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Bipolar Disorder - Major Depressive Episodes and Mixed Features

Rashmi Nemade, Ph.D. & Mark Dombeck, Ph.D., edited by Kathryn Patricelli, MA Updated: Feb 27th 2017

Just as the manic aspect of bipolar disorder is associated with manic episodes, the depressive aspect of bipolar disorder is likewise associated with depressive episodes. The severe form of depressive episode is known as a Major Depressive Episode.

depressed man at work Someone having a Major depressive episode must experience five or more of the following symptoms during the same two-week period for most of the day or nearly every day:

  • Feelings of sadness, emptiness, or hopelessness (in children, this may be irritability)
  • Having no interest or feeling no pleasure in all or almost all activities
  • Weight loss or weight gain by greater than 5% when not trying to lose or gain weight OR a change in appetite nearly every day
  • Sleeping too little or too much
  • Physical agitation or restlessness that is observed by others
  • Being tired and having a lack of energy
  • Feelings of worthlessness, self-hate, and guilt
  • Not being able to concentrate, think clearly, or make decisions
  • Being irritable
  • Ongoing thoughts of death or suicide - either thinking about suicide without a plan for how it would happen, having a specific plan or attempting to commit suicide

Depressive symptoms can vary a great deal from one person to the next. One person with depression may experience feelings of sadness, hopelessness, and helplessness. Another person may feel angry, irritated, and discouraged. These symptoms may also seem like a change in someone's personality. For example, someone who is usually patient might begin to lose his or her temper about things that normally would not bother him or her.

Symptoms can also change over time when someone is depressed. Someone who is initially withdrawn and sad can become very frustrated and irritable as a result of getting less sleep and not being able to accomplish simple tasks or make decisions. These symptoms cause stress that is noticed by others and cause problems at school, work or in relationships with others.

Unlike with mania and hypomania, there is no short-term depressive episode that can be diagnosed. There is a related condition known as Persistent Depressive Disorder, or Dysthymia,, which describes a long-lasting mild depression. Dysthymia cannot be diagnosed at the same time as bipolar disorder. This is because in order to qualify for a diagnosis of Dysthymia, you have to show evidence of consistently mild depressive symptoms occurring more days than not over a period of at least two years. The presence of manic or hypomanic episodes during the two-year period would disqualify a person from being diagnosed with Dysthymia.

Mixed Features

While bipolar disorder most frequently happens as a swing between manic and depressive episodes, in a minority of cases, a third type of episode can happen. One of the specifiers for Bipolar Disorder can be "with mixed features." This means that the criteria for mania and the criteria for depression are both simultaneously met. However, just because criteria for both manic and depressive episodes are both met during a single day, for example, does not mean that both sets of symptoms are present at the same time. Instead, what typically happens is that there is a rapid switching between manic and depressive states, happening one or more times in a single day. These mixed features tend to be severe when they occur with psychotic symptoms such as hallucinations and delusions, and suicidal thinking frequently present.


Reader Comments
Discuss this issue below or in our forums.

Just how it is. - Becky - Oct 10th 2012

I was diagnosed with bipolar disorder when I was 13, the sterotypes I'd heard about mental illnesses frightened me and I was petrified of what I'd become. I was put onto anti depressants after my first depressive episode in which I stayed in bed and refused to do anything because my body just wouldn't take it. I'd look myself in the bathroom for hours because it was the only place I felt safe. I self harmed but it wasn't because I wanted to die, only because it would take the mental pain away. After my first mania episode I was given mood stablizers and anti psychotics. Which made the illness worse. As I've began to progress and understand my illness, i've realised it's just how it is, I'm not proud of my illness, just grateful it's given me a new outlook on life. And to remember that however hard it gets, I could beat it any way I wanted too

Lost - Coleth - Mar 27th 2012

I feel lost, who can I talk to.  Sitting with my own thoughts day-by-day.  Is there someone who cares?  I'm all alone in this mess and no-one understands what I'm going through.  Everyday I ask the Lord just to help me put on my happy face when I go to work, for people not see how I really feels.  In this town there is no unmarried and below 35 years of age people.  A town to settle down.

