Mixed Episodes

Song of the Day: Kiss With a Fist by Florence & the Machine.

(Photo Credit: Tim Geers available under a Creative Commons Licence).

I have been experiencing a mixed episode over the last two weeks following a month-long period of hypomania. Olanzapine has been added to my current cocktail of prescription drugs, although I am reluctant to take it as it pretty much knocks me out for the day.

Mixed episodes are curious affairs and inadequately defined by the DSM IV in my opinion: criteria for both a manic and major depressive episode must have been met for at least one week. But what does this really look like in terms of real life? Thought this might be an ideal time to relay how I’ve been feeling over the last couple of weeks:


Irritability (unfortunately my partner seems to bare the brunt of this)

Anger and Hostility: feel like I’m looking for a fight, which is extremely out of character for me.

Anxiety: this seems to cluster around health and social issues

Rapid thoughts: ruminating , repetitive and obsessive- seem to be about social encounters more than anything.

Tired, but wired: can be extremely tired, other times really revved up, restless, can’t relax.

Unable to concentrate.

Dislike of self, fault-finding, blaming, criticizing, guilt etc.


I’ve been signed off work for a week as I’ve been getting upset easily and the anxiety has been getting worse. In the past I’ve felt guilty for spending time off work, but right now I actually feel really grateful and relieved to have the chance to regain my balance.

So what has caused the recent mood episode which began with hypomania about six weeks ago? My thoughts:


Primary Trigger: shorter days, decrease in daylight hours- this is becoming a regular trigger.

Result: Hypomania


Things I’ve done that have exacerbated symptoms (not purposefully- I was pretty unaware of how bad things had really gotten, mainly in the last week or so):

– Over-involved in other peoples lives and problems.

– Not looking after myself, diet & exercise.

– Too many social events involving drinking, loud music, crowds etc.

– Blaming my relationship which has caused things to worsen with me and Chris.

– Too much internet, get more addicted.

– Watching too much 9/11 coverage- always upsets me loads, but for some reason I feel compelled to watch it- bit dodgy really.


Secondary triggers: Major changes at work. Tension in relationship. Finances.

Result: Mixed Episode. Didn’t catch the hypomania early enough.


Things I can do to help myself now:

– Healthy, balanced diet. (Boring)

– Exercise. (Boring) Continue dog walks- increase length from 30 minutes to 45-60 minutes. Yoga in 10 minute stints.

– Do the things I love: writing, reading, drawing, piano, flute, singing. (Fun!)

– Let go of self-blame, guilt and anger using meditation and affirmations (see below).



I love and approve of myself just as I am.

I forgive myself the past.

I’m always doing the best I can.

I release the part of me which needs to criticize myself and others.

I allow myself to have fun.


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