logo
episode-header-image
Sep 2024
33m 15s

Bipolar Mixed Episodes: Navigating the U...

Gabe Howard & Dr. Nicole Washington
About this episode

Can mania and depression really coexist? In this episode, our hosts unravel the complexities of bipolar mixed episodes — where mania and depression collide in the same mind, often creating a personal hell for those experiencing it.

Gabe Howard, who lives with bipolar disorder, and Dr. Nicole Washington dive into the complexities of mixed episodes, highlighting that they’re far more than just mood changes. Bipolar mood episodes combine dangerous elements like high energy, impulsivity, and intense hopelessness.

They use vivid analogies, comparing it to mixing vodka and Red Bull — a chaotic blend where alcohol and caffeine each trigger distinct sensations but together create an entirely unpredictable and overwhelming effect. This can help listeners visualize the volatile nature of mixed episodes and why they are so challenging to manage.

Discover why mixed episodes carry a higher risk of suicide and why recognizing them matters. Tune in to learn how this evolving knowledge can lead to better diagnoses, treatment, and ultimately, better outcomes for those living with bipolar disorder.

When someone is sitting in front of me and I'm trying to figure out, what is this? Is this mania? Is this a mixed episode? And I'll be completely honest with you, a lot of times, mixed episodes don't even come to the forefront of my mind. It's not something I usually say, oh, let me screen for whether this is a manic episode or a mixed episode. In all the chaos of the mania, sometimes the depression parts can get missed.” ~Dr. Nicole Washington 


To learn more -- or read the transcript -- please visit the official episode page.


Our Host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author.

To learn more about Gabe, or book him for your next event, please visit his website, gabehoward.com. You can also follow him on Instagram and TikTok at @askabipolar.


Our host, Dr. Nicole Washington, is a native of Baton Rouge, Louisiana, where she attended Southern University and A&M College. After receiving her BS degree, she moved to Tulsa, Oklahoma to enroll in the Oklahoma State University College of Osteopathic Medicine. She completed a residency in psychiatry at the University of Oklahoma in Tulsa. Since completing her residency training, Washington has spent most of her career caring for and being an advocate for those who are not typically consumers of mental health services, namely underserved communities, those with severe mental health conditions, and high performing professionals. Through her private practice, podcast, speaking, and writing, she seeks to provide education to decrease the stigma associated with psychiatric conditions. Find out more at DrNicolePsych.com.

Learn more about your ad choices. Visit megaphone.fm/adchoices

Up next
Jun 30
New Bipolar Diagnosis? All the Basics Unlocked (Part 1 of 2)
Imagine hearing, “You have bipolar disorder,” and feeling the ground drop out from under you. That moment of shock and confusion is the very reason we made this episode. Join Gabe Howard (lived experience) and Dr. Nicole Washington (board certified psychiatrist) as they transform ... Show More
41m 36s
Jun 16
Breaking Stigma in Women’s Mental Health with Kit Wallis
In this female-centric episode, board certified psychiatrist Dr. Nicole Washington welcomes mental health advocate Kit Wallis, who lives with schizoaffective disorder, for a fearless “girl power” takeover. Kit shares raw stories of being dismissed, sexualized, and romanticized si ... Show More
46m 20s
Jun 2
The Bipolar Hack I Ignored for Years: Our Host’s Personal Walking Story
What if a secret weapon in managing bipolar disorder isn’t a new medication or a breakthrough therapy — but a brisk 20-minute walk? In this refreshingly honest and hilariously relatable episode, Gabe Howard, who lives with bipolar disorder, and Dr. Nicole Washington take on the l ... Show More
44m 45s
Recommended Episodes
Oct 2023
Bipolar Psychiatrist: Your Diagnosis Is NOT Your Prognosis | Dr. Joanna Jarecki | EP 38 🩺
Psychiatrist Dr. Joanna Jarecki shares a powerful story of living with bipolar disorder - from spiralling into depression to being taken to hospital in handcuffs during mania. Dr. Jarecki reveals how her experience with bipolar I disorder turned her to psychiatry to help others i ... Show More
46m 49s
Oct 2024
Is Med School Impossible with a Serious Mental Illness?
[Content warning: this episode contains frank discussions of mental health and mentions suicide.] Getting your support systems in order is key to success in med school with a mental health diagnosis In this episode listener Haley, who is considering medical school while managing ... Show More
1h 2m
Oct 2023
Mood Disorders
Did you know approximately 21% of US adults experience a mood disorder at some point in their lives? This is an extremely important, not to mention commonly tested, topic that all medical students should be familiar with. In this episode, our newest team member MS3 Bilal Rana wil ... Show More
40m 47s
Jul 2024
Unmasking Fakes: Is Mental Health the New Excuse? (From Listener Questions)
Dive into a candid discussion on mental health as host Gabe Howard speaks with Rachael Beairsto, a senior editor for Healthline. Together, they tackle tough questions about authenticity and stigma provided by listeners like you. Explore how misconceptions and pop culture blur the ... Show More
25m 32s
Mar 2025
Your Thoughts Are Lying to You: How to Take Back Control
In this episode, our host interviews Dr. David Burns about his methods for overcoming negative thoughts and promoting joy using CBT techniques. Dr. Burns discusses various techniques and introduces his new digital tool, the Feeling Great app, which tracks personal feelings to fac ... Show More
26m 59s
Oct 2024
Is NAC Promising in Bipolar and Depression Treatment?
In this episode, we explore the potential of N-acetylcysteine (NAC) in treating mood disorders. We discuss its mechanism of action, clinical evidence for its use in depression and bipolar disorder, and its possible benefits for both adults and children. Could this natural compoun ... Show More
7m 58s
May 2023
Healing the Unquiet Mind with Kay Redfield Jamison
Dr. Kay Redfield Jamison believes that medication is an overused option and that many people can make great strides recovering from “mental suffering” using therapy, art, and meaningful hobbies. She also shares that we can learn a lot by understanding the lessons learned from res ... Show More
26m 17s
Feb 2025
Harvard Psychiatrist: How To Heal Your Mind With Your Diet - The Scientific Connection Between Nutrition & Mental Health
I'm going on tour! Come see The School of Greatness LIVE in person!Get my new book Make Money Easy here!What if the root cause of mental health disorders isn't just in your mind, but in your metabolism? In this groundbreaking conversation, Harvard psychiatrist Dr. Chris Palmer ch ... Show More
1h 37m
Jun 2024
Bipolar Disorder
This episode covers bipolar disorder. Written notes can be found at https://zerotofinals.com/moremedicine/psychiatry/bipolar/ or in the psychiatry section of the Zero to Finals More Medicine book (due late 2024).The audio in the episode was expertly edited by Harry Watchman. 
7m 5s
Jul 3
Mental Fitness: Daily Hacks That Strengthen Your Mind
We all know about physical fitness, but what if we treated mental fitness with the same urgency and structure? In this episode, psychiatrist and author Dr. Drew Ramsey joins Gabe Howard to reveal how everyday choices like eating more vegetables or going on a daily walk can profou ... Show More
26m 48s