Try to keep myself busy.  Playing piano, seeking other job opportunities.  Visit other people?  The ladies I know have their own families, have to tend to the husband and children.  They do not have time to visit with a friend.  And not anyone will come and visit me, they wouldn't know how to ask for directions, cause the learners at the school is Deaf.

My colleagues and I are not the same culture, which makes it more difficult.  Sometimes these four walls is going to collapse on me.  I do not want to commit suicide. 

I just want a change, a place where I can meet more people my age.  I pray that I will make a friend or a couple.  I pray that we will go shopping together, watch a movie together, listen to one another and share problems and ideas.  Most important support each other.  Be there for one another.

Just to get out of town, I'm researching possible ideas.  If I don't leave I will die here.  I cannot continue like this.  I'm 40 years all and it passed just like another day, nothing special.  There is nothing to my life.

Wow!  That is a lot of negative thoughts.  What is positive.  The Lord loves me. He cares for me.  There is the promise of Joseph:  He will use the wrong doing in your life, change it around for the better.  I have a family and my father, younger sister do cares, a lot.  I love them tremendously.

What do I have to do?  Hold on to my faith and push through.

Help guys? - Maria - Aug 24th 2010

Hi, I'm a 21 year old girl and since about three years ago I have been struggling with severe anxiety, depression, paranoia and random thoughts that make no sense.

I had a normal childhood and teenage years, amazing supportive parents and healthy friendships, great grades, etc..

When I was about to graduate from high school, I developed depression and anorexia, which didn't last long but magnified my mental problems. At the worst of my anorexia I developed psychotic depression, and while my body fully recovered, my mental problems stayed. My shrink hasn't been able to determine what I have because anti-depressants increase my agitation and I would stay til 3 AM neurotically pacing around telling my head to shut up. I will get random thoughts (not voices) mixed with songs, phrases, and other words... but they are not the "flight of ideas" described in Bipolars. 

I have only tried one antipsychotic, Geodon, which almost permanently damaged my nervous system (my vision and hearing are impaired now). I don't know what to do anymore, if anyone has similar symptoms please let me know because this mental illness is so confusing.

four stressers at once are setting off my bi polarity - - Aug 1st 2010

I'm 53, had a huge successful career on madison avenue and lost it all when I got sick ten years ago. I am currently getting separated. My daughter whom I love more than anything has moved out of my house to go to college. I am moving back to nyc to try and pick up friendships and re build a life I had ten years ago. Plus my dog is dying. I'm not kidding. Anyone of these things could set off a bi polar depression but 4 at once?

Plus I"m on disability and haven't worked in years. My depression is unbearable. I have dreams of when things were great 10 years ago 4 - 5 nights a week. It has destroyed my marriage of 28 years and makes me so sad I think of suicide all the time.  I'm scared shitless of moving to nyc. Plus where I live is one of the most unfriendly cities in the country. For real. It's simply impossible to make friends here. My wife and I have tried for 8 years, unsuccessfully. We are each alone.

This is the perfect receipe for suicide. I have to leave where I live. It's awful. Any thoughts of anyone other than 'take it one day at a time' or some such b.s.? Is it possible that I'll be able to rebuild my life? Can things actually work out? Everyone I know from back east has moved on to great success and happiness. I have pretty much been depressed on and off, mostly on for 10 years. that destroys the soul.  I'm considered very handsome and made my living using my sense of humor and can be very, very funny when I'm o.k., but I fear I'll never hook up with a woman again.

