Dr. Ankur Saraiya explains about the bipolar disorder mixed episode.
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There's a lot of confusions surrounding what a Mixed Episode is and let me start out by saying that according to the Diagnostic manual somebody who has a Mixed Episode meets criteria for both depressive symptoms of a Depressive Episode at the same time that they're having the symptoms of a Manic Episode. And it can be confusing because people can often consider depression and mania to be opposites, so it's difficult at first glance to understand how you can have both symptoms at once. But usually individuals with a Mixed Episode exhibit irritable mood and it's a combination of the negative thinking of a Depressive Episode with the increased energy of a Manic Episode. So the individuals who have a Mixed Episode are going to be irritable and pessimistic but they are still at the same time going to have what we call flight of ideas or jumping from one idea to another. And they may have what we call psycho-motor agitation where they're moving around and very active as opposed to people who have a pure depressive episode: they tend to be lethargic and slow down. But a Mixed Episode is nothing more than having the symptoms of a Depressive Episode at the same time that you have symptoms of a Manic Episode. And it's usually going to be with irritable mood. And that's basically what a Mixed Episode is.