I’ve written a lot about bipolar mixed moods but not necessarily what bipolar mixed moods actually feel like. While it’s true mixed moods exist in bipolar I and bipolar II and it’s true mixed moods tend to worsen psychomotor agitation and increase the risk of suicide, this doesn’t tell you how bipolar mixed moods actually feel. This is different for everyone, but here is a window into how I experience mixed moods.
The Technical Definition of a Mixed Mood
The idea of a bipolar mixed mood is simple. It is when the symptoms of mania or hypomania appear concurrently with major depression symptoms. So you can have the vast energy of an elevated mood but the devastating sadness of a low mood at the same time. It’s generally, the worst of both worlds and it’s difficult to treat.
And because people experience hypomania/mania and depression differently, bipolar mixed moods vary in how they manifest dramatically.
My Bipolar Mixed Moods
In the Diagnostic and Statistical Manual of Mental Disorders (DSM; the manual that defines all mental illnesses) it used to be stated that mixed moods only occurred in bipolar I. In the latest edition of the DSM, however, it is written that mixed moods happen in bipolar II disorder as well (and, actually, in any affective disorder). And I can attest to the accuracy of this. I have bipolar II and I have nasty, wicked mixed moods. In fact, like a lot of people, I experience mixed moods more than I experience pure hypomania.
Mixed moods, for me, tend to happen when my medication gets out of whack. They can also appear thanks to stress. Last year, when I wrote my book, Lost Marbles, I had a bipolar mixed episode that lasted for months.
But How Do Bipolar Mixed Moods Really Feel?
When I say they are “the worst of both world,” I mean it. It’s like taking your least tolerable “up” symptoms with your least tolerable “down” symptoms, mixing them in a blender and being forced to roll around in the resulting muck. It is no wonder this state makes people want to commit suicide.
A Video on How Bipolar Mixed Moods Feel
See my explanation of how bipolar mixed moods feel for me:
I think my point here is that I can write and write about the technicalities of mixed moods and barely scratch the surface because the experience of this mood is so extreme. And a very important part of talking about any kind of bipolar specific is talking about how it affects us and not just what the doctor looks for to diagnose it.
Natasha Tracy YouTube Videos
By the way, I know I don’t do a lot of videos here. I plan on changing that, but for those of you who don’t know, I actually already do about 12 a year for HealthyPlace. Just do a good-‘ol-fashioned search on YouTube to see them.
Banner image by Flickr user: See-ming Lee.
im undiagnosed, friends say im bipolar. a few months now i’ve been worried over unemployment. im doing little about it, a classic depressive signal? im full of energy, not so mad as scattered. also my sudoko prowess is markedly lower. intellectual degradation. i think its an expression of my natural active self and no clear place to put it. hypomania feels as if it fits me.
i read how anti depressives are tested. rats are put in a tub of water with a weight. anti depressants are called effective if the rat fights drowning longer on drug than without. to me this isnt about hope and lack of depression. its about mobilizing energy to deal. i note that these drugs can cause involuntary movement-physical activity of no vonnection to ones intents, to any “mood” being experienced. is it true depressives want to get up from bed and deal with things but the energy cant be (usefully)mobilized? that certainly is how i have felt. maybe as crank old man thinks, the med failures are in our fumb thinking, our being to fast to connect behaviors with the synthetic and over divided clasdifications. gene research led one researcer to say genes and (behavior) “dont respect our classifications.” i think he hit it perfectly. behaviors are crude proxies for actual causes. drug uses are based on those crude classifications and a roll of the dice, often repeated nearly infinite times as are diagnostic “conclusions” are still the problem. someday RDoC will clarify and we can retire the dice. meanwhile please keep treading water, we all dearly appreciate and “love you , love you madly” (Duke Ellington’s words, not mine.)
I know how good it is to do videos as a blog owner because it will drive more traffic here and what not but as someone who doesn’t like watching videos, please consider having a written accompaniment to the posts. It doesn’t have to be a word for word thing of everything you said, but since I cannot watch videos (or choose not to) I still don’t know what the mixed moods feel like for you :)
Was deleted long comment.