Is there hope? Is there a success story out there? Is my life going to end with a bullet?



dear Jessica - meg - Mar 14th 2010

I was first hospitalised for a physcotic eppisode as a nineteen year old. I wasn't diagnosed as bi-polar till I was 25. I'm now 42 and I've had about 8 admissions for manic/physotic states. The depressions afterwards would be severe and lay me out for months. I drank alchoholically since my early teens as well and marajunna was a large factor in my first episode. I found lithium  helpful but had to switch to tegratol because of kidney problems. I have a huge list of terrible side effects that anti psycotic drugs have given me. The only one I've found to be any good is Seroquel. I even use it when I'm still reasonably stable as a sleeping aid so I don't go high. Sleep is key! I've been sober in AA for 6 years now and my episodes are getting much less severe and further apart. I also go to Al Anon to help me with the effects of growing up around alcholism and then repeatedley going out with alkies/addicts. I don't smoke marajuanna either. What I do do is excersise. I relate to your comments about the weight gain. Once when I was hospitalised epillum made me put on 10kg in 2 weeks! That suuucks! I stopped smoking, started running, joined a womens fight gym and started lifting weights. Excersise and fish oil capsules are as effective as anti depressants long term studies have shown. Since I've been doing all the exercise I have been able to lower my olanzapine which was making me fat/depressed. My panic attacks have stopped and I lost the 10 kg then another 4kg by not eating rice, potatoes or white bread after 5pm. I eat these wholemeal carbs/museli for breakfast or lunch though. I am weaning myself off lollies. I feel good and look great most of the time these days! I ask for help when I need it, I stick to my excersise routine no matter how I feel, it helps with both the up's and the downs. I learnt some breathing exercises and try to just take one day at a time. Believe in yourself! Good luck, Meg

24 female bipolar 2.... FINALLY correct diagnosis and found a treatment - d.b. - Oct 6th 2009

hi... i'm a 24 year old woman....  i grew up in foster care and group home so therapists etc. were  practically thrown at me... BUT  they  diagnosed me when i was a kid as being clinicly depressed and add and having "ODD" (thats oppositional defiant disorder for those that dont know THAT abbreviation)  as well as PTSD(which was the ONLY correct one out of the batch it turns out years later)  anyway..  so i went through growing up and graduated  and tried to work but life got out of hand and pretty soon i couldnt between   some times not being able to sleep for days and being on edge and aggitated and my brain going so fast that when i talk i'd stumble over words some times because my mouth couldnt keep up.  and at other times   just plain CRASHING and i dont mean as in just sleeping i mean emotionally and  like wanted to kill myself.... tried too....    also was dealing with panic attacks  some times which didnt help either...  so i ended up applying for disability  because i NEEDED to in order to  get government aid to be able to have any medical coverage to get TREATED because i hadnt been being because i didnt have any coverage and couldnt afford it.... welll they sent me to a GOOD psychiatrist to verify the diagnosis i was applying under and he was like NOPE thats NOT what she has but  she DOES have Bipolar along with the ptsd... so reapplied with the right diagnosis....    and   got coverage..........   but then  turns out i have a FUCKED up system..... my liver is over active and when they put me on depakote i had to be on 2250 mg to even get the minimum blood levels....  so they tried a few other things...  none worked...  anyway .... gave up.....   ended up moving and my new doctor found out i had migraines and sent me to a neurologist......... who put me on a low dose of topamax.... well.... helped almost completely get rid of the migraines so i rejoiced.... and  i lost my place i was living...... was homeless for 2 months..... but miraculously i did ok bipolar wise was actually doing kind of better....   not completely better but my  hypomanic and deprecive cycles were slightly milder.... not extremely noticable to me... but friends noticed...   then i got a place again... was doing ok still.... then my appendix went.... and  while i was in the hospital i missed my topamax......  and my bipolar went off like a bomb sort of... .... so talked to my doctor  after  and was explained to that topamax is sometimes used for bipolar as well as migraines too....  so anyway  started seeing a psychiatrist again and got it adjusted up and now i'm doing great and my bipolar is doing really good and i went from almost ALWAYS  somewhere in a bipolar cycle to now having some NORMAL times and the times when it is showing up its manageable....  its nice

