Mixed Episodes by Catherine Cottam #CompassionOrBust

You may recall that I briefly described mixed episodes in my blog post on Bipolar Disorder.  In case you need your memory jogged, here is what I said:

Mixed Episodes (Mixed States) are when someone experiences hypomania or mania and depression at the same time or in quick succession.  They are the most dangerous time for people with Bipolar Disorder because the person may have the desire to commit suicide and the energy to do it, as opposed to a depressive episode when they may have the desire but not the energy for follow through.  Mixed Episodes (Sometimes called Mixed States) are my least favorite part of having Bipolar Disorder.  At least with the mania and the depression, I know what to expect.  To me, mixed episodes are almost constant emotional pain.  There will be a whole post on them very very soon.

When I say that Mixed Episodes are almost constant emotional pain, I mean that I am completely miserable for the entire duration of the episode, which, by the way, can last and have previously lasted for months at a time.  Not only do I just feel “off,”  but I have this agitated sort of energy with a low depressed mood.  I often go into a mixed episode in between a manic episode and a depressed episode, so at first I may not even realize I’m in a mixed episode because I just think I’m manic or depressed.  Instead of telling you more about mixed states, I’m going to show you about mixed states.  Here is something I wrote for an anonymous blog I had in March of 2014.  It’s titled “RRRRRAAAAAAAAAAAWWWWWWRRRRR”

Disclaimer: I’m STILL in a mixed state. This post is all over the place and very stream of conscious.  Will my brain ever stop being this way? It feels like it’s constantly on overdrive. I misinterpret every signal from men. I realize that they want to be friendly, but – you know- in my head that typically means that we are going to get married if I am attracted to them even the slightest little bit. Does anyone else do that to the extreme? Like I play out relationships with people who are basically strangers all the way to the end in my head. I think if someone ever really is flirting with me I won’t even know because I’ll assume it’s my brain lying like it always does.

It isn’t just about that though, my brain feels like it is constantly either going at 100 or at -5. There is no happy medium. It’s black or white and there is no grey. I know this is a mixed episode, but the weepiness, irritability, racing thoughts, irresponsible spending, and FATIGUE have got to stop. Oh my god the fatigue. Some days it is a struggle to get out of bed. Other days I don’t bother. I feel like I could walk forever right now. If it weren’t so cold, I would probably take my dog for a walk even though it’s almost midnight. My body is tired right now but my mind is electrified.

If I only had the energy I could write a book or sell my knit crafts or start a baking business. If only I could get stable I could get my PhD and change the world!

My counselors have always said I have a great level of insight and I believe that must be true because I am completely aware that all of these thoughts are my bipolar brain and not rational, but that doesn’t mean I don’t have them.

I could do everything and nothing all at once. I could sleep all day or I could clean the whole house. I could be weepy or I could find everything hysterical. Will there EVER be a middle ground? Someone please tell me the answer is yes.

My racing thoughts are not positive ones. They are paranoid, hyper vigilant, delusional, self hating, self loathing, shaming, guilting, fat, stupid, ugly, alone, blaming thoughts.

OH! And I have a new favorite song! Beautiful Pain by Eminem ft. Sia. The problem is that when I get a new favorite song now I play it on repeat for hours and hours and hours. The lyrics are awesome though.  Here is a not so random sampling:


“I can feel the heat rising, everything is on fire”

“I’m standing in the flames and it’s a beautiful kind of pain”

“I’m pulling for you to push through this feeling and with a little time that should do the healing”

“It happens all the time, they take your heart and steal your life and it’s as though you feel you’ve died because you’ve been killed inside but yet you’re still alive which means you will survive. Although today you may weep because you’re weak and everything seems so bleak and hopeless.”


Really Eminem? You can be really amazing. You get me.

Another Ativan, methinks and then hopefully some sleep so I can be someone productive tomorrow! Sleep well!


That’s a sampling from my journal during a mixed episode.  I was very agitated and my thoughts were going a mile a minute most of the time, but they were also sometimes very punishing thoughts.  Also, as a feminist, I’m embarrassed to admit that I like Eminem, but here we are.  That song really spoke to me at the time.  Notice I think I can get a PhD and change the world!  That’s the mania part of the mixed episode.  The punishing thoughts, fatigue, etc. are the depressed part.



Mixed Episodes Video by Kati Morton

International Bipolar Foundation on Mixed Episodes

DualDiagnosis.org on Mixed Episodes

International Bipolar Foundation Video on Mixed Episodes

5 Common Misconceptions About Bipolar Disorder with Kati Morton

WebMD on Mixed Episodes


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