Dysphoric Mania: Symptoms, Treatment, and More


Dysphoric mania is an older term for bipolar disorder with mixed features. Some mental health professionals who treat people using psychoanalysis may still refer to the condition by this term.Bipolar disorder is a mental illness. An estimated 2.9 percent of Americans are diagnosed with this condition every year.

People with bipolar disorder with mixed features experience episodes of mania, hypomania, and depression at the same time. This can make treatment more challenging than treating bipolar disorder with no mixed features.

Keep reading to learn more about living with this condition.


People with dysphoric mania experience symptoms of depression and mania or hypermania (a milder form of mania) at the same time. People with other bipolar types experience mania or depression separately rather than simultaneously. Experiencing both depression and mania increases the risk of extreme behaviors.

People with dysphoric mania experience two to four symptoms of mania along with at least one symptom of depression. Below are some of the common symptoms of depression and mania:

Depression symptoms Mania symptoms
increased episodes of crying for no reason, or long periods of sadness exaggerated self-confidence and mood
anxiety, irritability, agitation, anger, or worry increased irritability and aggressive behavior
noticeable changes in sleep and appetite may require less sleep, or may not feel tired
inability to make decisions, or extreme difficulty making a decision impulsive, easily distracted, and may demonstrate poor judgment
feelings of worthlessness or guilt may demonstrate greater self-importance
no energy, or feelings of lethargy reckless behavior
social isolation delusions and hallucinations may occur
body aches and pains  
thoughts of self-harm, suicide, or death  

If you have dysphoric mania you could appear euphoric while also crying. Or your thoughts may race while you are feeling a lack of energy.

People with dysphoric mania are at an increased risk for suicide or violence towards others. Seek immediate help if you have suicidal or violent thoughts.

Causes and risk factors

Bipolar disorder is not fully understood, and no single cause has been identified. Possible causes include:

  • genetics
  • a brain chemical imbalance
  • hormonal imbalance
  • environmental factors like mental stress, history of abuse, or a significant loss

Gender does not seem to play a role in determining who will be diagnosed with bipolar disorder. Men and women are diagnosed in similar numbers. Most people are diagnosed between ages 15 to 25 years old.

Some risk factors include:

  • use of stimulants, like nicotine or caffeine, can increase risk of mania
  • family history of bipolar disorder
  • poor sleep habits
  • poor nutritional habits
  • inactivity


If you have symptoms of mania or depression, make an appointment to see a doctor. You can start by talking to your primary care doctor or reaching out directly to a mental health specialist.

Your doctor will ask questions about your symptoms. There may also be questions about your past, like where you grew up, what your childhood was like, or about relationships with other people.

During your appointment, your doctor may:

  • request you complete a mood questionnaire
  • ask if you have any thoughts of suicide
  • review current medications to determine if they may be causing your symptoms
  • review your health history to determine if other conditions may be causing your symptoms
  • order a blood test to check for hyperthyroidism, which may cause mania-type symptoms


Your doctor may recommend temporary hospitalization if your symptoms are severe or if you’re at risk of harming yourself or others. Medications may also help balance more severe symptoms. Other treatments may include:

  • psychotherapy on an individual or group basis
  • mood stabilizers like lithium
  • anticonvulsant medications like valproate (Depakote, Depakene, Stavzor), carbamazepine(Tegretol), lamotrigine (Lamictal)

Additional medications that may be used include:

  • aripiprazole (Abilify)
  • asenapine (Saphris)
  • haloperidol
  • risperidone (Risperdal)
  • ziprasidone (Geodon)

Your doctor may need to combine several medications. You may also need to try different combinations before finding something that works for you. Everyone responds a little differently to medications, so your treatment plan may be different from the treatment plan of a family member or friend.

According to a study published in 2014, the best treatment for dysphoric mania is combining atypical psychotic medications with mood stabilizers. Antidepressants are typically avoided as a treatment method for people with this condition.


Dysphoric mania or bipolar disorder with mixed features is a treatable condition. If you suspect you have this condition, or another mental health condition, talk to your doctor. Mental health conditions can be managed with treatment, but you will need to work with a doctor.

Seeking help is an important first step in treating your condition. You should also remember that while you can manage symptoms, this is a lifelong condition.

How can I manage my condition?

Consider joining a support group. These groups create environments where you can share your feelings and experiences with others who have similar conditions. One such support group is Depression and Bipolar Support Alliance (DBSA). The DBSA website also has a wealth of information to help educate yourself and those around you.

Here are some other ways to help manage your condition:

  • Determine what triggers or stressors exist for you and review how you react to them.
  • Be aware of your reactions and your attitude in different situations. This can help you identify your triggers.
  • Learn deep breathing techniques to reduce the triggers impacting your condition.
  • Remove weapons from your home, older medications that are no longer being used, or anything else that could be used to self-harm.
  • Keep a crisis hotline number readily available. You can even save one into your phone. In the United States, you can reach the National Suicide Prevention Lifeline at 1-800-273-8255, or you can text START (741741) to reach the Crisis Text Line.
  • Stay away from drugs and alcohol.
  • Follow your doctor’s recommendations and keep all follow-up appointments.
  • Adopt a healthy lifestyle by maintaining a healthy diet, exercising, and getting adequate sleep.

Source: healthline.com

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