CONVERSATIONS ABOUT Mixed episodes, Features & Misconceptions

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My name is Shaila Hoogendorn and I live with Bipolar 2 Disorder. Sharing with others is healing both individually and collectively. Sharing our stories will educate others, bring more understanding, shed more light and smash more stigma. Music. Our voices need to be heard. Our stories aren't over yet. This is Bipolar. Hi everyone. Welcome back to This is Bipolar. I am your host, Shaili Hoogendorn.

I am a mom. I am a teacher, I'm an event planner, and I'm a fierce mental health advocate that lives with Bipolar 2. And I'm really excited for my co-host to tell you about herself. This is Andrea. Hi, this is Dr. Andrea Vasilev. I'm a doctor of psychology, a mental health advocate, a therapist, and I guess I'm coming up on my 27-year anniversary with Bipolar. Before we get started, I just wanted to let everybody know that I have subscriptions on Instagram.

What is that, you ask? It is a place where you subscribe and then you have access to peer support. I have a peer support chat. There are people in there from all over the world that are subscribers. So if you are hopefully not awake at all hours, but if you happen to be awake at all hours, there is usually someone in there to respond. And then we meet on Zoom once a month to check in and just be together. It has been such a healing space for me.

It's been such a powerful space because you are showing up unmasked and exactly who you are and what you experience. And everyone has been there or recognizes it. And I would love, love, love for you to join. You can go to Instagram at this.is.bipolar and you can do it there. Otherwise, send me a message. I have a website. I've had a website for a couple months. And it's www.thisisbipolar.com and you can contact me there. I am really excited today because I am prepared to learn things. Okay.

When you visit Shaylee online, you can visit me too at best.life.bipolar on Instagram or my website, Andrea Vasilev. That's a really hard name to spell. V-A-S-S-I-L-E-V dot com. Yeah, and we are always open to messages and we are open books. We will answer the best we can. So go and find us there. Let's be besties. We would love to get started today. I'm really excited about this episode just because I know I'm going to learn a lot of things.

This isn't a topic that I am well versed in and wasn't sure if I ever experienced before, but we are slowly going to find out that is probably where I am at. Yeah, you might be better versed in it than you realize.

So today we're going to talk about mixed episodes and i would love dr andrea for you to tell us what it is what it's defined by so you're in good company when you say mixed episodes shaley i really have a lot of respect for our community our community is super well educated really informed. They want to learn things. So I'm not going to like water down any of this information. Mixed episodes clinically are complicated.

The first thing is they're no longer called mixed episodes. So if you're familiar, doctors, prescribers, et cetera, have this book, the DSM, where they write all of the rules about how to diagnose. And there's plenty of problems with that, but it's still what we use. In the old version, we called it mixed episodes and you had to meet all the criteria for depression and all the criteria for mania or hypomania, except the duration one, right? So that's like a lot of criteria to meet at once.

It's full mania or hypomania, full depression. That's a lot. In the new DSM, they call it mixed features. So you can have unipolar depression with mixed features. You can have a bipolar depressive episode with mixed features. You can have a bipolar hypomanic episode with mixed features. And it means that you're having that episode.

So let's say most common way I've seen it and experienced it is a depressive episode with mixed features, which means you're experiencing depression, but you also are experiencing some symptoms of mood elevation. That might be difficulty sleeping. That might be agitation. We'll get to what it looks like in a second, but just know it's this sort of really messy mix of things we call it we can call it a messy mix of course it's messy.

As we know with bipolar I'm curious does that look different people like we know it's a spectrum right I know there's bipolar one bipolar two other.

Unspecified but look at you with your dsm words i love it you're rubbing off on me does it look differently for different diagnosis or on different parts of the spectrum that is mood disorders interesting so there's a lot of heterogeneity meaning that every person with bipolar is going to show up differently so i think even from person to person it's going to look very different so what doctors try to do sometimes with more success than other times is draw themes and

draw a line through something so you can see a pattern right yeah one highly respected dr roger mcintyre he does his four a's about mixed features and they're pretty i know right everybody loves a good acronym. I'm a teacher. Right? So his four A's are anxiety, agitation, anger, and attention problems. Now, insomnia could also be included on that list, but that would ruin the four A's. So anxiety, agitation, anger, and attention problems.

