Say hi if yr having mixed episode or want to share re symptoms or how to manage them

How do you recognize, then manage a mixed episode? What are yours like?
Do you adjust meds, focus on self care, cut back on anything too ambitious, hide out w Netflix , avoid.big decisions and ambitious new things? I know some of my favorite people on the forum have mixed episodes, so lets share! What specific help could we ask for from those in our lives to make this easier for them as well as us?

Well I'm mixed and unfortunately, according to the pdoc, am always mixed unless I'm at a crushing low or manic high (either state needing hospitalization). I take it day by day. My meds have been the same for quite some time, but the Seroquel dose gets adjusted if I start becoming more obviously hypomanic or the Wellbutrin if I get very low. I've definitely had to lower my expectations. I've had to accept I can't work. Sometimes I do big projects and then get overwhelmed (like organizing my office, but I started it when I was a bit hypomanic) and now don't have the energy to continue (though I am hoping once my iron anemia is corrected, that will be helped).

One thing I try to do now is set a goal of one small thing to do each day. It doesn't have to be big. Maybe paint my fingernails, organize one drawer in the kitchen picking the one I most feel I can cope with, vacuuming but just set the goal to one room, and if I do more, that's great. Sometimes it's to bake a dessert from a mix. Sometimes, I do Netflix or Amazon Prime streaming or reading, depends on my concentration level. I make new music playlists on Spotify. I play mindless, easy free games on my tablet like cross-stiching games, word search, hidden objects, paint by number, etc. Once the free stuff runs out, I either start over or find another similar free program. Often I have the TV on, usually to Investigation Discovery (maybe it's because I like to read mysteries) but mostly because most of the shows are narrated. Sometimes, the History channel or PBS. Listening (occasionally watching) these narrated shows while I do mindless tablet games is calming to me.

Self-care is good too. Stretching, bath in Epsom salts, trying to use the relaxation techniques my T has taught me.

If I could get specific help for myself it would be to have H plan the menu, buy the food, and cook half the time. That would be more work and harder for him, but it would reduce my stress so much. I try to explain to my 11 year old daughter (who knows exactly how to goad me on and push my buttons) that certain things or not doing things she knows need to be done (brushing her teeth, getting dressed, etc.) just make my mood spiral out of control. It's hard though as I don't think she completely gets it, and I haven't explained the full implications of being mixed, what it's like to her. H isn't much for psychiatrists and therapy, so he doesn't talk to my daughter about it. Personally, if I could find a friend in real life who lives in my town or neighborhood, that would be fantastic. I have no friends close by.

My mixed are always hell on earth , I’m rage-y , or break down sobbing one minute, takes everything I have to not self harm or make an exit plan.

I want to be left alone, i can’t stay in one place for long , I go to bed and pull the covers over my head but then I have to get up and pace or go outside and just yell. I own acres so no neighbors but cows. If my phone beeps or dings I wanna bash it with a hammer, I’m short tempered, a few times in the past I have even yelled at my dog when he’s just trying to comfort me.

This is when I white knuckle like hell and will take Haldol for about a week and that usually stops it. But numerous times the only way for me to stay safe has been going IP

Mixed is terrifying and the most dangerous mood state I can be in.

Thanks, Blue, that was so helpful to me in so many ways. We like some of the same TV and genres. For me the biggest challenge is to minimize stressors and decide realistically how much to take on outside the home.

Thanks Christina and Blue. For in person friends: I met my good friend whose son is bipolar on Nextdoor, a community forum they might have in your area or they let people start it in their area. You could actually post asking for someone to do a particular thing with you or your daughter, like a personalized play group, asking for someone who is available during the day. I could try asking for a regular partner for a coffee date on Nextdoor , I dont do well except one on one. As my latest mixed episode grew in intensity, I really made the effort to ask for help, set boundaries on the things that I felt unduly stressed me . This has reminded me to stop trying to just push ahead with business as usual when I have a mixed state, but instead to have a definite strategy to follow. Thanks, ladies.