Its back.... - - Sep 29th 2009

I have been living with bipolor I believe my whole life , but I was not diagnosed untill I was 23 . I have been on so many diff meds i really couldn't name them all . Finally I gave up on meds and doctors after a year of them not helping me and tried a natural way out . I started working out everyday and would meditate 4-8 times a day , that wasn't easy it took a long time to train my brain to relax and let thoughts come , I read every book on medatation I could find , and it really started to work . Now I am 27 and I can't do it anymore , I can't stop thinking and the thoughts come so quickly I can't slow them down to come to a conclusion about one thought before another one comes . My long time boyfriend keeps telling me I have multiple personalities . I really feel that way too. I know since what I was doing obviously isn't working anymore I need to see a doctor , but everytime I try to go I stop myself saying "the meds didn't work before so whats diff now ?" I miss the old me , the one who felt normal , the one who loved life and my family . Now I feel crazy , and thats the worse part , now I have to figure out what to do next before i lose everything that was once so important to me .It feels like a hampster on a wheel in my brain that keeps running and running and if he would just stop for a little while so that I could sort out all my random thoughts and maybe get some rest , I know I'd feel a 100 times better .

Depression or bipolar - - May 12th 2009

I have always had a problem with depression. About six years ago the doctors dignosed me with major depression. I have been on all kinds of antidepressants. I came off the antidepressants this past october. I was doing great i went back to school and passed my last four classes with A's. Well a few weeks ago i had a panic attack in a restrant.It was bad. After that i started going down hill. I started feeling lost and confused all the time like i could do nothing right. I found that makeing simple diecsions was caues me a great deal of stress. Istarted paceing  back and forth in my house and was always shacking. I started crying at a drop of a hat. and i droped out of my classes. The doctor said she thoght i might be bipolar. This is really new to me It has only been two weeks since the doctor said i was bipolar. I know the antidepressants has not helped over the past six years thats why i stoped takeing them. Oh well i will figure this out one step at a time.

thoughts about thoughts... - nnejifer - Apr 13th 2009

um doctors are dumb.they only see you to drug you up.dont you know thats how they get paid.!

Money Issues - David - Sep 1st 2008

I'm only 18 and have bp and I was recently having trouble with my medication (long story) and I have recently depleted my $2400 bank account to -$416 and some cents.I can't believe I am actually in debt to the bank...oops.

I don't have bipolar but the father of my kids did - mary - May 31st 2008

I don't have bipolar but the father of my kids did... I didn't realize what it was until it was too late. He had committed suicide in 2005. I was only 19 when I met him and he was 24 so of course he was a gentlemen in the begining. I thought he did what most guys do cheat, lie the works. But after our second child which was his first son, he started to change. He was always angry. We can be arguing about one thing and he'll bring something we argued 2 mos ago. I learned later he was molested and was moved to different group homes and was still upset about whatever happened in the past.

supoort for the mantally ill in the home - - Mar 4th 2008


 Some of my family suffer from bi polar , i did not understand what it was as a child bride and a husband who would never admit there was mental illness in his family and i am sure his whole family had no idea of what was happening either. 

They lived in isolation in a country town. 

Because my mother in law told me in very jovial way how my ex husband as a child used to go off up tne hills every day talking to himself. I did not take it as serious stuff i was sixteen and a half when i met him. 

Where we were born, a lot of these problems were covered over with alcohol, and left undiagnosed.

My childern have suffered til in adulthood were diagnosed and accepted treatment.

I took them to many child guidance clinics and counsellors but never got the help we needed. 

I went into mental health training and worked in the area's for years  and later with training, became a counsellor.

Now i have retired i understand a lot about what i have been through in my life living with mental illness. 

My strong recommendation for those who live in their own homes and need to take medication each day is to set up a buddy system with one assinged to each family.  The buddy would have some training in that area and supervised medication is taken. Also they can moniterd that persons health from day to day, espially where there are childern are in the family. I hope this is usful to some peolpe. dette


Pregnancy and bipolar - Anne - Jan 14th 2008
I was diagnosed with Bipolar at the age of 16. Since then I've tried all different kinds of medication and found ones that fit me well. Two mood stabalizers and an anti depressant. I recently found out with my Fiancee that I was expecting a child. Because my medications do not have many studies on the effects on the unborn child, I was to stop the medication. Since then I have been going through what seems to be the longest winter with the raging hormones of pregnancy and the uncontrollable energy levels of bipolar. So for the people who have to go without the medications, I know it is hard, but when you are faced with needing to stop them, just know that as long as you are willing to try and recognize when you are on a high or low, you can make it.

