Some bipolar patients experience an episode that consists of symptoms of both mania and depression. This complicates a simplistic view mood as “bipolar:” having a depressed and manic pole, as if the two moods were mutually exclusive.
The existence of such Mixed Episodes is important in that it can have ramifications for the course of the illness and for treatment. Patients with “mixed mania” seem to recover less quickly and less completely than patients with “classic” mania.
For the mood disorders, DSM-IV describes several types of episodes. These episodes are not disorders in themselves, but descriptions of discrete syndromes, which can form the building blocks of actual disorders.
For a Mixed Episode, the Diagnostic and Statistical Manual, Fourth Edition (DSM-IV) requires that patients meet the full criteria both a Major Depressive Episode and Manic Episode.