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In the context of mental illness, a mixed state (also known as dysphoric mania, agitated
depression, or a mixed episode) is a condition during which symptoms of bipolar, mania and
depression occur simultaneously (e.g., agitation, anxiety, fatigue, guilt, impulsiveness,
irritability, morbid or suicidal ideation, panic, paranoia, pressured speech and rage).
Typical examples include tearfulness during a manic episode or racing thoughts during a
depressive episode. One may also feel incredibly frustrated in this state, since one may feel like
a failure and at the same time have a flight of ideas.
Signs and symptoms of mania (or a manic episode)
include:
- Increased energy, activity, and restlessness
- Excessively “high,” overly good, euphoric mood
- Extreme irritability
- Racing thoughts and talking very fast, jumping from one idea to another
- Distractibility, can’t concentrate well
- Little sleep needed
- Unrealistic beliefs in one’s abilities and powers
- Poor judgment
- Spending sprees
- A lasting period of behavior that is different from usual
- Increased sexual drive
- Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
- Provocative, intrusive, or aggressive behavior
- Denial that anything is wrong
Mixed states can be the most dangerous period of mood disorders, during which substance abuse,
panic disorder, suicide attempts, and other complications increase greatly.
A dysphoric mania consists of a manic episode with depressive symptoms. Increased energy and
some form of anger, from irritability to full blown rage, are the most common symptoms (MMDT).
Symptoms may also include auditory hallucinations, confusion, insomnia, persecutory delusions,
racing thoughts, restlessness, and suicidal ideation. Alcohol, drug abuse, and some antidepressant
drugs may trigger dysphoric mania in susceptible individuals.
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