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Hiya,

 

I've been diagnosed mixed affective disorder, and can't find much out online about it. My pdoc is one who, while brilliant, likes to skirt over diagnoses etc and just concentrate on how I'm feeling. All I know is it's definitely "bipolar" and not a "bipolar-like" illness.

 

A bit about what led to this diagnosis: I've struggled since the age of 12-13 with massive mood swings, but not like months of mania/depression- more like - any little thing could send me into a rage, or I could be feeling on top of the world, then flip into crying. I always knew something wasn't right but never fit into the normal category for bipolar so never sought help. My pdoc now thinks I have been having mixed episodes (in varying strengths) since then. I eventually got help after falling into a severe depression, first diagnosed as MDD, and trying to commit suicide. It's only since I've got significantly better from the depression that we've been discussing these mood swings, and the diagnosis has changed to mixed affective disorder.

 

Has anyone heard of it or could give me any more clues? I'd be grateful!

 

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An affective disorder is another term for a mood disorder.  It sounds like your pdoc has diagnosed you with mixed episodes, so I expect that's where the mixed part comes in.

 

My pdoc, whom I also greatly respect, doesn't go in for the whole bipolar term, either.  While I was diagnosed with bipolar disorder by previous psychiatrists, he calls it a "cyclical mood disorder".  It sounds like our pdocs are on the same page, describing what is going on with us with the terms they believe best describe our symptoms.

 

Welcome to CB!

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Sorry, mixed episodes are the very very worst. I can't find a DSM5 on line, so I can't double check, but I believe that mixed episodes are now considered a symptom of either BP I or II. Before it was just in BPI, and when I started having them (when I was still BP2), my pdoc switched my diagnosis to BP NOS.

 

Ironically, two years ago, I was rediagnosed with BP1. It turns out that my worst mixed episodes were actually, or became, dysphoric manias. 

 

Like many, I was initially diagnosed with MDD, which change to "some flavor of BP" when prozac made me manic.

 

Personally, I like some kind of diagnosis, I'm just the kind of person who does. But many pdocs don't like labels, especially with affective disorders (which as someone already told you,= mood disorder).  You can see, diagnoses can be very fluid.

 

But I try to coax out at least a working hypothesis. I am not very happy with my curren;t "pDoc."

 

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Thanks for all your responses. I never knew "effective disorder" mean mood disorder so that makes a lot more sense, thanks :) And yeah I get frequent mixed episodes.

 

I've managed to squeeze out of my pdoc that I am not bipolar I or II, because I've never had a hypomanic or manic episode (although I have a feeling that having had a depressed episode and mixed episodes its just a waiting game for the manic :S). So that answers a few questions, but I agree I would like a more definite diagnoses that I can research! She is a great pdoc though so I can't complain.

 

Thank you again :)

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I didn't know you could have a mixed episode and not be considered bipolar? Really?

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This about sums up what information I have:

 

"you're definitely on the bipolar spectrum"

"so what do I have?"

"mixed affective disorder"

"and is that a bipolar-type illness, or a type of bipolar"

"yes it's bipolar"

...

"so what type of bipolar do I have?"

"either mixed or rapid cycling"

"so not bipolar I or II?"

"no, you haven't had a manic or hypomanic episode"

 

so I think its some sort of Bipolar NOS - in the DSM V you can add a "mixed features" specifier to any type of bipolar - so I don't think you have to be bipolar I just because you've had a mixed episode any more, so I won't be bipolar I or II until I have an "up" episode (which I think is just a waiting game - I'm only 20, and have already had mixed and severe depressive episodes  :( ). 

 

Hope that clears it up a bit - tbh I'm still in the dark myself so you're all probably just feeling as confused as I feel now!

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Sort of sounds like what the DSM would call Bipolar NOS (the old DSM) or DSM5 would call Bipolar NEC.

Not diagnosing, just describing what I've read.

 

Either way, mixed episodes are hell. I hope you can sort out the confusion of the diagnosis, and get treated properly for it. Dx isn't that important, its mainly for insurance, proper treatment is what you need. Medications, therapy and whatnot. 

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saddest, does that mean they are implying that mixed episodes can be features of other MIs? They may not be, I just am not sure if that is what you meant.

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Yeah I drink a lot of caffeine. However I did actually spend two years caffeine free, due to heart palpitation caused by the caffeine, and found no difference in my mood. I'm not currently on the pill, but have been in the past. I found it actually helped my mental health as I get bad PMS! Fun fun fun. I don't drink, don't smoke and i've never taken drugs, so I'm pretty good really!

 

I agree that medication is more important than diagnosis, but there is a certain security in being able to research what you have. And if you try putting "mixed affective disorder" or variations on that into google you don't get a lot - just lots on mixed episodes, and a couple of scientific papers. it was a bit unnerving being diagnosed with something google hasn't heard of!

 

And the mixed feature specifier is only within bipolar. Ie, you can add "mixed features" to a manic, hypomanic, or depressive state, as long as there are three symptoms present from the opposite state - so if you were manic, there would need to be three depressive symptoms to qualify for mixed features. Hope that makes sense.

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saddest, does that mean they are implying that mixed episodes can be features of other MIs? They may not be, I just am not sure if that is what you meant.

 

I just checked the DSM-5 and, yes, the specifier "with mixed features" can be noted along with a diagnosis of a major depressive episode or MDD, not just bipolar disorders. Here is a quote from the chapter "Depressive Disorders" --

 

Note: Mixed features associated with a major depressive episode have been found to be a significant risk factor for the development of bipolar I or bipolar II disorder. As a result, it is clinically useful to note the presence of this specifier for treatment planning and monitoring of response to treatment.

 

Reference: American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013. 

Edited by Parapluie
wonky edit

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Para, where did you find the DSM 5 online? Or do you own one? Because I know several people here do own it. But I would prefer not to have to buy it.

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Para, where did you find the DSM 5 online? Or do you own one? Because I know several people here do own it. But I would prefer not to have to buy it.

I have free access (well, paid by my tuition fees) to it through my university library subscriptions. I specifically went to the database "Psychiatry Online", which has a full-text digital copy of the DSM-5.

I wish everyone had open access to academic materials (but I see all sides to that issue). I guess that's another topic for another day though.

Edited by Parapluie

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I just looked it up, and it cost $100. Don't think I am buying it, at least until they start selling used copies.

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