what is mixed mania that's what I'm
gonna talk about today I'm dr. Tracy
marks a psychiatrist and I published
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and self-improvement if you don't want
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today's topic is based on a viewer
question from princess consuela who
happens to look a whole lot like
Angelina Jolie and I'm gonna read her
question as a teenager I struggle most
with mixed episodes which to me are
actually more painful than mania mania
to me is just pure anger depression is
the best because it's just sadness and
your thoughts are slow and really calm
like you're a part of an ocean I know
they are dark but they are really the
best part of it all in short being a
teenager with bipolar has ruined my
future and most importantly me Thank You
princess consuela for that question it
made me sad to read her comment that
bipolar disorder has ruined her future
in my response to her on that issue was
to keep in mind that depression distorts
your outlook on life things everything
looks hopeless and you just can't get
out of that thinking on your own and
when you're in that state you can't see
the light at the end of the tunnel
but there is an end to the tunnel and
that's what I'm going to talk about now
the official term for mixed mania is
bipolar disorder either one or two with
mixed features with bipolar one disorder
you have episodes of depression and
episodes of mania with bipolar 2 you
have depression and hypomania I'll have
a link to my bipolar playlist where I
talk more about the difference between
mania and hypomania mix features means
that you have a combination of
depression symptoms and manic or
hypomanic symptoms occurring at the same
time so you maybe have a depressed mood
with lots of crying spells but then yet
your mind is racing and you're extremely
aggravated you may be making impulsive
decisions or having trouble getting
motive
to get out of the bed in the mornings so
it's like you're a hyped up sad negative
person and it can feel extremely
uncomfortable bipolar disorder with
mixed features is harder to treat than
pure bipolar disorder alone and the same
is true for depression with anxious
distress or anxious features and that's
a topic for another day some of the
recommended treatments for mixed mania
is lithium seroquel or quetiapine and
Latona lithium is particularly good for
aggression and suicidal thinking but
it's not that easy to take lithium
because it has a very narrow therapeutic
window this means you have to check
blood levels and make sure the
concentration is within a certain range
if you're below that range it's not
going to be effective and if you're
above that range you can experience
toxicity and see things like confusion
and tremor
seroquel can be very sedating which is
good if you're having trouble sleeping
but can also cause a lot of weight gain
letona is a newer agent so you may have
trouble getting it covered by your
insurance also it hasn't been around
long enough or as long as the others to
have as many studies showing its
effectiveness as lithium and seroquel
now I realize you can't prescribe these
things for yourself so this is just
information for you to talk to your
doctor about but be prepared because
with bipolar with mixed features is
harder to treat so there's a good chance
that you may have to take more than one
medication at the same time generally
antidepressants are discouraged for mix
mania if you still don't do well with
two medication trials lasting at least
four weeks each then there's electro
convulsive therapy or ECT in
transcranial magnetic stimulation or TMS
and these are non medication options
that work well for people who can't take
medications or don't respond too well to
medication so here's a little bit about
ECT and TMS ECT is still
a gold standard for difficult to treat
conditions and some people call it shock
therapy ECT is a procedure that works by
provoking a seizure under very
controlled condition so you're under
anesthesia and you hardly move around
but the monitors will still show seizure
activity exciting the brain this way
treats conditions such as depression
mania and psychosis you usually get a
series of treatments like three times a
week until your symptoms resolve and
this is customized for the individual
but an average may be 10 to 12
treatments then you may follow up with
maintenance treatments that occur less
frequently TMS uses magnetic stimulation
similar to the technology of an MRI
machine to stimulate your brain and
those sessions tend to be five days a
week for about six weeks
TMS is only approved fda-approved though
for treatment-resistant depression both
of these procedures can be done on an
outpatient basis so you don't need to be
in the hospital but ECT is done under
general and anesthesia whereas TMS is
not ECT is still more effective though
than TMS these treatments are heavy-duty
and they require a big time commitment
but they are very effective and don't
forget about therapy the best approach
to treatment is if you have the
resources is to do a combination of
medication and cognitive behavior
therapy or interpersonal therapy that's
mixed mania or bipolar disorder with
mixed features it's tough but there are
things that you can do to help ECT and
shock therapy is still alive and well
and very effective if all else fails
that's it thanks so much for watching
and I will see you next time
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