J
Excuse past comment,
Writing w/ out my glasses(!!!)
Don’t reccommend….
Natasha,I commend you for this topic for this blog
I can see ( though many ppl write,but I know this one will be especially flooded with commments)
I hate being frustrated 90% of the time plus my Dr asks me how much has my BP effected my life?
I said honestly,it has totally ruined my life,dreams sent me to hospital 10 x
When mum & dad where alive made them worry……my younger bro ( by 12 yr seen me prob carried out
due to numerous ODS stuff he he should never should’ve witnessed….
Yet we are closest ….Im very protective of him as when mum died I was in mum role ( he was just 16)
How do you do that with BP?
Plus I never really had a chance to grieve for mum,plus in charge cook dinner while dad worked…
EVERYDAY I HEARD VOICES THOUGHT MY HEAD WOULD POP OFF MY BODY.
But I had to keep on for them……….I felt suicidal said nothing …though I’d see flashbacks of mum in her
Last stages of cancer……..then I started to blamed me if I wasn’t so sick maybe she wouldn’t she haven’t she ever got it it in first place? You know….
Theory,I just got the correct diagnosis 5 yrs ago
Ever since I began seeing therapists / psychiatrists my diagnosists was also SHIZOEFFECTVE DISORDER
Excuse grammar ( still have the flu ?
I tell people that mixed moods are what the pit of hell feels like. Mixed episodes are the place all evil people go when they die. That’s the only way I can explain it.
Good analogy Dee.
Often I feel exactly the same.
SUCKS
Take care
Yes.
I spend a lot of time in mixed episodes,my Dr says they are the most dangerous state to be in.
I totally get the energy thing,I will walk hours & hours thinking ok this will help all the extra energy &
Anger & irritability……it doesn’t ….I just get in a very bad place of frustration……
The tears out of nowhere …..oh yes….I’ve sobbed feeling what this illness has taken from me!
As hard as I’ve tried ( I truly have tried as I believe we all have) it gets worse.
Plus today non related) I’m very sick with flu so that’s fun)
My sister keeps telling me she refuses to talk or hang with me due to all my negativity”
Wonder if anyone else has had fam members with high expectations don’t get it” but say they do……..
Probably a lot I’d think)
I become extremely exhausted fighting the beast” bipolar itsucks the life out of you….well….it does me.
We’re all different.
My brother stopped talking to me and banned me from speaking to his family “until I get my shit together” after I reached out while in the hospital right after a suicide attempt. It was the first time I ever tried to tell anyone and he crushed me. It’s years later now and he expects me to just forgive him and move on. But I cannot. His actions and words cut me very deep during my lowest point. I can’t forget. But I have accepted and moved on. Now he’s angry with me because I won’t see my niece and nephew growing up. Maybe he should of have thought harder about how to reply to family who reach out for help instead of drinking away problems like he and my father have.
I have Schizoaffective Disorder Bipolar type and I have had a few mixed episodes . They are the absolute worse I would rather deal with a regular depression. For me in presents as a period of high energy and racing thoughts similar to a mania with feelings of guilt and sadness mixed in. My racing thoughts typically are about death and suicide. It is a very bad combination and like you said its not surprising that people want to commit suicide while experiencing a mixed state.
I have been in a mixed state (mania/depression/anxiety, as far as I can identify, in retrospect) and I can honestly say it was hell on earth – no pain could conceivably be worse – it was shocking and it lasted 2-3 days with little respite while I was living up north, where I knew no-one (I had just moved up there when I had this episode) and my flatmate was away on a field trip with her university.
The pain was inconceivably bad and I would not have been able to cope with it had not my dear dysfunctional christian mum stayed on the line to me on and off for most of the three days I was in that state, giving me a sympathetic human connection (in short, enough love with heal anything, as we all know). (Lifeline phone counsellors are quite good for this sort of support too, as can be other phone helplines and God is the ultimate helpline, of course).
