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              As you will have found, if you or a friend or relative has been diagnosed with Bipolar Mixed States there is little information about it and what there is is spread all over the place.

              So far we have not found a book which is devoted entirely to Bipolar Mixed States. Should you find one, we would be most grateful if you would tell us. You may do so on the Contact Page

              When I was first diagnosed with Bipolar, I natually read up on it. However, I was not one who had definate periods of mania and of severe depresson (Bipolar I) or hypomania and usually severe depression (Bipolar II) with each of these mood states occuring separately. This I must say was really confusing. However an astute psychartrist and psychologist finally diagnosed Biplar Mixed States. Well some of this is now subject to question. See how difficult it is? Both of these medical practioners know their profession well.

              One of the first to investigate Bipolar Mixed States was Emil Kraepelin1, he postulated that mood, activity and thought sometimes varied independently during the transistion from depression to mania or vice versa. This produced Mixed States. He described six possible moods as follows:

                   •   depressive or anxious mania (flight of ideas, over-activity,                                   anxiety).

                   •   excited (agitated) depression (inhibition of thought, over-                                   activity,depressed mood).

                   •   unproductive mania (inhibition of thought over-activity, elation)

                   •   manic stupor (flight of ideas, gross motor retardation, elation)

                   •   depression with flight of ideas (flight of ideas, motor retardation,                         depression)

                   •   inhibited mania (inhibition of thought, motor retardation, elation)

              These states are usually transitional, but occasionly persistent2a.

              The DSM-IV (Diagnostic and Statistical Manual of Mental Disorders (DSM), 4th edition) recognizes only one form of mixed states in Bipolar Disorder. The criteria in the fourth edition are two weeks of Depression and one week of Mania. These criteria may change in the fifith edition of the DSM.

              Many individuals who have suffered a mixed episode, and many psychiatrists would carry these criteria further. Although psychiatrists do not yet agree on the defining characteristics for this state, they have long recognized that the symptoms of mania and depression seem to co-exist at the same time in some patients.2

              Psychiatrists today recognize that there are more variationss than Depressive Mania within the spectrum of mixed states, although the characteristics have not been defined, nor are these states official. Clinical experience has identified several different states that could be termed mixed states. These include Depressive Mania, Irritable Mania, Anxious Mania, Excited depression and Agitated Depression and others may exist.2

              So as you may see, currently it appears that the list of criteria for Mixed States Bipolar in the DSM-IV needs updating. Psychartists and researchers are finding that defining the criteria of Mixed States Bipolar is quite complex. Due to the diferent way the Bipolar Mixed States manifasts in each individual. It appears it will be difficult to list the criteria in DSM-V (to be printed in either 2012 or 2013).

              This current situation makes it particulary difficult for diagnosing medical practioners to diagnose Bipolar Mixed States and for patients to relate their own particular symptoms to Bipolar Mixed States.

              The following url where you may access the DSM-IV criteria for Bipolar:DSM-IV

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1. Emil Kraepelin (February 15, 1856 October 7, was a psychiatrist . The Encyclopedia of Psychology identifies him as the founder of contemporary scientific .... Source Article by Colleen Sullivan 2aPsychoses of Uncertain AetiologyBy Lorna Wing