Mixed Affective Bipolar: Information, Symptoms, Treatment and More

Mixed Affective Bipolar, also known as Mixed Bipolar State, is a mental health condition that can become a complication of Bipolar II Disorder.

A Mixed Bipolar State refers to the situation where an individual experiences symptoms of both depression and hypomania concurrently.

This form of Bipolar Disorder features both hypomanic and depressive mood states, which often appear at the same time. This mood state can last for several weeks, causing significant distress.

Bipolar Disorder is a very difficult condition to live with. However, with the right treatment and support, symptoms can be controlled more, which should lead to an improvement in quality of life.

What are the symptoms of Mixed Affective Bipolar?

The symptoms of Mixed Affective Bipolar typically fall into two categories – hypomania and depression.

An individual suffering from a mixed episode will usually see the symptoms of depression, and certain hypomanic symptoms, appear together. This episode is capable of lasting months.

The exact behaviour exhibited during this episode will vary from individual to individual. In between episodes, an individual will usually lead a relatively normal life.

Hypomania

• Happy feeling, euphoria
• Excitable
• Racing thoughts
• Higher confidence than usual
• Not needing much sleep
• Acting impulsively
• Taking risks
• Irritable

Depression

• Sadness
• Hopelessness
• Lack of energy
• Loss of interest in formerly enjoyable activities
• Feelings of guilt
• Changes in appetite
• Insomnia
• Low self-esteem
• Poor concentration
• Suicidal or Self-Harm Ideation

This isn’t an exhaustive list of symptoms. These symptoms will typically lead to an individual behaving in a markedly different way from their normal self.

Because the two mood states appear either together or in close proximity to one another, the individual affected may feel very impulsive and agitated, but also incredibly low.

This can sometimes be a toxic mix, with suicidal feelings common in those undergoing a mixed bipolar state. During a mixed state, an individual can go from a feeling of intense euphoria to disarray rapidly.

What are the causes of Mixed Affective Bipolar?

Scientists are unsure on what causes Bipolar Disorder. This includes the sub-types of Bipolar, such as Mixed Affective Bipolar.

It is possible that a combination of factors may contribute to the condition developing. For instance, this could be a traumatic experience, a chemical imbalance, past abuse, or a major life event.

Research also shows that having a parent or family member with Bipolar Disorder is a risk factor, with the condition having a strong genetic element [1].

It is also believed that substance abuse in those with Bipolar Disorder can result in a mixed episode developing.

In other cases, Mixed Affective Bipolar can develop following a previous diagnosis of Bipolar II Disorder, or a condition like Depression.

Diagnosis of Mixed Affective Bipolar

It is important for an individual to see a Doctor or mental health professional if they believe they are suffering from a mixed bipolar state as part of Bipolar Disorder. Bipolar Disorder is a serious illness, which left untreated, can cause enormous distress.

When a person attends an appointment, the doctor will ask them several questions. They will ask about their symptoms, how episodes manifest, any potential causes, and general feelings, along with anything else relevant.

If the doctor suspects that the individual has Bipolar Disorder, the patient will be referred to a mental health specialist for a diagnosis.

When meeting a mental health specialist, a full assessment of the individual’s condition will be conducted. This will include more detailed questions regarding the symptoms. In the build-up to an appointment, they may request that a mood diary is used to aid a diagnosis.

For Mixed Affective Bipolar to be diagnosed, an individual will have:

• Experienced at least one episode of hypomania and depression at the same time

It is common for Bipolar II Disorder to be diagnosed at first, before an individual later exhibits hypomania and depression at the same time. In this event, they would then be diagnosed with Mixed Affective Bipolar, or Bipolar II Disorder with Mixed Features.

A diagnosis is rarely made over one appointment. A specialist may want to observe the behaviour of an individual over a period of time, due to risks of misdiagnosis. Bipolar Disorder can easily be confused with other mental health conditions.

How is Mixed Affective Bipolar treated?

Treatment is available for Mixed Bipolar State. In many instances, with the right treatment plan, symptoms can be controlled much more. Treatment normally consists of:

Talking Therapy

Talking therapy is often used in the early stages of Bipolar Disorder, when the individual attempts to come to terms with their condition.

As time goes by, with the person becoming used to living with the condition, they may not need talking therapy. In any case, therapy can be helpful in identifying possible triggers, changing harmful thought patterns and coming up with healthier ways of living. Possible types of therapy include:

Psychoanalytical Psychotherapy: Psychoanalytical Psychotherapy is a talking therapy that aims to help uncover and resolve unconscious beliefs that cause psychiatric conditions. Traumatic experiences that may or may not be buried in the unconscious mind can be highlighted and processed. Psychoanalytical psychotherapy involves talking to a trained therapist. The therapist can show the individual how early memories and past traumas have affected their thinking, behaviour and attitude in the modern day. Psychoanalytical psychotherapy is especially useful for any condition that involves past trauma. Renowned neurologist Sigmund Freud developed this therapy, which is typically completed over a long-term basis.

There are a huge range of types of talking therapies available, many people react differently to different types. For more information on therapy, see our Therapy section.

Medication

Medication plays an important role in the treatment of Bipolar Disorder, and is the primary component of treatment. There is an array of medicines that can be used in the treatment of Bipolar Disorder.

Mood stabilisers are mainly used, and are taken on a long-term basis. Depending on the symptoms displayed, antipsychotics may also be used.

If a person is in the midst of a mixed episode and needs to be sedated, they may be prescribed a benzodiazepine on a short-term basis.

Mood Stabilisers: Mood stabilisers can help level out moods, meaning fewer lows, and fewer euphoric highs are felt. Lithium Carbonate is the best-known mood stabiliser. Others include Lamotrigine and Sodium Valproate, which are anticonvulsant medicines that have mood stabilising properties. These medicines are generally taken on a long-term basis.

Antipsychotics: Antipsychotics (also known as neuroleptics) block the effect of dopamine – a chemical in the brain that is heavily linked to psychotic symptoms like hallucinations. They can also be useful for stabilising mood, and treating anxiety. They are not suitable for everyone however, and are often associated with many side effects like weight gain, dizziness and dry mouth.

Benzodiazepines: Benzodiazepines are fast-acting sedatives, which can relax an individual and improve their mood. Any anxiety should fade rapidly upon consumption. The individual should therefore have an improved level of functioning. Benzodiazepines cannot be taken for more than a few weeks, due to acute risk of both physical and psychological dependence.

Other

In some cases, treatment may need to take place in a secure hospital. This is rather rare, but is sometimes necessary due to the difficulties caused by a mixed Bipolar episode.

Summary

A mixed Bipolar state is a very challenging condition to live with. It can last for a while, and can be very debilitating.

Anyone that is suffering from any type of mental illness should seek help. There is a lot of information across our website to assist you.

See Also

• Bipolar Disorder Section
• What Is The Prognosis for Bipolar Disorder?
• Therapy Homepage
• Medicine Homepage