What we’ve said about Mixed states

“The big problem is mixed depressions because you're right down next to unipolar. In fact, finally in the DSM-5, they got as close as they possibly could to you saying, yes, it's a spectrum by saying that there's this thing called major depression with mixed features”

“The four things are anxiety, anger, Agitation, Physical Agitation, and Attention Problems. He puts them that way to make the four A's. So once one admits that the four A's, anxiety, anger, agitation, and attention problems can be manic symptoms in unipolar, this is part of a bipolar mixed state”

“the more you look and screen for mixed episodes, the more you see them. You know, patients who only report depression, and then when you dive into their symptoms, you do hear hypomanic or manic-type symptoms”

“if you are able to detect a episodic and recurrent major depressive picture, that starts to raise the possibility that there is a bipolar spectrum disorder or at least a possibility of mixed depression or refractory or biological seeming depression rather than depression secondary to life circumstances or personality”

“if you see substantially worsening sleep and physiologically improbable sleep, like three, four, five hours in somebody, especially when they don't have a trauma disorder, You really need to start considering the possibility of bipolar”

“major depression plus PTSD with an agitated state, major depression plus generalized anxiety disorder with an anxious state, major depression with attention deficit disorder with irritable phases, major depression with borderline personality disorder with phases of variety of symptoms”

“The big problem is inducing mood instability and mixed states. You make cycling more likely to happen because antidepressants are Antidepressant, all antidepressants with almost no exceptions are pro cycling”