In plain words
A mixed state is a mood episode with signs of mania or and signs of depression at the same time. A person may feel wired, racing, or irritable while also feeling hopeless or very low. It is different from a simple low mood or a simple high. Mixed states can be dangerous because they raise the risk of self-harm and impulsive action. They can occur in . They are one reason perinatal mood problems need a careful assessment. If you notice this combination in yourself or someone else, call your provider the same day. If there are thoughts of self-harm, call or text now.
The deeper version
A mixed state is a mood episode meeting criteria for both manic or hypomanic and major depressive symptoms, most often in bipolar I or II disorder, as defined in DSM-5-TR (American Psychiatric Association, 2022). Mixed features, meaning sub-threshold opposite-pole symptoms, are common in bipolar depression and are linked with higher suicidality. In the perinatal period, the differential includes depression with irritability, , bipolar spectrum disorder, premenstrual dysphoric disorder, with , , , sleep deprivation, and situational anger. Screening with the is commonly recommended before antidepressant treatment. The controversy concerns antidepressant-associated switching and how to recognize mixed presentations in the postpartum window.
Where it comes up
- Postpartum ragePostpartum: Mind
- Therapy and medication after birth: what the options arePostpartum: Mind
- When to get help, and who to call tonightPostpartum: Mind
What mothers here say about mixed state
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Sources
- American Psychiatric Association — Diagnostic and Statistical Manual of Mental Disorders, DSM-5-TR (2022)