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Mixed state v. dysphoric manias?


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So OK, when my pdoc met me, he diagnosed me (roughly) as BPII, rapid cycling, mixed state.  Or somewise.  Anyhow, for years now I've used the terms "mixed state" and "dysphoric" pretty much interchangeably.  I'm wondering if there actually is a difference.  What have you heard?

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Riiiight, but there's no discussion of what dysphoric mania is.  I take it from your answer that mixed state = dysphoria?  I mean sure, in common language all my mixed states were nasty.  I'm just asking whether in psychiatric terms they're equivalent.

Sorry to be nitpicking.  It's just my nature.

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Dr. Brigham has this to say:

Rapid cycling and mixed-state/dysphoric mania

Rapid cycling is defined in DSM-4 as four or more episodes of abnormal mood (depression or mania) within 12 months, demarcated either by partial or full remission for at least two months or a switch to an episode of opposite polarity. Mixed-state or "dysphoric" mania describes those patients with simultaneous symptoms of depression and mania; according to DSM-4, the full criteria for both must be met. A great many more patients will have subsyndromal mixed states, failing to meet criteria for either mania or depression, or both. Many now feel (e.g., McElroy) that the DSM criteria are too restrictive, and that these subsyndromal patients should be treated as having mixed bipolar disorder. Mood in these patients is typically irritable and/or depressed, with other signs of activation (agitation, a feeling of internal pressure, racing thoughts, restless energy).

http://home.comcast.net/~pmbrig/BP_pharm.html

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A.M., you are a doll, and extraordinarily patient.  I've got this bad habit of hopping on the boards at work, getting an idea, then posting because I don't find an answer to my question the first few minutes I search for an answer.  It does indeed look like psychiatry uses the term "dysphoric" in its ordinary meaning.  And I'm not convinced anyone really knows the difference between dysphoric mania, irritable depression, and mixed states (and who cares, when you're in them?).  It's just semantics.  I think I'll stick with mixed state, since that covers the various mixtures of mania & depression that I experienced.

Someday when I start getting caught up at work I'm going to take some time to study up on BP.  Dr. Phelps' site is always full of surprises; I'm not sure I ever looked at the page you linked.  I know he digests a ton of information, and is a bit too edgy with his theory for some folks.  I really did stop reading about BP once I gave in to my diagnosis.  But I've got some resistance, probably because of my recent mood adventures; as soon as I start reading the diagnostic stuff I find myself searching my past and digging up icky shit.  Anyhow I'll bookmark the page so I can go back and read more as I get the chance.

So thanks again for your help.  I'll try to be more responsible about doing my own research for a while...

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