Patients who meet the full criteria for both a manic and depressive episode simultaneously meet the diagnosis for a manic episode with mixed features. To qualify as having a manic or hypomanic episode with mixed features, individuals must also have at least three of these symptoms during most days of the current or most recent episode of mania/hypomania:
Depressed mood or prominent dysphoria
Markedly diminished pleasure or interest in nearly all activities
Loss of energy or fatigue
Feelings of worthlessness or excessive guilt
Preoccupation with death or suicide, recurrent suicidal ideation without a specific plan, or a suicide plan/attempt
Learn more about the presentation of bipolar disorder.
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Cite this: Stephen Soreff. Fast Five Quiz: Bipolar Disorder Practice Essentials - Medscape - Jan 19, 2022.