So we'll talk about a little bit later. Those symptoms, Shirley, have you had those symptoms before?

Yes. Yeah. All of the above. uh-huh they can show up in in different diagnoses they can show up in different places right so it's really the context in which you see those so for example if we have somebody who's experiencing depression low mood loss of interest in activities loss of pleasure changes in weight eating etc and they're also experiencing increased energy but this dysphoric very unpleasant increased energy talking more,

more ideas, things like that, that might be a depressive episode with mixed features. Interesting. That is really interesting and sounds slightly familiar. How would one, besides reading the book, how would one begin to recognize that? I can speak from personal experience because I have had some brutal episodes with mixed features. And what's interesting is that clinicians will say, again, we'll talk about this in a minute.

Clinicians will say it's very hard to diagnose and differentiate from other things like depression plus anxiety, depression plus ADHD, depression plus PTSD, things like that. But I feel like when you've lived through it, Like it hits you over the head and you just know. So for me, it's a very physical experience. It feels a lot like jumping out of your skin or a friend of mine once described it as her brain banging up against her skull, right? Oh, yeah.

Doesn't that sound familiar? Yes. So if you're living through it, I feel like it's almost easier for you to say what's happening than for a doctor to observe you and say, oh, this is what I think is happening. And that's why it's so important to advocate and to speak up about your experience when you're talking to your clinician. I can imagine, especially when pre-diagnosis or if you are untreated, that you wouldn't actually know because you're not aware.

I know I was just trying to feel better, so I wasn't like super reflective of how I'm feeling. Mood tracking and all of those things are important but sometimes I feel like I'm just surviving or that bipolar disorder takes over so much that sometimes I don't feel like writing it down because I feel like even acknowledging it more even though I know it's good so I know that's probably recommended and you'd probably be able to see it if you did that as you're talking right now.

I just did a little 10-minute update a couple weeks ago, and I talked about being in what I think is a mixed episode, which now I know is mixed features. I don't know how to differentiate, maybe you have in your experience, if it would be a depressive episode with mixed features or a hypomanic episode with mixed features if you're feeling both at the same time. Is one dominant? The different question, what matters most is that you get the right treatment.

So we can split hairs all day. Let's take our whole community, our brilliant community and nerd out. I'm down. Let's do that. About which, how to define it, how to classify it and how to code it. But remember that the ultimate goal isn't necessarily to have a title, but to have a treatment. Yeah.

But to answer your question, if you have a hypomanic, manic or depressive episode, you have to meet all of those criteria except the duration one. And then you have a sprinkling of the other one. You have full depressive criteria except duration and then sprinkle hypomania and sprinkle depression. Got it. Yeah, that makes sense.

I find that really interesting what you said because sometimes it's such a fine balance for me to focus on the treatment and focus on doing the helpful things and the strategies and keep showing up that way. And also hyper fixating on trying to figure it out and weed it out, right? What is bipolar? What is Shaylee? What is my personality? So I could see how I want to understand that. But. I can get caught up in trying so hard to untangle it and it doesn't actually feel possible.

And then I get overwhelmed, which makes things worse. Do you ever experience that? Does that sound familiar? Yes. Overwhelm is a good friend of mine. I'm interested to hear that you've also met her. Oh. I wish she wouldn't visit so often, but yeah. No, she's a bit of a chore. You're like rude. No way.

But yes and this kind of goes to something i talk about with some regularity which is that we have diagnoses in order to inform treatment people get really caught up on their label their diagnosis and they're really just there as shortcuts for doctors to know what treatment is going to help you that's why it matters other than that i'm not sure that it has any inherent value having a diagnosis speaking of labels can i give you some news shaley yes Yes, I have a title for my book.

P.S. everybody, Andrea's writing an amazing book. Yes, tell us the title. Because I said the magic word and now I'm taking a tangent for a second. The book is about self-stigma. It is a workbook, an interactive workbook. It'll be published by New Harbinger June 2026. And the title is Beyond the Bipolar Label, a workbook to overcome self-stigma, break the cycle of shame, and live authentically. So you said the magic word label, and here we are.

