Two recent shareposts, “The Depression-Mania Two Step” ( Part I and Part II ), zeroed in on a crucial fact that tends to be overlooked by clinicians, namely: Despite the fact that depression and mania present as polar opposites, the two can hardly be viewed as unrelated. For our own health and safety, they need to be seen together as part of the same cycling phenomenon. Today’s depression is tomorrow’s mania, but there is another twist: Too often, depression fails to clear the room. Too often, mania doesn’t wait to be invited in. The two show up at once. The dance is over. A free-for-all breaks out. The experts refer to the condition as a “mixed” episode or state. Sweet mania turns sour. Vegetative depression becomes animated. Those who have been through either describe the experience as akin to wanting to crawl out of your skin, of feeling the urge to grab the world by the throat and wring it. I used to joke: “I get road rage a lot - ...
Hypomania is not all fun and games. While working on technical update to the DSM, Trisha Suppes MD, PhD of the University of Texas Medical Center in Dallas carefully read its criteria for hypomania, and had an epiphany. "I said, wait," she told a UCLA grand rounds lecture in April 2003, "where are all those patients of mine who are hypomanic and say they don’t feel good?" These are your typical road rage cases. Why was there no mention of that in hypomania? Dr Suppes wondered. A subsequent literature search yielded virtually no data. The DSM defines hypomania as "a distinct period of persistently elevated, expansive, or irritable mood." Note that overlooked word, irritable. We’re not talking about letting the good times roll. In an irritable state, depression symptoms typically intrude into hypomania, what is called a “mixed” state. Unaccountably, although the DSM acknowledges mixed states in full blown mania, it is silent on the phenomenon in hypomania. Many of us wind up spending a goo...
Mixed tension migraine is a headache with features of both tension and migraine headaches.
Headache - mixed tension migraine
Causes, incidence, and risk factors
Migraine headaches affect millions of people. Tension headaches are even more common, affecting about 40% of the population. People with mixed tension migraine have features of both types of headaches. It is difficult to differentiate which symptoms are due to which type of headache. Women have mixed tension migraines more often than men.
Common triggers for these headaches are hormonal changes, dietary factors, environmental factors, stimulation, and stress. Examples include:
Food and food additives
Missed or delayed meals
Too much or too little sleep
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