im outta control - jersey girl - Dec 19th 2007
Since i was a teenager i have experienced severe irritability.  i have always been very aggresive with loved ones, friends, strangers.. you name it.  I also engaged in extreme promiscuity, use of illegal drugs, life risking situations that i didnt seem to think of consequences or repurcussions like i was invicible.  I thought it was attributed to being a mother which i just recently found out also suffers from bipolar was as you can imagine very hard to get along with. so because i was unaware of her condition i didnt nderstand her actions..and i hindsight mine. this must be some type of genetic thing.  Most of my symptoms initally were manic until i was 17 and depression started.  I was able to graduate HS considering i barely attended classes, but i had so much potential to achieve greatness and was throwing it away. Fortunatly i was dating someone that abetted me in snapping out of those feeling and pursuing college.  College was definitly a point where i became more manic than before because i was now an adult..I must admit I put myself in situations that were very dangerous and continued my drug use.  I became a criminal minded manic depressive sociopath if u will b/c i felt no remorse of my actions and was doing harm to body. I met my fiance when i was 20.  I am 24 now and we are still together.. barely. We have 2 yr old daughter.  My manic episodes have increased and gotton severly worse. I get so angry i scream and curse and swing and throw things thru walls that makes holes in walls. i feel like i wanna kill someone or hurt them badly. i know this is not normal behavior.  I am isolating myslef from my fiance my father and now my daughter.  i flip out on her sometimes and she is innocent.  i kno i need help/meds but have no health ins.  I realized my moods were dramatically worse after i had my daughter. like i said b4 i thought i was just a rebellous teenager. i was diagnosed in feb. 2007 with bi polar disorder and was prescribed symbyax but i had some side efftects and discontinued use.  I feel like its getting worse and now my fiance wants to leave me.  I need to rectify this problem b4 its out of hand.  I can never hold down a job for more then months at a time( that why no  health ins) b/c when i am depressed i cant get outta bed and get scarred to go outside in public b/c i have gained weight with the pregancy and i am embarassed of my appearence and i feel like im nothing..  then i get fired or i just stop showing up.  This is affecting my life in every aspect.  any advice?

There is hope - Barbara - Jun 6th 2007

Everyday is a new day. Everyday when you wake up just think that there is someone there that is supporting you and will be there for you. I have a daughter that has been going through alot lately but I know with our suport and her husbands support she will be just fine.

I dont know what to do. - Catalina Peterson - May 1st 2007

My dad has manic bipolar and I know i have it to. I have a lot of symtoms like low energy then high energy. Episodes that last a long time. Spending money on stuff that doesnt matter. And I have been in the hospital twice for cutting myself and taking 29 anitripalings. My problem is getting a dignose because i get realy nearves talking to a docter and forget what to tell him.
i have refused treatment at the hospital for who knows why. Almost lost my boyfriend because I act on impolse. Im worried about my desitions. I race threw thoughts that sometimes i think about crazy stuff that has to do with god and the devil and it seems to make sence sometimes. I am not sure if medication is the best thing forme. But Im not really sure. Sometimes I get really confused and I dont know what I know. Sometimes I think I have illnesses thats not there. Like i thought I had HIV from low energy and sleeeping alot. My biggest problem is when I get mad or sad. When I get made its like the devil is inside of me. I dont care what I do or who i hurt. And I say what ever posible to hurt someone. Ive punched holes in the walls, tryed to hit my mom with a stick. How can I get a dignose without getting nearves when talking to the docter.

Editor's Note:  Only a doctor can diagnose bipolar disorder, and only a psychiatrist is really specialized to treat it.  Bipolar disorder is serious (as you know from two suicide attempts), and the only really effective treatment is medicine.  It is important that you get over your fear and talk to a doctor about your symptoms.  If you get nervous and forget what to say then write down what you want to say before you go visit the doctor.  That way you'll have an aide to help you remember what you want to say. 