I love it so much. And I have had the privilege of seeing little tidbits of said amazing workbook. So we watch for that. We will be screaming about it from the rooftops. And I'm actually really excited, not just because Andrea is my friend and an amazing clinician and so wise, it's because I think that it will be really helpful because I have.

A lot of treatment and I've done a lot of things and I still struggle deeply with self-stigma and I find it very difficult to root out and I go back to it very easily depending on what episode I'm in. So you described a little bit about what it feels like in the body. Can you tell me, you said you have experience with it, what it looked like in your life. Like what did it look like in your daily life or what did it feel in your body specifically?

Because I have a few things I wanted to read from the Instagram community. The Bipolar Besties wrote to me some of their feelings. So I just love to bring it to that because what I love about talking with you is that you have the clinical side, but also you've experienced this. So I like super duper trust you. So I'm curious about what that looked like or looks like in your daily life. Sure. So I remember one time I was put on an SSRI, which we know can be tricky.

I was having bad OCD symptoms, which it turns out is just something that the volume sort of gets turned up on if I'm having a depressive episode. Interesting, maybe a topic for another episode. Yeah. So my doctor's like, okay, I'll put you on this SSRI for OCD, but I don't know that this is going to go well. I don't know that that was a great choice on his part, but neither here nor there.

I remember pacing around my guest room, and I know if you're listening, you can't see, but shaking my hands like this because I was trying so hard to discharge this energy that was just coursing around me. And I did feel like my brain was banging up against my skull, but the skull was banging back, so it's fine. There's that. There's also, and this is common to a lot of people, a reason that mixed features are super dangerous is because that's when the incidence of suicide is the highest.

Think about it this way. You're feeling terrible. You're in a depressive episode. You're experiencing all of those really painful things. And then you get a burst of agitated energy and you have enough energy to do something about it. And that's why it's so dangerous. So the closest I ever came to taking my own life was during a mixed episode because I was jumping out of my skin.

Like I couldn't, I couldn't take it anymore. And I just, it was like a electricity was buzzing through me and I desperately needed to turn the switch off, like to pull the break or whatever. Yeah. I'm so sorry you experienced that. That just reminded me of an interview I did with Sarah and I'll put it below.

But a while back she's a musician and she was saying to me one of the biggest thing that she wanted to talk about and I think I did an Instagram live anyways go search for that if you're interested but I remember it was the first time I heard someone say that her attempts we read all the things to watch for right and there are all these things to watch for and as we know everything is nuanced but she had told me that it wasn't it was impulsive for her so I'm curious if that was a mixed episode,

but she said it was impulsive. She wasn't planning. She didn't have a plan, wasn't doing the things that all the list says, although that is important, but it isn't for everyone. And that was really eye-opening in what you're telling me now, because I think that changes what we've, should look for in ourselves and in the people around us. Yeah, that's wild to me. It's a really good point. Recklessness, right? Or impulsivity, which is more like hypomania or mania.

So that would be like the sprinkle there that you were talking about. And when I am in a depressive episode, I am numb. Doing stuff is hard.

Actually, even if I feel like going to sleep forever or not existing to actually have to do something about that. Someone jolts you with this agitation and this energy and the four A's, et cetera. And next thing you're driving down the freeway at 90 miles an hour, et cetera, et cetera. Yeah. Or you have those thoughts. And as always, I think it's the nature of the podcast that people know there could be a blanket activation warning over the whole thing.

But I know for me, what I think now looking back might have been mixed features or just the A's. Sometimes I have these thoughts and people don't talk about them. And when I talk about them, there's a lot of people that are like relieved and say me too. And it doesn't, I don't tell people because I'm afraid like to scare them. But to me, it looks like impulsive.

Like I just think about just driving over here a little bit and getting just into a little bit of an accident or do you know what I mean or those things pop in my head like I should just veer into traffic and I don't have a plan and it's not like I want to die but it's a strong feeling right or I have ones too where not just considered suicidality but like where if I just got hurt right if it just broke my leg or I was in the hospital,

then maybe people would see my pain. So I understand both of those. One's. This urge to end pain and in this recklessness mixed together, again, is a very potent, dangerous combination, which is why it's so important to be on the lookout for mixed features because they can blow up fast. Yeah, I wanted to read something that I just found so powerful that someone wrote in when I was talking about it on Instagram. And I just thought it was so well written and I was just like, uh-huh, yes.

And the person wrote, for me, my first mixed episode felt like being strapped to two different roller coasters going in opposite directions at the same time. I had this intense energy like I could run a marathon, but my thoughts were dark and racing, telling me I was worthless. I remember pacing in my apartment for hours, feeling the unbearable need to do something, anything, but also the crushing weight of despair. It was terrifying because the energy should have felt good, but it was twisted

and fueled by negativity. That's gorgeous. Terrible that they experienced that, but so articulate and put together. Yeah. I often say it's like your brain is throwing rocks at you, but really fast. Yeah. Like, how are you supposed to defend yourself from the inside? Yeah. Let's title this episode that, How Are You Supposed to Defend Yourself from the Inside? That's great. Deep thoughts by Shaylee.

So we've talked about a few things about what it might look like, but I wanted to go a little bit deeper. So what are some other features or is there anything else we should know or be looking for? I think that a lot of clinicians struggle to diagnose mixed features because, like we talked about before, it can look like other things or rather other things can look like mixed features. So we talked about the four A's. I'm going to get them in the wrong order. Sorry, Roger McIntyre.

Of agitation, anger, anxiety, and attention. That's not the order I did before, but that's fine. Those four things show up in generalized anxiety disorder. Anxiety is right in there. They show up in ADHD. Attention is right in there. If you're really anxious, you might be feeling agitated. If you have ADHD, you might be feeling agitated as well. This is the limits of languages. These might be different flavors of agitation, but you're looking at diagnostic criteria, they're the same words.

If you have experienced PTSD, post-traumatic stress disorder, you might be feeling anger. You might have attention problems, right? Executive functioning struggles. So on paper, they can all look similar. I think, like I said before, once you've had a bipolar mixed features state, mixed episode, whatever we're calling it, it becomes really obvious the next time you have one. It's such a specific feeling, and I'm probably not doing it justice, but it is such a specific feeling.

I live with ADHD. If you've ever had the pleasure of speaking to me before I take my pills at 8.30, Shaylee, it's a trip. I love it. It's a trip. So having ADHD and having attention problems and being a little agitated, right? That is a different feeling for me than having a depressive episode with mixed features, right? There's the mood component. So if you only look at the four A's by themselves, they can look like other

things. But are they layered on top of a full-blown mood episode, mania, hypomania, or depression? Yeah, which, like, I'm sorry. I want to have a hissy fit. That seems unfair. And that's why I was excited to do this. And I'm so excited to do it with you because I didn't know.

And if someone like me that talks about it all the time and is looking into it all the time doesn't know, I can imagine that others don't know or we use it in the wrong way. And I am here to tell everyone that I am experiencing this exact thing right now. So it is very, it feels like whiplash to me. It feels very confusing because one of the things that I get with generally experience some hypomanic symptoms in the spring all the time.

Very different now that I have medication, but it is a pattern. I'm getting those like the energy that I didn't have, right? And also, when I am hypomanic, I want to change everything, right? Like just, I get excited. I want to change everything. I want to move everything around in my house. I want to get a new wardrobe. But I'm not getting the energy that it takes to do it. And so then I also feel like not the happy want to change everything.

Like everything totally sucks. And if I don't change it, my life is going to be horrible forever. When I am hypomanic, the future seems bright and exciting. And I'll get little glimpses of maybe it could be different, maybe it could be better, but mostly I'm hyper and thinking that the world is a dumpster fire at the same time and that's. Very confusing to me because usually it just comes with sadness and heaviness and numbness. And I think it's confusing for the people around me as well.

It's like, awesome, bipolar, at least like then they're opposite and then now they're not. And it just seems like a train wreck. What you described, Shaylee, is you had asked previously, is there like in-between space, basically? And we talk about clinically, like you have one kind of episode and you sprinkle on the features of the other kind of episode, right?

