Mixed Bipolar Disorder

In most types of bipolar disorder, a patient struggles with episodes of depression and episodes of mania, or high energy, in a cyclical pattern, but mixed bipolar disorder is defined by the experience of episodes characterized by both mania and depression simultaneously or in quick sequence.

Those who experience mixed episodes are often diagnosed with bipolar I disorder but may be diagnosed with mixed bipolar disorder depending upon their other mood episodes – or lack thereof. Between 20 percent and 70 percent of patients diagnosed with bipolar disorder will experience mixed episodes, according to WebMD, and those who begin to experience bipolar symptoms at a young age (e.g., during adolescence) are more likely to struggle with mixed episodes and/ or mixed bipolar disorder.

What Are the Symptoms of Mixed Bipolar Disorder?

The mixed episodes experienced by those living with mixed bipolar disorder are defined by depressive symptoms and manic symptoms that occur in quick sequence or at the same time. These can include a range or combination of specific issues, including:

Manic symptoms:

  • Racing thoughts
  • Rapid speech
  • Agitation
  • High energy
  • High activity levels
  • Irritability


Depressive symptoms:

  • Low energy
  • Suicidal thoughts
  • Self-harm behaviors
  • Low interest in usual activities or managing day-to-day affairs
  • Sadness
  • Hopelessness
  • Guilt
  • Feelings of worthlessness


Though it may seem impossible to experience such extremes at the same time, these episodes defy logic or any predictable pattern of behavior. For example, a patient may quickly jump from extreme sadness to feelings of exuberance in a short period or laugh hysterically while describing feelings of deep pain or worthlessness.

No matter what the specifics, mixed state episodes can last a few days, a few weeks, or a few months. Every patient’s experience is different.

Drug and Alcohol Abuse and Mixed Episodes

Some patients drink or use drugs during their mixed episodes. It may be behavior that results from their symptoms or it may be an attempt to curb the symptoms that are disrupting their ability to function.

Some patients live with an active substance abuse or addiction problem and then experience mixed episodes as well. Their use of drugs and alcohol can serve to exacerbate symptoms, lengthen the term of the episode, or increase the frequency of episodes experienced.

No matter how the two issues occur, it is important for patients who struggle with both mixed episodes and substance abuse to seek treatment that addresses both problems simultaneously.

The Risks of Avoiding Treatment

Without treatment for both disorders, patients take on a number of risks that threaten their health, their social relationships, their position in the community, and their lives.

Struggling with untreated mental health issues and substance abuse problems can lead to:

  • Legal problems
  • Family conflict
  • Inability to get or maintain employment
  • Financial distress


Family members are often instrumental in helping loved ones living with co-occurring disorders to get the help that they need to heal. Without their assistance, many patients would continue to avoid seeking treatment or live in denial that they have any issue that requires medical and psychiatric care.

Find a Dual Diagnosis Rehab Program Today

If your family member is struggling with mixed bipolar disorder or problematic mental health symptoms as well as substance abuse issues, we can help you to locate the treatment program that will best serve their needs. Call 844-567-9906 now to speak to an admissions coordinator and help your loved one begin their journey toward recovery today.

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