Here, down below - Ken - Mar 18th 2007

I feel at times I can not take one more step. The dark surounds me, and there is no escape, not just darkness, evil darkness, ,the kind that makes a man think he is nothing, and so be your whole life. You ponder, no you seek, and end, but even this brings a scream, more palitable,is the coward you would be if you give in. I Love my wife and family more than I could ever express in words. But so is the burden I feel as I contemplate ever hurting her again which I know is unavoidable. I would most assuridly recomend that you seek help for yourself and those you Love. We may always have to live with this but remember those we Love have a choice. Help them to do so.

Bipolar folks discuss meds and treatments - - Feb 24th 2007

on Bipolar folks discuss meds and side effects on These sites are not limited to bipolar folks, although the bipolar sections have the most posts, I think.

Personally, I have had MDD. I found wisdom and practical suggestions at these sites, including observations that I MUST discuss with my psychiatrist because they suggested a subtle counterindication for the meds I was on. The people who post on these sites are people who are living it and have lived through it.

Courtesy rules. Probably because everybody going there is stressed to a greater or lesser degree by common illness, the protocol - and it is strictly enforced by the moderators - is to extend extreme consideration to fellow sufferers (sufferettes?).

Bless you and your family.

Personally, I took the geographic cure - moved away from an oppressive environment, found a job somehow, got an apartment, got a dog, walk the dog, studiously go through the motions of life, concentrate mightily on getting engaged with necessary conversation. I am slowly coming back. although under no circumstances would I say that I made the move and never looked back. I get through every day concentrating on what I have to do, and every day is a victory. I look forward to coming home and ordering my own evening. I am ever vigilant against the return of MDD, but I've gotten so I know what it feels like before the sink into the gloom, and I now know what to do.

Lest I give the wrong impression, I'm not exactly running through meadows with "The Sound of Music" soundtrack playing behind me. However, it is so much better than it was before I left. I found myself making a couple of jokes a week or two ago. I am content.

It took years to get into a depressive cycle. I don't expect to rebound to where I was when I was twenty five, and I don't expect habis of mind such as "contentment" or "joy" to get hardwired without some time and some diligence. But I tried to kick start it by going through the motions of a good life, and this practice has worked: my life has gotten considerably better.

PS - in no way do I suggest that MEDS, PSYCHIATRIST and SUPPORT GROUPS are not the first line of defense. It is a measure of how far I have come that I can even imagine concepts such as hardwiring contentment. For me, I needed every bit of help from ALL of the big guns -- AND getting a distance away before I could begin the slow process of getting well.

Good luck.

Don't give up - - Feb 16th 2007

 I have lived with bi polar disorder since Iwas 15, I married at 22 and had 5 children  and I had 6 years without any illnesss. After a severe mania and depressive eposides I was put on lithium. I was on it for 22 years and I had a few hiccups,I was hospitilised once since.Last may I decided to give my body a rest from lithium. I am  in a depressed mood now and I also have agitation, anxiety and negativity. I am currently being treated with olanzipine 2.5 mg I have been on this tablet for over a week and I am improving. I managed to bring my childern up well and 4 of them have university degrees, the youngest is studying.    So don't let this beat you you have so much to live for.

I've been there. It will get better. - BuffaloGal - Feb 13th 2007

I know where you are and where you've been.  In college, I could stay up for days straight studying.  My brain worked so quickly and processed faster than other students.  It was like I was on speed or something.  To most college students, this seems ideal.  For me, it was far from ideal. 

With studying and grades aside, I'd come home (after 4-7 days without sleep), tired, exhausted, and desperate for sleep.  Still, my brain was in overdrive mode, and running so fast that I couldn't even sit down to watch TV.  I couldn't sit still for even a short period of time.  I was highly agitated, and silence was deafening.  I couldn't stand being alone, but people irritated me.  I was hungry, but nothing was satisfying.  I was restless, jumpy, and needed to move, talk, or do "something" even though there was truly "nothing" to ease this tension.  It was like having cabin fever -- constantly!  As a college girl, I did VERY stupid, risky things. Drinking and sex replaced reason.  My actions moved faster than my judgement, and my daring activities became more and more dangerous. 