But there is room for all of these in-between experiences where maybe you're not experiencing a full depressive episode or a full manic or hypomanic episode with the sprinkle of the other thing. Like maybe you're just experiencing two sprinkles. Like ever go to the ice cream parlor and you're like, I just want sprinkles. Fair. So you can be having a mix of depressive symptoms and a mix of hypomanic manic symptoms together.

That's still clinically relevant and important, even if you don't meet all of these kind of arbitrary requirements for this episode or that episode i just want to validate everybody who's in that in-between space because that means so much yeah and it's so hard because as humans we want to categorize things and put things in boxes and make sense of things and i think that's just an added hard thing about this illness and a hard thing to explain to other folks because Because they'll be like,

you just said you felt like this last month for people that love people with bipolar. If it's confusing for you, 100 percent, and that's hard for you. But could you imagine living it? I'm just saying. Just saying. Yeah, exactly. And we think of bipolar as up and down, but mixed features almost feels like a separate dimension, right?

That's an interesting story. I'm on this lived experience advisory board for this project, and we were developing a sort of general measure of how someone's bipolar condition was doing. So they'd have one for the up and one for the down. I can tell you all the people on the lived experience advisory panel wanted there to be a third item.

For mixed features because we were like no it's not just a combination of up and down like it is in the book on the paper yeah technicality it feels like a separate experience we didn't end up losing that battle but neither here nor there everybody who had lived it said this is a separate dimension interesting i feel kind of like equally sad and also comforted that i actually can understand it and that there's actually I always feel good I think language is so important like

that there can be language for my experience because the tendency even with a giant community and a podcast and all the things and so many bipolar besties I still it goes back to thinking I'm the only one and this is a flaw of mine and even within the community of lived experience of those with bipolar disorder, of course, like I'm different, of course. Isolating by nature. Yeah. And I think that goes back to the self-stigma, right?

The idea that this is something that I can fix in my personality. Applying that it's broken. If it needs fixing, of course, it's broken. Of course. Another thing I want to talk about, the community just showed up big time when it came to this, and there was just some really eloquent things, and then I put it together, and there was a few more things that I wanted to talk to you about some of the symptoms.

And one of the things, one of the A's, the agitation, there's also agitation with despair coexisting. So I think that's what I'm talking about, because I'm also mad that the world is a dumpster fire, but I'm so sad, and I try to remind myself, I know... Shout out to Jodi Carrington. I believe she's a therapist. I don't know. Shout out to Jodi Carrington. But I learned from her, she had this phrase is anger is the bodyguard to sad.

Or because anger is a secondary emotion, there's always something behind it. And that gave me great relief because I just thought I was an angry, bitter person a lot of the time. And I was like, no, that's how it portrays, which is like an extra barrier.

Because if you look angry, nobody has sympathy or empathy for you. You just look like a jerk. If you're having mixed features, it's possible to have that sort of rageful anger on its own. Also, as a therapist, I had this cool worksheet that shows anger is the tip of the iceberg and what's underneath. But also having mixed features, it might just be anger alongside. You're just feeling rageful. That's a thing. And sometimes it's hard to tell because sometimes it's legit.

The state of the world is legit to be angry or sad over, but it's hard to explain to people that sometimes the bipolar disorder makes it next level. You know what I mean? So someone wrote in about agitation and despair coexisting, and they said, it's like your mind is screaming two opposite things at the same volume. Right. One part is saying, you're a failure, give up. And the other is saying, you need to fix this now. And they find the internal battle exhausting.

And they can't think clearly or make rational decisions. It's harder to make decisions. But right now, as I've told you, I think I'm having mixed features. I have decision paralysis because I've been working more than usual. And it's like deciding what to eat. And I annoy the crap out of my people because I can't. And then I go back and forth and I'm like, okay, we have this. So then they're all like, oh, yeah, let's do that. And then I'm like, wait a minute, that might be terrible.

