What happens during a mixed episode in bipolar disorder?

The Diagnostic and Statistical Manual of Mental Disorders (DSM) defines a mixed episode in bipolar disorder as a period of at least one week during which the criteria for both a manic episode and a major depressive episode are met. Here, a person experiences rapidly changing moods such as sadness, anger, and extreme happiness, accompanied by the previously listed symptoms of a manic episode and a major depressive episode. The symptoms experienced in a mixed episode often include agitation, irregular appetite, insomnia, psychotic symptoms, and suicidal thoughts.

Mixed episodes can be more difficult to identify because of the wide array of symptoms involved, but proper medical treatment is even more essential with these episodes, because the outcome for people experiencing them is poorer than for other forms of bipolar disorder.

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