria. (As I noted, mixed moods are only technically recognized in bipolar type 1.)

Changes to the mixed mood diagnosis will help people with bipolar 1, bipolar 2 and unipolar depression get better treatment.

Mixed Bipolar Disorder – Mixed Mood Episodes in Bipolar 2

Posted by Natasha Tracy | Aug 10, 2011

As I mentioned, mixed moods are technically considered part of the manic phase of bipolar disorder and thus, by definition, are only a part of bipolar disorder type 1. However, those of us with bipolar type 2 can tell you we mix it up with the best of them.

So, in part II of this series on mixed moods in bipolar disorder, I look at mixed moods in bipolar type II.

Mixed Moods in Bipolar Type II

Now that we’ve wandered into Diagnostic and Statistical Manual (DSM)-free territory, definitions on mixed states get a bit looser.

Mixed mood states may be, in fact, the most common way of experiencing bipolar type II. I find most people have a hard time distinctly separating “depression” from “hypomania” from “normal” moods. There is just too much crossover.

Two Types of Mixed Moods in Bipolar Disorder

Additionally, considering mixed moods to be part of the manic phase of bipolar disorder becomes useless when looking at bipolar II. As an article in Psychiatric Times suggests, there are really two types of mixed moods in bipolar disorder:

Mixed mood with depression as the primary mood (meeting the criteria for depression with some hypomania symptoms present)
Mixed mood with hypomania as the primary mood (meeting the criteria for hypomania with some depression symptoms present)

Those two mood types better reflect my own experience and I think the clinical experience of other patients and doctors.

Bipolar, Hypomania, Depression and Looking Crazy

Posted by Natasha Tracy | Jan 10, 2011

I can feel the post-depression-bounce-back hypomania beginning in my brain; not in my body, only in my brain. Hypomanic symptoms started yesterday evening. Things started seeming clear, perhaps just a little too clear, and certainly a little too fast. Bipolar fast. Gospel music (yes, oddly) played in my head intermittently while I guided an old tourist couple to the park, I drafted my upcoming novel, planned a conversation, and I investigated the fallen tree branch in the middle of the baseball field. Rapid fire thoughts, hypomanic thoughts, took over.

Hypomanic Morning Means A Devastating Afternoon

Posted by Natasha Tracy | Aug 25, 2010

This is not of the quality you typically find here. Sorry.

I knew I was hypomanic because yesterday I couldn’t sleep.

Not sleeping. Waking multiple times during the night. That’s hypomania.

I’m sleeping too little, eating too little, producing too much and feeling too OK; that’s hypomania. It makes you brilliant and insightful and creative and magical. It also makes me completely fucked up.