What is Mixed Bipolar Disorder

Mixed bipolar disorder is a mental health disorder in which a person has episodes of emotional highs (mania), lows (depression), or both of these feelings at the same time.

People with this disorder have very big mood changes (mood swings) that happen quickly on a regular basis. These episodes may be severe enough to cause problems with relationships, school, or work. In some cases, they can cause the person to be unsafe, and the person may need to be hospitalized.

What are the causes?

The cause of this condition is not known.

What increases the risk?

The following factors may make you more likely to develop this condition:

• Having a family history of the disorder.
• Abusing substances such as alcohol or drugs.
• Having an anxiety disorder.
• Having another illness, such as heart disease or thyroid disease.

What are the signs or symptoms?

Symptoms of this condition include having episodes of mania, depression, and sometimes symptoms of both at the same time. For instance, you may feel sad and full of energy at the same time. You may have mood swings almost every day.

Symptoms of mania may include:

• Very high self-esteem or self-confidence.
• Being unusually talkative, or feeling a need to keep talking. Speech may be very fast. It may seem like you cannot stop talking.
• Racing thoughts or constant talking, with quick shifts between topics that may or may not be related (flight of ideas).
• Decreased ability to focus or concentrate.
• Increased purposeful activity, such as work, study, or social activity.
• Increased nonproductive activity. This could be pacing, squirming and fidgeting, or finger and toe tapping.
• Impulsive behavior and poor judgment. This may result in high-risk activities, such as having unprotected sex or spending a lot of money.

Symptoms of depression may include:

• Feeling sad, hopeless, or helpless.
• Lack of feeling or caring about anything.
• Not being able to enjoy things that you used to enjoy.
• Trouble concentrating or remembering.
• Trouble making decisions.
• Thoughts of death, or desire to harm yourself.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms and medical history. Your health care provider will ask about your emotional episodes.
• A physical exam. This is done to rule out any health problems that may be causing symptoms. Your health care provider will also ask about your alcohol and drug use.

How is this treated?

Bipolar disorder is a long-term (chronic) illness. It is best controlled with treatment that is given on an ongoing basis, rather than only when symptoms are present. Treatment may include:

• Medicine. Medicine can be prescribed by a provider who specializes in treating mental disorders (psychiatrist).
  • Medicines called mood stabilizers, antipsychotics, or antidepressants may be prescribed.
  • If symptoms occur even while one type of medicine is taken, other medicines may be added.
• Psychotherapy. Some forms of talk therapy, such as cognitive behavioral therapy (CBT), can provide support, education, and guidance.
• Coping methods, such as journaling or relaxation exercises. These may include:
  • Yoga.
  • Meditation.
  • Deep breathing.
• Lifestyle changes, such as:
  • Limiting alcohol and drug use.
  • Exercising regularly.
  • Getting plenty of sleep.
  • Making healthy eating choices.

A combination of medicine, talk therapy, and coping methods is best. In severe cases, if other treatments do not work, a procedure may be used to change the brain chemicals that send messages between brain cells (neurotransmitters). This procedure, called electroconvulsive therapy (ECT), applies short electrical pulses to the brain through the scalp.

Follow these instructions at home:

Activity

• Return to your normal activities as told by your health care provider.
• Find activities that you enjoy, and make time to do them.
• Exercise regularly as told by your health care provider.

Lifestyle

• Follow a set schedule for eating and sleeping.
• Eat a balanced diet that includes fresh fruits and vegetables, whole grains, low-fat dairy products, and lean meats.
• Get 7–8 or more hours of sleep each night.
• Do not drink alcohol or use illegal drugs.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Think about joining a support group. Your health care provider may be able to recommend a group for you.
• Talk with your family and loved ones about your treatment goals and about how they can help.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your symptoms get worse.
• You have side effects from your medicine.
• You have trouble sleeping.
• You have trouble doing daily activities.
• You feel unsafe in your surroundings.
• You are dealing with substance abuse.

Get help right away if:

• You think about hurting yourself or you try to hurt yourself.
• You think about suicide.

You can go to your nearest emergency department or call:

• Your local emergency services (911 in the U.S.).
• A suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255. This is open 24 hours a day.

Summary

• Mixed bipolar disorder is a mental health disorder in which a person has episodes of emotional highs (mania), lows (depression), or both of these feelings at the same time.
• Bipolar disorder is a long-term (chronic) illness. It is best controlled with treatment that is given on an ongoing basis, rather than only when symptoms are present.
• A combination of medicine, talk therapy, and coping methods is best for treating this condition.