My mixed episodes feel like agitated depression — restless, racing, and raw. I’ve learned to recognize the signs and hold onto structure to find stability.
It’s dusk and I’m sitting with my arms around my knees at the junction of a turbulent and muddy river and the slow, dark water of an ocean inlet. As I sit at the meeting point of two vastly different, yet somehow connected, forces, my mind, too, finds itself at its own convergence.
Somehow, two moods — opposite in nature yet oddly intertwined — have merged into something terrifying, feverish, and inexplicably sad.
Hours earlier, when I’d been overflowing with love and grandiose dreams, I’d spent several hundred dollars on gourmet cookies and bouquets of roses and lilies to hand out to friends. Later, as day turned into evening, mania and depression blended together into the unique and startling pain of a bipolar mixed episode.
Rapid Cycling as a Precursor to a Mixed Episode
The above was nearly two decades ago, and I’d held a notebook and pen in my lap on that muddy river’s shore. I wrote with a fury, as if I were actually in those swirling waters, uncontrolled and wild, and yet full of despair.
The racing thoughts soon turned to suicidal thinking, and as they grabbed at that all-too-familiar concept, the idea formed a rapid loop in my brain. The rest of my mind — where logic and reason resides — grew dark and unfamiliar as I became stuck in an obsessive circle of thought.
In the many years since my initial diagnosis with bipolar 1 disorder, I have tried to understand the nature of a bipolar mixed episode. Even today, after so many years of experiencing them, I still have trouble recognizing the difference between a mixed episode and my ultra-, ultra-rapid (ultradian) cycling.
For me, the mixed episode often comes after the quick ups-and-downs of the rapid cycling, when mania and depression merge into something particularly disconcerting and painful.
Trying to Make Sense of My Mixed Episodes
During the early years of my bipolar diagnosis, as the rapid cycling took over and then morphed into the longer mixed episodes, I would lose all sense of the “normal” cadence of human life.
I stopped sleeping, I stopped eating, and I drank coffee all night, using a black marker to scribble poetry onto the living room curtains. I also had riveting conversations with the moon about my own magnificence, as well as agonized on the linoleum floor in my kitchen.
For me, trying to describe a mixed episode to someone who has never experienced one has always been difficult. For others, it may be easier — or it may be even harder.
RELATED: The Mental Push and Pull of Bipolar Mixed Episodes
I have tried, weakly, to compare it to the feeling that results from being over-caffeinated and tired at the same time, when your body quivers with energy while you also feel completely exhausted.
I have thought of other analogies over the years, some vague and esoteric, others clearer and more obvious:
- I am a heavy stone in a hurricane.
- I am lightning in a black sky.
- I am a woman at the cloudy confluence of a raging river and a dark sea.
Mixed Episodes Can Vary From Person to Person
Some people who have bipolar mixed episodes experience euphoric mania and severe depression at the same time.
Throughout my life, I have also occasionally felt euphoric and depressed simultaneously, and when I have, it was even more confusing than my usual agitated, dysphoric manias.
I’ve sobbed while talking about how I was going to be a world-famous author. I have celebrated my own greatness — an ecstatic megalomaniac — by sorting and piling my writings all over my bed, papers flying, while still overwhelmed with feelings of hopelessness and sorrow.
Recognizing the Common Features of My Mixed Episodes
Today, I can recognize the common features of most of my mixed episodes.
If I have a hypomanic “up,” for example, then I usually know that I will crash into one of my agitated depressions.
During these mixed cycles, I feel frantic and hypersensitive, irrationally sad, and always terrified. My thoughts are negative, obsessive, and frequently paranoid.
But, sometimes, I can also recognize that I am in the midst of a cycle, and that the toxic loop of my racing thoughts does not reflect reality.
Learning to Prevent Mixed Episodes
While recognition is of paramount importance when trying to emerge from a mixed episode, prevention of the episode itself is even more important.
This means, above all, that I keep a regular schedule. I must sleep, eat, and take my medication at the same time every day. As soon as that structure begins to unravel, or when stress breaks my rhythm, I may cycle — and for me, that usually means I will have a mixed episode.
RELATED: Self-Tracking: Moving Forward After a Bipolar Episode
The agitated despair of a mixed episode may often feel unbearable, and it may feel like we are at the mercy of the rushing river in our minds. But there is hope in our ability to watch downstream, to be ready to recognize the early signs of a coming episode, and, ultimately, to prevent the mixed states by keeping a steady rhythm and daily structure in our everyday lives.
UPDATED: Originally posted March 16, 2017