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Mixed Episode or Hypomania?


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Ok.. My Pdoc (the current and the old one) were never very uhm.. Helpful in aiding me in actually recognizing my swings, what was what.. The depression is so overwhelmingly obvious, but I haven't been massively depressed in about a year or so (since I started "trying out" all the meds for the one that fits). I have instead been going from being "ok" and "blah" to irate and talkative and hyper and can't sit still or concentrate then back down to blah then back up to irate.. wash rinse repeat. I'm quite confused as to whether I'm stuck in some sort of mixed cycle or a hypomania? I "cycle" like this every 3-4 days with maybe an "ok" day or 2 in between... Up and down up and down.. Doc took me off Topamax, saying the Abilify was what I needed, not the Topamax (had a reaction to being on both) and now I'm in a state of utter insanity, feel like I'm crawling out of my skin about 90% of the time, don't want to be touched, rapid speech, the only way I sit and focus if if I'm researching on the computer, other wise I'm up pacing the house like a caged cat, trying to clean everything and screaming at the kids for every little thing.. This morning I flipped out because breakfast wasn't cooking right and yesterday I was giddy as a lark and in SUCH a good mood and I'm thinking it was the start of my "episode" this time round and I'm not really sure what to do about it.. Going to call the doc in the morning for an appt, my appt isn't scheduled until the end of May. So what do you guys think, am I experiencing a hypomania or mixed? That sort of stuff really confuses me and this newer Pdoc has never fully come out and said what she thinks which frustrates me to no end, at least the old Pdoc gave her opinion and tried to help me figure out the moods better. Ugh why can't this be simple? Ok, I'm going to shut up now.

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Guest Vapourware

I'm not a professional so take my word with a grain of salt, but it sounds like you are getting some hypomania in there, rather than a mixed state. I think a mixed state would involve more feelings of depression and less of the giddiness that you have described. Just going from personal experience, when I was in a mixed state, I was both depressed and manic at the same time - so I was very unhappy, plus I had racing thoughts, energy and my sleep was disrupted. I didn't get any spikes of elevated mood during my mixed state.

Also, to complicate matters, you can be irritable while in a hypomanic mood and I wonder if that's been happening with you.

Anyways, I think it might be a good idea to give a call to your pdoc about your fluctuating moods, because they don't sound very pleasant, and to see if you can have a medication tweak. It sounds like being on a mood stabiliser would be helpful for you.

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Thank you for the reply! Can you tell me, is it possible to go from a euphoric mania to a dysphoric mania all in one mania episode? I really appreciate the help, and I plan to call the pdoc as soon as her office opens and get an earlier appt... My experience with a lot of the mood stabilizers unfortunately has been that I get "rage-y" with them, esp Keppra and Depakote and I wonder now if the meds triggered a hypomania. I had the best help from Lamictal but broke out in a rash about a week into the meds and the doc decided I was allergic (same happened with trileptal) so it just figures I'd be allergic to a med that made me feel normal. *rolls eyes* I'm exhausted today (fibromyalgia from doing so much work yesterday) and still having very foggy and disconnected thoughts. Again, thanks for the help!! I really appreciate it. I feel like such a noob, but I know I need all the info I can get, esp if I want to be able to fully understand and get better. As I learn more about it all I have begun to question all my previous moods, going back through my mood journals and seeing less "ultra rapid" and more concrete moods that I thought were separate and now I see may be longer swings.

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Can you tell me, is it possible to go from a euphoric mania to a dysphoric mania all in one mania episode?

Yes, you can go from one to the other or switch back and forth. And to complicate matters you can have both euphoria and irritability at once (like being giddy and excited about things, but getting ragey at people if they get in your way). Irritability is just as much a sign of hypomania / mania as euphoria is.

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One small thing to note. Abilify can often cause EPS, specifically Akathisia - a type of inner restlessness that makes you kinda feel like you have to move. 5mg isn't a whole lot and probably doesn't have anything to do with your manic symptoms right now; however, should you get those under control to some extent only to have that "crawling out of my skin" remain, it's a possibility to have looked at.

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One small thing to note. Abilify can often cause EPS, specifically Akathisia - a type of inner restlessness that makes you kinda feel like you have to move. 5mg isn't a whole lot and probably doesn't have anything to do with your manic symptoms right now; however, should you get those under control to some extent only to have that "crawling out of my skin" remain, it's a possibility to have looked at.

I read that and I have a pdoc appt in 30 min, they are squeezing me in today.. going to be one of the things we talk about. thanks! Going to show her my "chart" from going back over my journal posts to chart my moods again, much clearer pattern emerging.. I hope we can find me something to level this out!

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]I read that and I have a pdoc appt in 30 min, they are squeezing me in today.. going to be one of the things we talk about. thanks! Going to show her my "chart" from going back over my journal posts to chart my moods again, much clearer pattern emerging.. I hope we can find me something to level this out!

That's great! Hope everything goes well. ;)

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