Mixed states

Mixed states occur when a person with bipolar disorder suffers from both depression and mania at the same time. It is a very volatile and dangerous situation to find yourself in. For example, you might feel suicidal and an energised depression might make you more likely to go through with it. 

I have had many mixed states. On one occasion I was upset at work because someone was writing notes about me on the toilet walls. I was so upset after this i ran out of the store shouting at my boss. Without doubt it was a mixed state. It didn’t help that the night before I did some heavy drinking. Alcohol is sometimes a trigger for mixed states.

I had taken my client who had chronic cerebral palsy to the London Paralympic closing ceremony in 2012. It was too much for me. When we got home I just started shouting to my boss down the phone. I thought someone had made it look like I had stolen some money, or they had planted money to look like I had stolen it. Also I thought someone had criticised the colour of my yellow car, and I was adamant that someone had been tampering with his hoist equipment. I was really tearful and kept shouting which is a symptom of mixed states.

In a mixed state you can feel out of control, angry, upset, energetic yet depressed, scared, have terrible insomnia, suicidal, impulsivity, terrible risk taking and racing thoughts…

Treatment

Typical treatments for mixed states are atypical antipsychotics such as Olanzapine or Quetiapine. If you are already taking an antipsychotic your doctor or psychiatrist may increase your dose. Anti-depressants may not be a wise choice for you as they can make a person display volatile behaviour. You may not know there is anything wrong with you. Take care of yourself..