Then, all the sudden, it would all stop.  But the stop was just a CRASH.  I needed sleep (for days, not hours).  I couldn't work, show up for classes, answer the phone, eat, bathe, or do anything with others.  It was the complete opposite of the previous week/days. I felt fat, ugly, stupid, lazy, and worthless.  I hated myself for the foolish and risky things I had just done.  I found I couldn't pay the bills from all the erratic spending I did.  I felt trapped, isolated, scared.  I knew it was only a matter of days/weeks until the mania would come again, and the depression would soon follow.  Over and over....  (This seems to be what you're going through)

At doctor appointments, I knew something was wrong, but I didn't know how to describe what was wrong with me.  I talked to my doctor about the depression (from my perspective, that was the part that was hurting my friendships, family, job, classes, etc.).  I didn't know that my mania was technically "wrong".  I didn't want the "positive qualities" (as I perceived them) to leave.  So, I kept quiet about it.  The doc diagnosed me with depression, and put me on anti-depressants (Zoloft).  As you can imagine, this made my mania worse!!!  I spun out of control...

Finally, one of my (MANY) boyfriends talked about his bipolar symptoms.  I couldn't believe how familiar it sounded.  I put my pride aside and went to see a psychiatrist.  She tried a number of different meds, but the current one has changed my life.  Now, I'm 30, taking Lamictal, and my ups and downs are far less severe.  When the mania "rears its ugly head", I have some Clozepam (sp?) to calm me down.  Now, I'm married, have a steady job, two master's degrees, and live a full and stable life. 

If you are not finding success with your current meds or psychiatrist, you should seek out another medical professional.  For example, I now drive farther from home to see a psychiatrist who SPECIALIZES in bipolar disorder.  WOW -- what a difference!  Be sure to mention that your sleeplessness isn't stopping.  He/she can prescribe something to calm you down more (it might be stress/anxiety).  Anti-anxiety medications "killed" my racing thoughts, calmed me down, and let me relax enough to sleep.  It also helped me focus more at home and at work.  It kinda slammed the breaks on my racing brain.

 Hang in there, things will get better.  :)

- - Jan 29th 2007
Hang in there . It can take a while to find the right combo of meds for you. It took my shrink and me 3 years to discover how to keep my mood stable and not cause depression instead...Keep telling them how you feel. Keep asking about side effects. Consider using Metformin with antipsychotics to reduce the tendency to gain weight. Learn all you can. Be active in your care. N

Emotional Rollicoaster, Mental anguish - Jessica - Dec 29th 2006
I have been diagnosed as having bipolar disorder II with rapid cyclying. I have just recently been properly diagnosed after seeing my first Phychiatrist at the age of fourteen. I was given antidepressants for years, and suffered needlessly because i was told i had major depressive disorder. The antidepressants sent me into a manic phase so severe I could sometimes stay awake for days at a time. Some people think this sounds great beacuse you could get things done, but it was and still is the absolute worst feeling in the world. Sounds become extreamly loud, lights way to bright, every thing is extreamly elevated and you feel like you will crawl out of your skin. There is an intense feeling of fear and paranoia and you are so tired yet you feel wired. The thoughts come so fast that you cant put them together and it is like a record playing over and over in your'e head. Between this and the severe depression, I dont know whats worse. I am irratable all the time and have very few days in between when i actually feel happy. My moods change so many times in a day i never know what i really want or how i really feel. This disease is ruining my life, and the cocktails of meds that im currently on make me phisically sick, and i dont seem to respond well to any of them. When i come across a mood stabilizer that actually helps a little, I gain weight rapidly. Im deaperate for answers and a treatment that works. My relationships suffer, and I have a four year old beautiful daughter that deserves a mommy that she can recognize every day not just on my good days. Can any one offer some advice on medicatons that may be helpfull? Is there hope of ever living a normal life? Are there other alternitives? I feel so alone and helpless.

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