Hi, Maria. I'm a fellow mixed nut, as are a lot of us. I think that big number is a DSM code so the doc will get paid There is a lot of diagnostic confusion about mixed episodes. It is easiest simply to think of mania mixed with depressive features. These tend to be dysphoric or agitated manias as opposed to euphoric or overly happy manias. Or the depressions may have mania features. Thus agitated or anxious depressions. Road rage may be the best way to describe either mixed mania or mixed depression. You feel like you're crawling out of your skin, very much ill at ease with yourself.
Meds treatment becomes more problematic for those in mixed states. I have found over the years that anger seems to drive my mixed states. Thus, by managing my anger, I can get a handle on my mixed states. Not all the time, mind you. I'm far from perfect. But my life is a lot better by catching my anger early when it is manageable.
You may find that something else drives your mixed states. Observe yourself carefully, perhaps keep a journal, look for patterns. Hope this helps -
what is bipolar 1 disorder,mixed moderate?