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what's the difference between dysphoric mania and mixed state


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I'm just curious. My pdoc never really explained it(or maybe I never asked). What is the difference between dyshoric mania and mixed stated. I have both of those instead of the "classic" mania where you run down the street naked. I feel extreme irritability and agitation, like I want to crawl out of my skin. Oh BTW, today I figured out a release for that unpleasant "energy". I took my kids into the pool and held onto the side and kicked my legs as hard as I could for as long as I could- until my legs were on fire and felt like rubber. This is actually a very good thing because I've gained 15-20 lbs. on Seroquel(which is very very good for the mixed state/dyshoric mania(whatever you want to call it). Ironic, isn't it?

I was just wondering if anyone else out there has experienced the same thing and if so , what do you do? I sometimes feel like I want to smash my head against the wall to make it go away! (Fortunately,, I am wimp about pain ;) ) mel1

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From Wikipedia, the free encyclopedia

"In the context of mental illness, a mixed state (also known as dysphoric mania, agitated depression, or a mixed episode) is a condition during which symptoms of mania and depression occur simultaneously (e.g., agitation, anxiety, fatigue, guilt, impulsiveness, insomnia, irritability, morbid and/or suicidal ideation, panic, paranoia, pressured speech and rage). Typical examples include tearfulness during a manic episode or racing thoughts during a depressive episode. Mixed states can be the most dangerous period of mood disorders, during which substance abuse, panic disorder, suicide attempts, and other complications increase greatly."

Tommy

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Hi mel1

I get dysphoric mania, too, and it's no picnic. When I read the symptoms of classic mania and talked about them with my pdoc, I said, Hey, why can't I get some of this? This actually sounds fun! I get so irritable and like you said, I just want to crawl out of my skin. No fun at all. I walk a lot. And I go out of coffee and talk a lot--decaf only. Or I'll clean out a closet. Throwing things away or tearing up paper makes me feel good when I'm annoyed.

From what I understand, the difference between dysphoric mania and a mixed state is that in a mixed state, you have symptoms from both mania and depression (from the DSM-IV) occurring simultaneously, thus the rather morbid joke, I'm so happy I could kill myself. You can be ramped up, high energy, pacing around like a nut, crawling out of your skin, yet full of negative thoughts, feeling terrible about yourself and/or the world around you, possible suicidal ideation, stuff like that. Dysphoric mania is more a mania that is an irritable mania, a mania that is not elated, but it is not depressive, you don't feel depressed or negative about yourself per se, not crying and sad, etc., just like an angry manic or an easily frustrated, irritated manic.

Does that help at all, mel? It's kind of nuanced. I think the main and important difference is that in a mixed state, someone is in grave danger of suicide. The depression is there and the energy to follow through on suicidal thoughts is there because you're generally not holed up in bed. You know? Not a good place to be in at all. Definitely need to be in touch with the pdoc at that point.

My thoughts are with you....I know how hard the dysphoric stuff is. Try not to be alone when it gets too bad. Any understanding soul who will walk or swim or listen to you ramble...

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I have been having a hell of a day. My 4yr. old is at that incessant talking and asking questions stage, which is normally OK. But, today, it is sooo getting on my nerves. And I feel guilty about it. I really feel like I am going to hit the ceiling. Does anyone else feel this way? It's been a while for me since it was this bad. I'm typing at hyperspeed , which I normally can't do. Mania, for sure. Knowing that doesn't make it easier. I just took my Seroquel, so hopefully it will kick in before I kick in a wall. ouch.

Strange thing is , I saw my tdoc today and had nothing MI related to say to her (what a waste of a 20$ co-pay) I wasn't really honest w/ her about something I did recently(cut) which I have never done before. She told me I sound like I'm doing great and didn't even make an appt. for me. Just said call and make appt. when I need to. She is emailing me some book suggesions.

Blah, blah. mel1

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WOW--according to Wikipedia ( I love that name) I am the Queen and eternal ruller of Mixed states/dysphoric mania!!!

I know that gig line by line--AND have done it enough and often enough to be declared the absolute champion of that whole riff.

Of course, I am so fucking medicated right now, I couldn't work up even a half-mixed state (LOL)--and I almost miss it. Then I remember my brief encounter with Prednisone, and head for the Klonopin. It sounds like more fun than it is, alas.

china---bored and very heavily medicated , and very unhappy about life in general, but too loaded to do much about it. Sigh--

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Mixed state, pure torture: All the suicidality of depression with all the energy and impulsiveness of mania (for me anyway.)

I agree that mixed states are the most dangerous for me, and pure rolling hell. I've unintentionally hurt myself badly while beating the malfunctioning refrigerator. Stalked the aisles of the grocery store with thoughts so black that if a store employee said anything wrong to me that I might not be able to keep from assaulting them (like over not having plain spare ribs in stock).

Part of the learning curve for the illness. Now I know that I will call the Pdoc and we will get some Zyprexa or Risperdal to keep from getting out of control or hurting myself.

a.m.

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I once back-handed a Dempsy-Dumpster, forgetting I was wearing, at the time, a bracelet made from a piece of motorcycle chain. Nice scar, that one.

