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A bipolar mixed episode, also known as a mixed state or dysphoric mania, is a unique and challenging aspect of bipolar disorder characterized by the coexistence of symptoms of mania or hypomania and depression simultaneously or in rapid alternation. This state can be particularly distressing and disruptive for individuals experiencing it, as it combines the agitation, impulsivity, and racing thoughts of mania with the despair, lethargy, and hopelessness of depression.