According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a mixed episode is an acute episode in which manic and depressive symptoms co-occur. A mixed episode is not considered a stand-alone disorder, but it is a description or specifier of major depressive disorder, bipolar I disorder, or bipolar II disorder. This specifier requires an individual to meet the full criteria for one mood episode and also have three or more symptoms of the other pole. For those with predominant mania/hypomania, one must have at least four of the following symptoms for at least 4 days of an episode: (1) depressed mood, (2) anhedonia, (3) decreased energy, (4) fatigue, (5) diminished physical reactions, and (6) suicidal ideation. For one with predominant depression, ...