Then there was the time I kicked the door of a way-t00-slow elevator, and broke my big toe. Now,see, if I had had on my boots, that would never have happened (the broken toe, I mean)

I also had to go to the ER once cause my ex slammed down a phone which proceeded to fly thru the air and clip me across the nose--

And he once held me over the balcony of a Daytona Beach hotel about 10 stories up, cause I threw his bag of weed over the balcony during one of our more interesting fights--

Ah, the bad ole days

china--older, slower, and more medicated--sigh---

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This is exactly how I feel during my very worst attacks, those being the ones that typically put me in the hospital. 5 times so far, 2 times in the 2 years since my dad committed suicide. I just can't handle his death.

But yes, I have the energy to do serious damage to myself and everyone around me (recklessness, ect), but my thoughts are dark, so there are racing dark thoughts and lots of energy.

I think that dysphoric mania and a mixed state may be the same thing, or the mania is something thta can occur in a depression.

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I'm kind of thinking that maybe the health professionals don't have their stuff together on what's a dysphoric mania and what's a mixed state, because I hear different things.

I've had what I thought was a dysphoric hypomania - no depression, but anxiety and agitation - and had it called a mixed state by a pdoc (I thought mixed state = agitated depression).

Some of this may be that the DSM-IV defines mixed states as full mania + full depression, and has no actual definition of dysphoric mania (or of anything less than full mania + full depression).

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Heya mel1,

Well my mixeds take the form of full-on depression plus the drive to crash the car and take you all with me in a fiery collision.

<<shudder>>

In terms of nomenclature.

There's a whole mixup at the DSM these days as they work on DSM-V. http://www.dsm5.org

From the books I've been reading, there's currently a lot of overlap between mixed, agitated depression, and dysphoric mania. Kindof like the bipolar spectrum thing.

I think.

--ncc--

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Mel, I have a 4yo and 6yo too, and it's already hard enough dealing with a mixed episode without having small children drug into it. I don't have any helpful suggestions for it, I literally had to take it one hour at a time sometimes (one minute at a time, too), and I definitely sympathize and understand. I hope your day was a little better?

Can you take her outside and let her play in a wading pool or with the water hose? I have found that helps get them out of my hair, and helps to exhaust them as well. They're usually much quieter when they come back in.

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Rabbit- we're like twins! Luckily, my bad "mood" didn't last too long. Seroquel is good stuff. I don't like the weight gain (15-20 lbs.) but it is the best for mixed state/agitation,etc. Good advice. I have a fenced in backyard w/3 large dogs who guard the kids. So I can throw them in the back yard, open a window, and chill.

I guess it doesn't matter what you call it. It seems to be the same thing w/ a lot of different names.

My kids are at Grandma's for the weekend! mel1

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I can relate to what AM said. I once made a woman cry in walmart (hey- she shoulda known better than to invade my private space!) Anyone who gets in my way I will curse to hell.

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Guest Guest

"dysphoric hypo/mania" or whatever it's called, is for me, where I flash into sudden anger or rage which collapses into helplessness and sobbing, then ugly dark thoughts of not wanting to live but afraid of pain, and often all of the above at the same time. I hate everyone then- especially myself- and the guilt for everything I've ever done is unbearable. I get alot done- vicious energy where I often DO hurt myself...But wait- the mood lifts, sometimes just a little, and I'm back to some kind of function and nobody knows what just happened.

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Oh, that was also ME "above"--you described it better than I ever could--am printing that out to take to pdoc, cause I'm in the middle of that shit right this very minute.

Stable? Ha--ehat a fucking jike.

China--next mood leaving the gate in approximately 5 minutes

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  • 3 years later...
Guest Catherine

Dear Friends,

I'm pretty sure I have this. When my momma gave birth to her first child (me!) at age 30, it's like a switch went off! BAM - she had Bipolar I, the traditional manic depression with euphoria and little depression. The EXACT same thing happened with her identical twin sister when she popped out her first baby!

Now, I'm 29 and it seems I have moved from regular depression to... (drumroll!) - mixed dysphoric mania bipolar. I'm never euphoric. I'm really depressed, but agitated, irritable, so angry within and restless! I wish I could sleep forever. I NEVER act outwardly like something's wrong, or scream at people or throw stuff, 'cuz I don't want anyone around to know.

Sometimes, I feel like a sinister demon is behind me. I feel like my eyes get super-wide and opened, I guess like a person on meth looks like. At these times I'm so paranoid people around me will know. But, they never do. They tell me that I'm a very happy, cheery person. (I can't believe this! They have no idea what's going on inside)!

On 20 mg's Paxil. 100 mgs' Lamictal. Pdoc is starting me on Respirdol. I hope this will be the winning combo.

Hang on, guys. We are SOOO lucky to live in America. And I mean so lucky. There are MANY, MANY countries where no such psychiatric (med's) care is available to people. I have lived overseas and seen it. I guess it's just a matter of finding the right med's.

God, help us all. We believe into You and trust You will take us through this! CB

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