The cyclothymia collective

A mixed state is when symptoms of mania and depression are present at the same time, so you have the over-active brain of hypomania with symptoms of depression, a racing mind churning with negativity.

The mixed state is the most dangerous phase of Bipolar Disorder because a common feature is suicidal ideation (thinking about death/suicide). This is where the high suicide rate (said to be something like 20% for people with Bipolar Disorder compared to 1-2% for the general population) and the high rate of substance abuse (said to be more than 60% for people with BP) come in.

For me, the mixed state comes at the tail end of the cycle. First, I become hypomanic over the course of a couple of weeks). Everything is fun and interesting and I'm very productive and social. I don't realize I'm hypomanic for some time- I just think I am "the old me/the real me." My mind stays racing along, but then my mood plummets. I am irritated by noises, get angry when driving, begin to think life is stupid, that everyone is stupid, and that it is all for nothing.

This is the Mixed State. It can continue for days, or weeks. It gets very tiring, very frustrating, and it gets boring, not being able to switch out of this mood. This is where substance abuse and thoughts of life-ending come in-- what better way to get my brain to SHUT UP....I have never had actual suicidal thoughts, just vague fantasies about the relief of not having thoughts anymore. Eventually there comes the crash, a fall into depression. My mind is still, but it is painful and I spend weeks crawling out of it and pulling myself together.

I then go through a period of feeling shaken by my experience. I have just spent weeks intensely questioning everything, looking for answers, looking for relief. I must rebuild my life, from the inside out. Often I feel residual surprise, disappointment, anger, embarrassment, frustration that I go through such a cycle, that I need to see a doctor. I don't want to see anyone, I don't want to do anything. Gradually I recover, but it takes time for the memory of all that negativity to pass.

Following is a list of symptoms, arranged alphabetically, thatare often given for Bipolar disorder. To the right are my experience with how they feel to me. You may experience some of them, but not others, or you may feel them more intensely. Or not. If you can think of some I haven't listed, let me know and I'll add them. Always let your doctor know if you are experiencing
any of these feelings. Adjustments to your med regime really can reduce suffering.

Agitation
Feel like there is electricity coursing through my body at an even rate. I can't shut it off. Have to keep moving, can't settle down.

Anger
Feel like I am going to fly off the handle at the slightest little thing. This makes me paranoid that I am going to do something I will regret.

Anxiety
For no specific reason, I feel like something horrible is going to happen at any moment, even though I know perfectly well that everything is okay. I call it "Chicken Little Syndrome," this feeling of impending doom. It's like the switch in the brain that signals crises is stuck.

Appetite changes
Eating too much, or eating too little.It's like I am trying to medicate myself with food: "If
I just eat x, then this feeling will go away...."

Delusions of failure<
Am convinced that my life is a failure, that my marriage is not what it seems, that my boss is going to decide I'm incompetent, and I feel like crying because I have no friends. No evidence supports any of this. In fact, the reality is quite the opposite. I am successful and loved.

Destructive
I do things that I know are bad, like smoking and drinking. I drive a little too fast. I hurt my relationships, I tear my cuticles, I cut my hair impulsively, especially if I feel anxious.

Fatigue
From not being able to sleep, and then being too tired to sleep.

Fear<
Having a racing mind full of anger, paranoia, anxiety and self-loathing is frightening in the immediate sense (what if I lose control and say or do something that will ruin my life?), but also in the long-term sense (what if I completely lose control and end up institutionalized?).

Feeling "on edge"
For me it's like my engine is idling at too high a rate, almost like a vibration in the background, and that any minute the thing is going to shake apart.

Guilt
I feel responsible for everything, even mean comments I made thirty years ago, every failed
plan. I become filled with regret and embarrassment and replay those old scenes endlessly.

Increased libido
(but not necessarily out of positive feelings)

Impatience
This goes along with "feeling on edge", I'm hopped up, I'm ready, what the hell is wrong with
you? Can't you see the light is GREEN? Road rage figures in here.

Impulsiveness
Every February I buy clothes I never wear during a bouts of "retail therapy", and get my hair cut very short. I buy books on obscure topics to impress myself, and start creating websites I won't follow through on.

Insomnia
My brand is morning insomnia, waking up, wired at 4:30-5:00.

Irritability
Grrrr...what did you say? I know I am irritable when the street noise outside our urban house begins to really bother me. I think everyone is stupid, including myself, being civil takes nerves of steel. Road rage figures in here, too.

Melodrama
No one has EVER been depressed like I have...oh, woe is me...Small things get blown way out of proportion.

Mind racing
Manic mind stuck in a long rut of negativity, mulling over bad moments, making plans
to get out. I get so tired of this. Just SHUT UP already! It's exhausting.

Morbid ideation
Thinking about death and existence. Not necessarily about suicide, although it can be. Can be about how good it will be to pass out of this existence, how everyone in the past has died, how I will die too, how none of it is important because the worms will get us all in the end. Everybody thinks about death and existence, but not constantly, for weeks or months.

Panic
Along with the general feeling of heightened anxiety, there is a specific impulse that I must be ready to flee. Some people have all-out panic attacks with adrenaline and racing heart.

Paranoia
I feel like everybody is looking at me- in a bad way. I make little jokes to my husband about him and other women (which otherwise does not occur to me). At work I suspect office politics are going against me. For none of these is there any evidence.=Pressured speech

Pressured Speech
I feel like I must speak. I bombard my husband at the breakfast table with sociological
observations (when I know perfectly well his brain is incapable ofaccepting information until he's finished his coffee). Sometimes it's pressured, angry speech, like when I feel compelled to lecture
strangers about their bad behavior. My husband calls it a "Pandora's box" moment.

Rage
With all this negative energy coursing through my body, I feel like I am going to explode
at any little thing. Driving is a challenge: everyone is an idiot.

Weeping
Feeling anxiety, guilt, anger, panic, and fear for my mental state, I cry easily and often.

Do you have bouts of mixed state? Want to talk about it? Come over to the Forum and join the discussion.