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Dr. K, Psychiatrist
Category: Mental Health
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Experience:  15 years clinical experience in all areas of psychiatry. Holistic and practical approach.
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Bipolar ... Would someone please explain what a mixed episode

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Bipolar ... Would someone please explain what a mixed episode is please?

I am currently very confused about what I am going through. My mood is extremely low and I feel very, very agitated and I am extremely tearful. At the same time though I feel like I need to be 'on the go', my head is buzzing, I have so much energy.
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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