Living with Manic Depressive Bipolar Mixed States

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During my training as a psychologist, mixed states, defined as one in which an individual experiences symptoms of both depression and mania occur at the same time, never quite made sense to me. The existence of mixed states seemed paradoxical, and counterintuitive. How was it possible, I wondered, to experience symptoms of heightened energy and agitation characteristic of hypomania while also experiencing symptoms of depression and suicidal despair?

It wasn't until my own personal experience with mixed states that I truly understood.

For me, in a mixed state, I begin to experience a beauty in life that is characteristic of hypomania at the same time that I feel suicidal and wish to die. I feel a deep, gentle sadness at the realities and transience of life, and this emotion is present in the sound of leaves shifting in trees, the wind in blades of grass, the light shining across water. A simple breeze can move me to tears and when I'm in this mood, I can't help but think how beautiful and calming it would be to die and be one with the universe and stars in the sky. 

In her book, Touched with Fire, Kay Jamison notes that these mixed moods are often how poetry and art are made. See poet Vladimir Mayakovsky's suicide note:

Past one o’clock. You must have gone to bed.
The Milky Way streams silver through the night. 
I’m in no hurry; with lightning telegrams
I have no cause to wake or trouble you. 
And, as they say, the incident is closed.
Love’s boat has smashed against the daily grind. 
Now you and I are quits. Why bother then
To balance mutual sorrows, pains, and hurts. 
Behold what quiet settles on the world. 
Night wraps the sky in tribute from the stars.
In hours like these, one rises to address
The ages, history, and all creation.

In his note, he replaced 'you' with 'life'.

For me, mixed states are incredibly beautiful and wistful. It is like living with a melancholic Chopin nocturne present and playing throughout the soul of all things. But somewhere deep within me, I felt and recognized something deadly about them, more deadly for me than depression. There was a peaceful allure to them, something that called me in a way that felt as natural as sleep. But in the end, I decided to let go of these moods, as romantic as  they were, and as much as I wanted to hold onto them. They are difficult to survive.

So I went on lithium, and they've disappeared ever since. Every once in a while, I miss these moods and the insight they bring. But I remind myself of the peace that is found in feeling healthy and alive. There is hope with help, support, and treatment.