A mixed episode is basically when a person has both a manic & depressive episode occurring at the same time. It can be hard to tell the difference between a mixed episode & rapid cycling bipolar...but the good news that the treatment is relatively the same.
You should contact your doc to discuss your symptoms & see if there is a med change that might help. Increasing the olanzapine would most likely help the manic episodes & might also help the depression...but any time you increase a dose you can get more side effects.
Increasing the agomelatine could help the depression. However, keep in mind that most traditional antidepressants can also increase manic symptoms. Lamotrigene is a unique medication for bipolar that is especially good for the depression part & actually also treat the mania & shouldn't increase the mania.
Wellbutin is the other antidepressant that is known to to not increase mania as often as other antidepressants (but still has a slight risk of such.)
Don't forget that it's important to treat any episode holistically.
This would include 1) psychotherapy with a live therapist, and 2) learning some formal relaxation therapy.
The last 2 treatments I mentioned are proven by sophisticated studies using brain scans (CT, MRI, EEG, pet scans) to improve brain function.
Also, by formal relaxation therapy I mean yoga, meditation
, or similar methods. Having relaxing hobbies is also important, but not quite the same as formal relaxation therapy.
And remember you can't separate emotional health from physical health, so exercise & nutrition are vital.
There are also several self-help books you can read which can help including: 1) "The Seven Spiritual Laws of Success" by Deepak Chopra, 2) "The Feeling Good Handbook" by David D. Burns, 3) "The Relaxation & Stress
Reduction Workbook" by XXXXX XXXXX, & 4) "The Depression Workbook: A Guide for Living with Depression and Manic Depression" by Mary Ellen Copeland and Matthew McKay.
I hope this helps. Let me know if you need more feedback. Good luck & take care.
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