Mixed Episode

Mixed Episode

A mixed affective state, formerly known as a mixed-manic or mixed episode, has been defined as a state wherein features unique to both depression and (hypo)mania—such as episodes of depression, with: despair, feelings of worthlessness, uselessness or helplessness anguish, suicidal ideation severe anergy anhedonia decreased motivation including: Work avoidance, school avoidance, asocial, and Asexual. and severe apathy. And episodes of hypomania and mania such as: impulsivity or increased energy, decreased need for sleep, emotional liability, racing thoughts, restlessness or hyperactivity pressure of speech, increased self confidence or grandiosity talkativity or pressured speech and heightened, increased, or sudden onset of irritability—occur either simultaneously or in very short succession. Previously, the diagnostic criteria for both a manic and depressive episode had to be met in a consistent and sustained fashion, with symptoms enduring for at least a week (or any duration if psychiatric hospitalization was required), thereby restricting the official acknowledgement of mixed affective states to only a minority of patients with bipolar I disorder. In current DSM-5 nomenclature, however, a "mixed episode" no longer stands as an episode of illness unto itself; rather, the symptomology specifier "with mixed features" can be applied to any major affective episode (manic, hypomanic, or depressive), meaning that they are now officially recognized in patients with, in addition to bipolar I disorder, bipolar II disorder and, by convention, major depressive disorder. A depressive mixed state in a patient, however, even in the absence of discrete periods of mania or hypomania, effectively rules out unipolar depression.

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