What is meant by a mixed state?
A mixed state is a combination of manic and depressive symptoms. While common, mixed states are underrecognized, with an estimated 40% of people who present with manic symptoms having a sufficient number of depressive symptoms to be diagnosed as being in a mixed manic and depressive state. Some studies have shown that suicidal thoughts are greatly increased in people in the midst of a mixed state. Treatment has been poorly studied, but recent evidence indicates that some of the newer medications, such as divalproex and olanzapine (Zyprexa), may be more beneficial than older drugs like lithium.