Maybe we should do this. And it really causes me a lot of problems in my relationships. Everything is like a big deal. Yeah. And that if you don't make the right decision, like there's going to be a huge consequence. I don't know what this huge consequence is, but it feels like that. A feature of anxiety for sure. Do you ever get decision paralysis? I think a better question is, do I ever not get decision paralysis?

I have been known to be indecisive. It is, of course, worse when I'm having symptoms, but indecision can be a big thing in anxiety because there's this fear of not making the right choice. And what happens if I don't make the right choice? So I could see anxiety being one of our A's here where that could be a problem, but also compounded with the urgency of that energy elevation. Yes.

Like when I was able to hear about that symptoms, I explained so well, like it just, if I can look back a couple hours later, I was like, why is that so important? Why did I have to make a decision so quickly? The urgency is really hard to explain. It's not like a suggestion in your brain of what to do or how to react or whatever. It's like your brain is demanding it of you. And then I look back later and I have reflective capacity and I'm just like, why was that so important?

And it's worse when we are hypomanic or you're someone that has a comorbidity of ADHD because you're going so far ahead that you could think of catastrophically everything that could go wrong in every decision. Nothing seems like a good decision. So that's when I start to make really impulsive, fast decisions because I just want to end the decision-making process. Just buff the band-aid. Yeah. And then I tell people, you just decide.

And then they decide. And then I'm like, nope. And I tell them why. And it seems like I don't care about their ideas. Or it seems like I'm not open. And I just shut people down. And really, you're just trying to relieve that distress. Yeah. And I think that's the hardest thing. And especially when you're trying to have relationship with other people, I can see it from their side. Oh, my gosh. You're telling me to make a decision. You can't make a decision.

But you don't want to do my decision. And it's just, it's an awful state. So if you ever feel like that, please know that you're not alone.

And it seems like coping skills are very hard at that point, which brings up that we are going to do a follow-up episode as we do with coping strategies and treatment. But if you are experiencing mixed features, I would encourage you not to wait for our episode on coping. Oh, yes. Absolutely. This is medically urgent. I won't say emergency, but this is medically urgent in that, as we said, the risk of suicide is greatly increased. It is deeply uncomfortable.

People start making impulsive decisions. If you're experiencing these features, try to put off making any big life decisions. But get medical treatments. See your prescriber. Talk to your therapist as soon as you can, because the longer it goes on, the worse it feels, and the more it can escalate. Yeah. Clinically, how hypomania or depression have, they give it time limits-ish. We know it's all different for everybody. We know all these things. But is there in the magic book?

I forgot the name of it. So that's what I said. I just thought you were being reverent. I should have been. But you know what I say? I say the DMV, which is the driver. I always say it. And it's like getting your driver's license. It's called the DMV. So I mess it up. Yes. So diagnostic statistical manual. That magic book. Oh my gosh, I'm ridiculous. In that book, or in your experience with all your research and all the people you know, do they give a range of how long mixed features might last?

Do they usually last the same length as the episode, or could they sprinkle in and leave, or do we know? So that's interesting. So according to the magic book, makes it sound of like a book of spells or something. I hear magic that's what I think. It's like a book of spells. I'll read it to you. It's three of the following symptoms, so the sprinkle symptoms, present during the majority of days of the current or most recent episode. Okay. So it says majority of days. So not all.

Yeah. There are duration requirements for episode. Depressive episode is two weeks. Hypomatic episode is four to seven days. Manic is seven days unless you're hospitalized or experience psychosis. So there are duration. this is a whole other thing i could talk about because some of those duration.

Requirements are a little bit arbitrary in my opinion like i've experienced manic symptoms but not for seven days so then i don't fall into a category so whatever yeah but for this mixed sprinkles business mixed sprinkles you may be making it sound awesome it's not they're like really bad tasting sprinkles horrible flavor just majority of days of the episode okay okay I think that it's smart that they left that deliberately vague because there is so much individuality here and

so many ways that this can show up. While we're on magic book topic, what is the year's difference between 4 and 5? The DSM-5 came out in 2013. And I think the DSM-4 was in 94, if I'm not mistaken. Wow. So we had an update recently. But I wonder if we're due for a new one soon. So it was quite a range. It was almost 20 years. Yeah. Wow. What do you think about diagnosis and how it's hard and how it's even hard for clinicians and doctors and everything?