I have ‘literally’ been to hell and back hundreds of times for hundreds, if not thousands, of hours with this disorder, and only God has gotten me through it all. I have prayed to Him for healing and for people to help me and He has done it. Thank you, Lord most high. Praise your Holy Name! :)
ps. post-mental illness, i now go to the beach and out to lunch a lot! There always is, always was, and always will be hope – even when there is no hope, there is hope. Praise God
Lithium is a life-saver for me… but now on carbamazepine cause of a blood pressure med that doesn’t mix with lithium…
I have more Mixed than i used to…. I absolutely HATE THEM..
I feel as if I could take my hands and claw my skin loose from my skeleton… all the restlessness and agitation and pent up pressure that builds, but then the want to just end it all at the same time and nothing seems worth it… yet, can’t seem to slow myself internally cause I am ramping
I am sort of in one now..
I used to describe it like when you are driving a car, you are at a stoplight but the engine runs rough when you idle… so, one foot on brake and one foot on accelerator and the car kinda jolts and jerks… got the brake on so that you don’t fly out into the intersection and you got the accelerator pressed to keep the engine running at a higher idle….
absolutely horriable
Thank you for posting this and for all of what you share on your blog and in your book. It really helps me to have a better understanding of my wife’s life with Bi-polar disorder.
I think your description of mixed episodes (or episodes with “mixed features” as is the description in the DSM-5) was excellent. You are also right that we don’t all experience them exactly the same.
I have bipolar type 1, and though the exact diagnosis codes varied depending on the type and severity of episodes I was having, most of my worst episodes usually turned into mixed episodes, mostly full blown mania w/mixed features. With the full blown mania I did not really have the fatigue you described in your video. I flat out couldn’t sleep, and felt full energy ALL of the time. Adrenaline rushes almost non-stop. It was extremely distressing because I’d have major tirades and outbursts of extreme degrees mixed with periods of elation, grandiosity, delusions of persecution, hallucinations, and all the other usual symptoms. My impulsivity was through the roof. I was not the kind of full blown manic person that could function in any way outside of the hospital for long. Very often I was dragged into isolation rooms and followed around the psychiatric ward because I was a danger to myself (mostly) and they perceived me as being a danger to others, on occasion.
Though less common for me, I did experience mixed episodes that were more depression w/mixed features. At those times I DID experience an underlying fatigue like you described. During these episodes I rarely had periods of elation mixed in. Mostly just extreme depression with psychomotor agitation, and again, irritability.
Though my worst episodes usually turn into mixed episodes, I did experience pure mania and pure depression occasionally, and when I’m at the level of hypomania, I’m almost always in an elated state with only occasions of outbursts that are not born from depression, but are just plain irritability. Actually, despite having had many full blown manias, I historically have spent more time in elated hypomania than any other state. Perhaps mild depression a close second over the course of my life. Since finding a pretty good medication cocktail, I ONLY ever experience hypomania or mild depression at the worst. That’s probably something I will have to deal with long-term, as just minor mood lability.
I think that even though the DSM-IV didn’t include mixed episodes with bipolar type 2, that a lot of psychiatrists did so anyway. I know that from conversations with different doctors I’ve met.
i’m old-fashioned in my belief that all these new flavors of manic depression are the diagnostic equivalent of “bracket creep,” eg, what happens when a diagnostic label gets popular and suddenly it seems like an epidemic. for example, look what’s happened with autism… it used to be rare, but when everyone decided it was more hopeful than other labels (mental retardation, etc) it started showing up everywhere.
if you’re taking lithium, i’m willing to believe you’re a classic bipole just like me. if you’re taking antipsychotics, you’re probably just like the people those meds were made for in the first, that is, schizo-hyphen-whatever. if you’re taking a $billion drug still on patent, your caregiver is probably getting fat stacks to give speeches in hawaii.
i know, i’m a cranky old man. in real life, i know that everyone, normies included, falls somewhere on every spectrum there is. categorical thinking is one of the most problematic traits of western thought. still, just as i would never join any club so disreputable as to have me as a member, i can’t help but look askance at all the disorders getting lumped into my exclusive club. joyous in june, desolate in december, it’s a hard way to live, but it’s the party of lincoln (and beethoven,) so you rapid cyclers and mixed-state hummingbirds should either get on the lithium bus or start your own darn club.