I can relate. I can cite the last time I had felt a “mixed state.” Last summer. I don’t get it often but I brought up “mixed state” when describing it to both my therapist and psychiatrist. I think the pdoc was concerned and wanted to switch around my meds (which I always have troubles with med changes which is why I haven’t changed mine in years.). But my therapist and I really dove into many layers of practical realities I wanted to discuss in depth.

For me, mixed state comes from something (memory?) that is totally bottled up inside with nowhere to go. I try and try to avoid it but it bubbles and brews to the surface, and in a physical manifestation, it becomes apparent in my moods and emotional states. I wake up with energy and gusto, then crash into a teary depressive state hours later, unable to pinpoint what it is. Then the next night may be accompanied by trouble sleeping, and so I work to focus on schedule and basic needs. I used therapy to unload, I had a short car travel vacation planned and because of this unpredictability I wanted to stay home and just curl up in a fetal position and hide. But I went through with it and it eventually passed.

I think bottled up truths hold the key for me so its a combination of things that connect the dots for me. The deep dive In therapy helps. There isnt a magic cure or solution of words to solve the issues, but sharing a problem and unloading it already helps just in the act of doing so. Processing emotion is important for my continued recovery. Managing my sleep with my pdoc and managing med regimes work alongside that. That is my experience.

Hope you get to feeling good soon. Try not to think of these mixed states as feeling as less than a whole person, maybe, but instead see the breaks as a sign of strength to push forward to articulate the things that will continue to help move forward - if that helps. Or if it doesn’t help, and you feel it’s entirely medication-related, then work closely with your pdoc to create a new med cocktail solution. Sometimes that may be all that’s needed. Best wishes.

Being BP2 I'm not supposed to have "mixed state" but my psychiatrist muttered it after once when I turned up for my appointment in a generally aggressively agitated state. Very impatient, very speedy, very arrogant and generally a danger to myself and others. Pretty much unaware of how far I'd gone until he made the call for an anti-psychotic about 10 minutes into the appointment.

I totally relate to this. It is very exhausting and confusing. I am sorry you are struggling.

thanks everyone for your input. SHL that detail you provided is extremely helpful. I can really see how it is from your perspective and that is what I'm looking for. I think there is something inside triggering this that I need to deal with, but my therapist is not doing in-person at the moment with the Delta thing, and I just don't like Zoom style sessions at all. I need to get back to in-person a.s.a.p. so I can get some things out.

Fish, I know exactly what you're talking about. That's very similar to what happened the day my pdoc finally saw that I was bipolar. I wasn't aggressive or dangerous necessarily, but I was very agitated, hyper, and super impatient, Nothing like I had ever presented to anyone before. For once, I was clearly manic and not hiding it and she said "you're manic right now." I'll never, ever forget that moment. It literally changed my life.

I think part of my confusion right now is that I'm not popping out of bed each morning and I'm waking up a little late even still feeling like I could sleep a few more hours. That's not like me so I can't figure out what's going on there.

I'm afraid that if I tried to find a pinpoint moment to look back on and sort thru issues that have developed from it, I would end up looking at somethin akin to a map of the United States with push-pins marking the location of every McDonalds. :O

No doctor or therapist I've seen has really delved into, either. Most likely my fault there. I don't attend appointments often or regularly.

What ypu have described, though, sounds pretty spot on and seems to have the general consensus all around.

After reading the Verywellmind.com page on bipolar mixed state that Suncloud was kind enough to provide on another thread (thanks!), I am not sure if I actually meet that official criteria. If I did, it would be the depression with mixed features of mania in a predominantly depressed state. It comes and goes, but I don't know if I experience the minimum of 3 symptoms of mania.
It's kind of like I'm more depressed overall, sleeping a lot more, generally down and hard on myself, etc., but can get amped up at times during the day where I'm overly talkative, more positive than earlier, and I can still get things done. Actually, at those times I feel more in the normal range than hypomanic or manic. That's not how I usually am when I'm depressed. Maybe I'm just near baseline but just little depressed. It's the sleeping thing that has me most confused. When I'm near baseline or higher, I always pop out of bed in the morning. I'm not doing that right now and that's very unusual for me unless I"m deeply depressed.
I'm so confused.


https://www.verywellmind.com/bipolar-disorder-mixed-features-380387#:~:text=Bipolar%20disorder%20with%20mixed%20features%20is%20a%20term,symptoms%20or%20a%20depressive%20state%20with%20manic%20symptoms.

Please take good care of yourself as you process. Try your best to get a good night’s rest. And keep an open line with your pdoc and therapist as you sort. I think almost everyone here has been through difficult days and know that it gets better.

Take some deep breaths. I have anxiety as well and breathing exercises help.

Keep an eye open in regard to the mania aspect. It's weird because you may be feeling like "Wow. Things are going pretty okay" and that you are having what other people have on their "Just another normal day" days, right? And you kinda feel pretty happy because, Hey! Your getting a little bit of time where you feel like an actual human! Awesome! So you're kinda diggin' it, cuz it's kinda rare. I say roll with those moments, for sure!

I think, though - no medical basis, just personal experience and feedback from others - that though it feels a lot like enjoying some normal, outwardly people can see a bigger difference (and during some episodes you can, too - those you are a certain of having mania lol). With the good, euphoric mania you can appear more animated and engaged, more interested or enthusiastic or passionate about this or that than you usually would and not realize it . You just don't always really see how much of a difference in your demeanor the mania can make (good or bad). You know your feelings and how they feel to you so that's kind of the standard you hold to for human emotions in general. However, and though we have the same emotions everyone else could have, I think the depth with which we are able to experience them may be incrementally deeper - and that is OUR normal. We have big feels. :)

How is your temperament DO??.... I found when in a mixed state I got easily agitated

My temperament is actually very good, thanks. But then again, I'm keeping myself at 1200 mg of the Trileptal first thing in the morning and another 1200 in the afternoon. It works really great to keep a cap on the mania. But the flip side is it puts the brakes on my drive to work out big time. I was just getting into a good groove with that and lost my momentum about 2 weeks ago. At 47, the momentum is crucial to success. The price of stability I guess.

passing4sane (great handle btw), what you described was me from early July to about mid-August when a med switch kicked off a rather nice episode of hypomania. It never really went manic and it had a good amount of borderline euphoria, which I hadn't felt in a long, long time. Was talking about it with my wife just the other day and she said "It was starting to be a little much, actually." (lol) But of course I did not see it that way. To me it was a joy just to be not-depressed and not-manic and I wanted to express that, maybe too much. It didn't feel like pressured speech to me. But then it rarely does to us, right?

Interestingly, it was showing up in my posts here. They were all very long. And they kind of are right now so am I hypomanic again? Maybe I'm manic with depressed features? Just like before, I am kind of talking/typing a lot and do sense it's probably pressured whether I want to actually admit it to myself officially or not. Honestly, part of that right now is that you all are some very wise people and I'm having a very interesting discussion with you here. And now I'm rambling again, but I just wanted to make sure I at least got that out.

Yeah, I'm in the hypomanic neighborhood again. For sure. It must be the Trileptal making me sleep more that's confusing me.