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Bipolar Disorder With A Mixed Episode


Introduction

You may have heard of Bipolar Disorder with a Manic Episode or Bipolar Disorder with a Depressed Episode.  However, have you heard of Bipolar Disorder with a Mixed Episode?  This article will explore what Bipolar Disorder with a Mixed Episode is.

What Is Bipolar Disorder With A Mixed Episode?

According to www.verywell.com, the following criteria must be present for a mixed episode to occur:

Manic or Hypomanic Episode With Mixed Features

The criteria are as follows:

A. First of all, the patient has to have all the required symptoms of mania or of hypomania. In addition, at least three of these depressive symptoms must be occurring:

  1. Feeling depressed, dysphoric, sad or empty, crying or appearing tearful, feeling hopeless, etc.
  1. Losing interest or pleasure in most activities normally enjoyable.
  2. Physically slowing down to a point that others can notice it (see psychomotor retardation).
  3. Tiredness or energy loss.
  4. Feeling worthless, or feeling extremely or unreasonably guilty.
  5. Any of the following:*Recurring thoughts of death
    *Recurring suicidal ideation without a plan
    *A suicide attempt.
    *Making a specific plan to commit suicide.

B. Other people can see the mixed symptoms, and they are different from the person’s normal behavior.

C. If all criteria are met for both a manic and a depressive episode (what used to be the definition of a mixed episode), the diagnosis should be manic episode, with mixed features. The DSM-5 says this is “due to the marked impairment and clinical severity of full mania.”

D. The mixed symptoms aren’t caused by a substance, whether an abused drug, a medication (prescription or over-the-counter), a treatment, etc.

Depressive Episode With Mixed Features

A. The patient has all the required symptoms for a major depressive episode.

In addition, at least three of these seven symptoms of mania/hypomania are occurring:

The criteria are as follows:

A. First of all, the patient has to have all the required symptoms of mania or of hypomania. In addition, at least three of these depressive symptoms must be occurring:

  1. Feeling depressed, dysphoric, sad or empty, crying or appearing tearful, feeling hopeless, etc.
  1. Losing interest or pleasure in most activities normally enjoyable.
  2. Physically slowing down to a point that others can notice it (see psychomotor retardation).
  3. Tiredness or energy loss.
  4. Feeling worthless, or feeling extremely or unreasonably guilty.
  5. Any of the following:*Recurring thoughts of death
    *Recurring suicidal ideation without a plan
    *A suicide attempt.
    *Making a specific plan to commit suicide.

B. Other people can see the mixed symptoms, and they are different from the person’s normal behavior.

C. If all criteria are met for both a manic and a depressive episode (what used to be the definition of a mixed episode), the diagnosis should be manic episode, with mixed features. The DSM-5 says this is “due to the marked impairment and clinical severity of full mania.”

D. The mixed symptoms aren’t caused by a substance, whether an abused drug, a medication (prescription or over-the-counter), a treatment, etc.

Depressive Episode With Mixed Features

A. The patient has all the required symptoms for a major depressive episode.

In addition, at least three of these seven symptoms of mania/hypomania are occurring:

  1. Elevated, expansive mood.
  2. Grandiosity or inflated self-esteem.
  3. Pressured speech or increased talkativity.
  4. Racing thoughts or flight of ideas
  5. Increase in energy or goal-directed activity.
  6. Increased or excessive risky behavior.
  7. Decreased need for sleep.

B. The mixed symptoms can be observed by others and are a departure from normal behavior.

Items C. and D. are the same as above.

The DSM-5’s description of the “With Mixed Features” specifier ends with this note:

Mixed features associated with a major depressive episode have been found to be a significant risk factor for the development of bipolar I or bipolar II disorder. As a result, it is clinically useful to note the presence of this specifier for treatment planning and monitoring of response to treatment.

What Is The Treatment For Bipolar Disorder With A Mixed Episode?

According to www.verywell.com, the treatment for Bipolar Disorder with a Mixed Episode is known to be antipsychotic medication.  According to www.verywell.com, “Many atypical antipsychotic drugs are effective FDA-approved treatments for manic episodes with mixed features. These include aripiprazole (Abilify), asenapine (Saphris), olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), and ziprasidone (Geodon). Antipsychotic drugs are also sometimes used alone or in combination with mood stabilizers for preventive treatment.”

Conclusion

This article has described the criteria for Bipolar Disorder with a Mixed Episode and the treatment medication for Bipolar Disorder with a Mixed Episode.

 

Bipolar Disorder With A Mixed Episode


Lauren Walters

My name is Lauren Walters. I am currently heading into my final semester of graduate school for Mental Health Counseling in the Spring of 2016. Through my own experiences with mental illness, I love to inspire others through my writings and reassure them that they can live healthy, productive lives, despite mental illness. I hope you enjoy my articles. Feel free to comment. I will be sure to respond to you questions and/or comments in a prompt manner. Enjoy!


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APA Reference
Walters, L. (2016). Bipolar Disorder With A Mixed Episode. Psych Central. Retrieved on October 20, 2020, from https://blogs.psychcentral.com/coping-depression/2016/12/bipolar-disorder-with-a-mixed-episode/

 

Last updated: 19 Dec 2016
Statement of review: Psych Central does not review the content that appears in our blog network (blogs.psychcentral.com) prior to publication. All opinions expressed herein are exclusively those of the author alone, and do not reflect the views of the editorial staff or management of Psych Central. Published on PsychCentral.com. All rights reserved.