Symptoms, rage, anger, frustration, lashing out, internal disgust, self liathing. To hell with everyone else.and anything else. Starting many things at once then overwhelming myself because I don't havd the energy or mental energy to finish them. Hygiene goes out the window. No showers for a fortnight, who cares. Not brush teeth for a seek, meh. Throw all the food out in ghe house because of glancing in ghd mirror, yes.


Strategies. Stay in bed whilst maintaining or trying to maintain tablet and basic hygenetakingprotect others by pulling away. Shrink my word, staying inside until I know I can go out and not wang to throttle the first person I see.TTrtinv to see the sun once, even if it's just walking to the bin. This one, walking outside has become incredibly hard arm. Trying self-love by allowing myself to feel this say for today, but resolved to try and change and up the ante tomorrow. Sleep.

As Christina said, mixed is hell. For many years I lived in a mild mixed state and had at least 3 severe episodes of it a year that would require hospitalisation. My symptoms generally are; incredible agitation, rage, irritability, intense will to die, racing thoughts, high energy, erratic, short-fused, no concentration, switching from task to task, achieving nothing, and basically feeling more overwhelmed than words can say. When it's mild to moderate coping skills like distraction, self-care, exercise, relaxation techniques, and the use of anti-psychotics help bring me down. The times it gets to severe I need to be hospitalised for my own safety. Often no amount of medication helps much so I just sit in hospital and wait it out. It gets even worse if I am also psychotic. For me, the key is to do what I must do to stay alive.

**TRIGGER WARNING**

I’m mixed frequently. There’s usually no rhyme or reason. It’s how I wake up - low but a fast brain full of dangerous ideas.
Because I worked in healthcare in my prebipolar life I know what works and what doesn’t in terms of plans. I usually can’t control being suicidal except with a med increase.

To get over a mixed episode and be safe I end up IP 99% of the time. Seroquel and Epilim are always increased temporarily.

Group hug, everybody! Thanks so much for responding. For years, I didnt write threads, only responded to other peoples posts. I was a teacher for years so sharing info came naturally. As the stress increases in my caregiving/medical advocacy for my ex, I finally decided in desperation to reach out and there you all were-the greatest —and I so appreciate you. I have learned so much from this, I do need reminders to do self care and to plan strategies. You are all so strong!

Hi luvyrself. I'm currently pretty stable, but I'm definitely prone to mixed states, especially on the manic side of them. As others said, they are particularly bad. They have been the cause of most of my hospitalizations and worst episodes with psychosis. Though I never label myself as "bipolar 1 with mixed features" because I have plenty of euphoric hypomanias and manias, and have had some significant pure depressions, very often my worst episodes always end up mixed in the end. I, too, get short-term mixed moods more often than I would like.

You listed a lot of good coping skills, as did others. I've used many that were listed. I guess my first steps are deescalation by avoiding triggers that exacerbate the episode, like staying home and trying to slow myself down. I avoid negative things, like the news and crowding/traffic. If anxiety, frustration, negativity, and anger is involved (frequently) I use CBT techniques, like challenging dysfunctional thinking (Dysfunctional Thought Records). Grounding techniques may also help. If I know I have to put myself into a triggering situation, I do preparation exercises ahead of time. When hard to control, my antipsychotic dose is manipulated. I find Seroquel XR effective for everything, including mixed states.

I dont have a pdoc, she is leaving (no loss, has made many mistakes, big ones) and turning things over to a practitioner. Gives me time to think. This week. I tried some no THC cannabis gummy bears and I sure felt better LOL. It pushed the big panic over my ex’s medical conditions aside and I was having fun for a change! The nice cannabis store is only a mile away. It’s pricey, but I deserve it, as my friend says. Before that, I always felt like I wanted to run away!

Mood checker on the PC now helps to better identify when manic and depressive symtoms co-occure. Mixed is the worse from all episodes, it's hard to manage them. I'm glad that recently I've not have many of them. Usually no med changes are made or if there are any, then more antpsychotics. It helps to think that these will pass, as any episode of bipolar comes and goes.