Dysphoric mania is an older term for bipolar disorder with mixed features. Some mental health professionals who treat people using psychoanalysis may still refer to the condition by this term.

Bipolar disorder is a mental illness. An estimated 2.8 percent of people in the United States are diagnosed with this condition. It’s estimated that 40 percent of people with bipolar disorder experience mixed episodes.

People with bipolar disorder with mixed features experience episodes of mania, hypomania, and depression at the same time. This can make treatment more challenging. Keep reading to learn more about living with this condition.

People with dysphoric mania experience the same symptoms as those of bipolar disorder — the depression, mania, or hypomania (a milder form of mania) — just at the same time. People with other bipolar types experience mania or depression separately, rather than simultaneously. Experiencing both depression and mania increases the risk of extreme behavior.

People with mixed features experience two to four symptoms of mania along with at least one symptom of depression. Below are some of the common symptoms of depression and mania:

Depression symptomsMania symptoms
increased episodes of crying for no reason, or long periods of sadnessexaggerated self-confidence and mood
anxiety, irritability, agitation, anger, or worryincreased irritability and aggressive behavior
noticeable changes in sleep and appetitemay require less sleep, or may not feel tired
inability to make decisions, or extreme difficulty making a decisionimpulsive, easily distracted, and may demonstrate poor judgment
feelings of worthlessness or guiltmay demonstrate greater self-importance
no energy, or feelings of lethargyengages in reckless behavior
social isolationdelusions and hallucinations may occur
body aches and pains
thoughts of self-harm, suicide, or death

If you have mixed features, you could appear euphoric while also crying. Or your thoughts may race while you’re feeling a lack of energy.

People with dysphoric mania are at an increased risk for suicide or violence toward others. If you think someone is at immediate risk of self-harm or hurting another person:

  • Call 911 or your local emergency number.
  • Stay with the person until help arrives.
  • Remove any guns, knives, medications, or other things that may cause harm.
  • Listen, but don’t judge, argue, threaten, or yell.

If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Bipolar disorder isn’t fully understood, and no single cause has been identified. Possible causes include:

  • genetics
  • a brain chemical imbalance
  • hormonal imbalance
  • environmental factors like mental stress, history of abuse, or a significant loss

Gender doesn’t seem to play a role in determining who will be diagnosed with bipolar disorder. Men and women are diagnosed in similar numbers. Most people are diagnosed between the ages of 15 to 25 years old.

Some risk factors include:

  • use of stimulants, like nicotine or caffeine, increases the risk of mania
  • family history of bipolar disorder
  • poor sleep habits
  • poor nutritional habits
  • inactivity

If you have symptoms of mania or depression, make an appointment to see a doctor. You can start by talking to your primary care doctor or reaching out directly to a mental health specialist.

Your doctor will ask questions about your symptoms. There may also be questions about your past, like where you grew up, what your childhood was like, or about your relationships with other people.

During your appointment, your doctor may:

  • request you complete a mood questionnaire
  • ask if you have any thoughts of suicide
  • review current medications to determine if they may be causing your symptoms
  • review your health history to determine if other conditions may be causing your symptoms
  • order a blood test to check for hyperthyroidism, which may cause mania-like symptoms

Your doctor may recommend temporary hospitalization if your symptoms are severe or if you’re at risk of harming yourself or others. Medications may also help balance more severe symptoms. Other treatments may include:

  • psychotherapy on an individual or group basis
  • mood stabilizers like lithium
  • anticonvulsant medications like valproate (Depakote, Depakene, Stavzor), carbamazepine (Tegretol), and lamotrigine (Lamictal)

Additional medications that may be used include:

  • aripiprazole (Abilify)
  • asenapine (Saphris)
  • haloperidol
  • risperidone (Risperdal)
  • ziprasidone (Geodon)

Your doctor may need to combine several medications. You may also need to try different combinations before finding something that works for you. Everyone responds a little differently to medications, so your treatment plan may be different from the treatment plan of a family member or friend.

According to a study published in 2014, the best treatment for dysphoric mania is combining atypical psychotic medications with mood stabilizers. Antidepressants are typically avoided as a treatment method for people with this condition.

Bipolar disorder with mixed features is a treatable condition. If you suspect you have this condition, or another mental health condition, talk to your doctor. Mental health conditions can be managed with treatment, but you’ll need to work with a doctor.

Seeking help is an important first step in treating your condition. You should also remember that while you can manage symptoms, this is a lifelong condition. Check out some resources here.

Consider joining a support group. These groups create environments where you can share your feelings and experiences with others who have similar conditions. One such support group is the Depression and Bipolar Support Alliance (DBSA). The DBSA website has a wealth of information to help educate yourself and those around you.