Bipolar 'mixed episode'

[MitchyInge]

Seems to be relative dearth of information about this, is first time have ever been diagnosed with one. Usually fairly normal bipolar highs and occasional low. Wondering if people have them and revert to their normal mood cycle or if is sign of things to come (please no!).

Anxious that, if is misdiagnosed (how do they know it's not agitated depression?) the treatment is all wrong. Although am coming together a bit so maybe it doesn't matter.

ignorez-vous me then

Hi Mitchy

Have you been diagnosed as currently experiencing a 'mixed affective state'?

Or did they say it was more of a persistent diagnosis, IYKWIM?

Yeah, first one. Normal episodes = normal highs and sometimes lows

treatment has been pretty much the same as for mania - really hope it never happens again but if anything would have thought was extremely agitated depression. Bet if had seen dr in different area who didn't have my notes and I hadn't disclosed my diagnosis they would have given antidepressants. It's just a minor worry.

What symptoms are you experiencing?

And what treatment are you on?

On plus side they seem confident is a discrete episode, usually make v good recovery. Wonder if will have to up my game in terms of lifestyle management stuff to avoid future such episodes?

Was hoping for flood of shared experiences and curious about which meds other people have been prescribed. Paranoid thought: are you my doctor?

LOL at me being a DR

(I work in mental health though)

I wonder in view of the fact you have had previous 'high' episodes they are being cautious wrt treatment in trying to prevent a further high developing?

Have they put you on mood stabilisers? Or adjusted your dose if that's what you take already?

Horrible symptoms have passed, thank goodness, but was really extreme anxiety and distress and insomnia and agitation and couldn't eat or sleep for a week, or stop myself from crying and pacing around where ever I was and who ever was around. It would lift for brief periods but come back with a vengeance. Never had anything like it, the most awful intrusive thoughts.

Was on lamictal and quetiapine with homeopathic dose of reboxetine, reboxetine stopped and resumed lithium (which have not taken since about 7 yrs ago) and diazepam few times a day, temazepam and now also promethiazine (phenergan) at night. Don't bother with q'pine these days as maxed out at 800mg and it did nothing, is a rubbish antimanic.

Think when mood has stabilised am changing to abilify, but allegedly too activating at moment. Obviously will drop the benzos but keep the li-la combination. Not keen on promethazine though, headachenosity!

I agree it could easily sound like agitated depression, but if you have a diagnosis of BPAD (given by a psychiatrist, not say, a GP) I would be leaning toward the mixed affective state also... esp as you have had elated mood episodes before, not just lows

Do you feel the meds regime you're on now is working?

IME Quetiapine is either Great or Crap (personally think it is better at treating anxiety/agitation symptoms at lower doses - say like you'd use Diazepam for)

From what you're taking, sounds like they want to stop you going (you know, properly) high

Hope you have lots of support in place and folk looking out for you, not just the meds

Gotta dash - England and all that - but will check in later

I've only ever had one serious episode of depression, I would actually kill myself if I thought I'd ever have another. Diagnosed about a decade ago by a consultant, a few hospitalisations, fairly text book - actually diagnosis was manic depressive psychosis but my consultant v old fashioned.

Probably too soon to attribute feeling better to all those horrible meds, could be though? Thanks for talking to me about it! I just want my reboxetine back, it may have been rubbished everywhere as the weakest antidepressant in the world ever but is the only one I have ever got away with. I LOVE it!

Hi mitchy. Really sorry missd your original post on Monday. Glad you are seeing some improvements- whether it's down to the mess or not x

Hope the weekend has been ok for you, Mitchy

Thanks

bit surprised at how sort of functional I am today, might be psychological boost from having home visits dwindle? wondered if I was actually depressed earlier before it dawned on me that am just CALM and mind is CLEAR. No pleasing some people!

Just enjoy the clarity, Mitchy!

Keep it in the day and all that

glad you are having better day

Want BRAIN TRANSPLANT. Why is it taking so long to get better?

Sorry its dragging on Mitchy .
Do you think its a bad day or has it been going on for a while?
Does the dr know you are struggling at mo? x

Just takes an age to stabilise mood, keep reminding self am lucky that normally make good recovery and can probably look forward to a year or two or three before next episodes. There obviously are far more challenging conditions to live with but am lapsing into whingey self pity a bit too much.

On whole am thinking, so what if have virtually no work left and even less money at moment - here is opportunity to edit my life a bit, maybe yet another new career, make use of direct payments for support that will bring lasting improvements etc. One thing this illness promotes is adaptability. It's also invaluable in terms of discovering just how kind and supportive friends are. So apart from feeling shit 90% of time (and hard done by that can't have an antidepressant ) it's not all bad!

How are things with you?

oh you are so good at trying to see the positive side. Much better than me.

Ive stabilised on the ad over last few weeks so fingers crossed all continues like that.

Hope your better times come really soon. i do honestly think you cope with it so brilliantly x

Aw thanks pleased to hear things are going well for you too.

Think my brain is just naturally wired in quite an optimistic way, which might be why I have such poor tolerance of feeling low. It does make me feel better to think about all the plus points of any given situation, the idea that problems are opportunities makes intuitive (and experiential) sense to me.

have already been bounced back to the crisis team and thought was doing quite well with community team, thought had good appointment today then had call a bit later to say the team would be visiting again

must try not to be upset as this just compounds things