Why do you think that mixed features in bipolar disorder are so often misdiagnosed? The symptoms on paper overlap with other conditions like anxiety disorders, ADHD, PTSD. And every clinician is just a thousand percent doing their best to get you the right treatment. But if you are worried about a misdiagnosis, it's totally fine to get a second opinion to see somebody who maybe specializes in bipolar and see what they think, right?

That's totally reasonable. I don't think there's not a clinician worth their salt who would be like, why did you get a second opinion. My opinion's fine. Get a second opinion. Yeah. And if you're in Canada that it's very hard to get a doctor, you can't. No, it's different all over the world. But there are, yeah, look into different places to, I'm leaving that part out. I don't even know what to say about that. I feel like we have learned a lot. A lot of things in this episode. I know I have.

It's a different episode for me because usually I have so much experience to share, but I think I need to sit back and look back on, you know, things I've had before. I think looking back would explain a lot of things. And because I am in it right now, yeah, just that two roller coasters just pulling me. I very much feel like that.

So this episode has really helped me feel understood, much like I want to do for our community. So we always want to remind you that you are not your diagnosis. We want to remind you that if you experience any of those things, please ask for help. Please keep asking for help. If you are not listened to or you're worried that you have a misdiagnosis, track your moods. I'm going to be talking about it a lot in the future, but there is a lot of apps I've tried, but there is one app.

Called Polar Us, and it is something that I was helped to work on a board or whatever, but it came out and it looks at our quality of life.

But there are articles in there about these mixed features and they have such a huge group of people that are not just experts in experience but also experts in research and studying in their field so that might be a good resource to you and check out the app if you are rating your mood tracking your mood i have my clients track their mood from negative 10 to positive 10 with zero being basically without symptoms and 10 being the worst meaning you've

ever experienced a negative 10 being the worst depression. It's possible doing it that way that you could be simultaneously like a negative four and a positive two at the same time. That's okay. And that does not make a negative two. That makes a negative four and a positive two. Don't add the numbers. You can be on both sides of it at once. Yeah. I prefer the memes that have, I don't know, like a dog or like a clown or whatever.

And it says rate your mood and then they look happy and disheveled. And I have a feeling that you wouldn't recommend that as tracking your moods. Whatever works, as long as you're consistent with your rating scale and what you want to see is changes over time. Okay, 100%. I'm going to bring that to my therapist. Just so you know, this week I am... I'm going to freak out.

Oh, Shaylee. I am so glad that even in these hard topics, that we can have fun together and that we can talk about hard things and also be able to laugh. We know this is a really serious matter, but sometimes to cope, we need to laugh at ourselves. And that's why the community is so grateful for you. Yes, thank you. And you, Andrea, what is a word of encouragement or kind word that you would have for someone that's experiencing these really bad tasting sprinkles? The icky sprinkles? Yeah.

It doesn't last forever. And in my experience, I don't know if I have clinical data to back this up, but in my experience, it's shorter lived than other episodes.

Even in the definition majority of days of the episode majority could be just over half so it is shorter lived which thank heavens because it's so intense so don't give up and as always know that it's not permanent this is something that's happening to you you are not this experience all of those things and i think i would say to tell someone i would rather you scare someone a little bit, then follow through with some of your thoughts.

And you would be surprised how many people have ideation that isn't a plan or isn't going to lead to an attempt. I think that it will be easier for people to say things out loud because we know that when we keep things inside, it grows and where if we bring it out into the light.

I just want to say, my friends, keep showing up, stay alive our stories aren't over yet thank you Andrea we love you guys This Is Bipolar. Thanks again for tuning in you can find video versions of This Is Bipolar on our YouTube channel we also have all our previous episodes of the podcast on Apple, Podbean Spotify and Google Play we spend most of our time on Instagram at this.is.bipolar. There is a vibrant community there where we have conversations and posts.

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Let's share lived experiences so that we can change the ideas that people have about bipolar and help those of us that live with it feel less alone. This is Bipolar. Music.