There is some major progress in the treatment of persons with Bipolar DO - Mixed episodes. Bipolar DO-Mixed is characterized by less serious manic symptoms, or hypomania, and significant depressive symptoms occuring at the same time. As you might expect, having a high energy level, little impulse control, impaired judgment and significant depression is a miserable condition, prone to substance abuse, suicide ideation and serious attempts. Persons with BPDO-Mixed are more prevalent in my practice than any other subtype of the disorder. That fact could be an artifact of primary finding of the following studies.

Anti-depressants, when combined with mood stabilizers such as Lithium or Depakote, or atypical anti-psychotic medications like Abilify or Seroquel have been found to provide no more symptomatic relief for the depressive symptoms and a significant risk of increasing manic symptoms. The contradicts standard psychiatric practice which calls for treating mania with mood stabilizers or atypical anti-psychotic medications and the depression with anti-depressants.

Intensive psychotherapy has been found to be modestly helpful with persons with Bipolar DO-Mixed. These findings affirms my recent clinical findings that persons with Bipolar DO-Mixed can experience significant symptomatic relief and, perhaps more importantly, a budding sense of recovery based on personal responsibility and enhanced skills in managing moods.

Excerpts from a review of the research follow: