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This new specifier takes the place of “mixed episode” and can be applied when depressive features are present during an episode of mania or hypomania—Youngstrom uses the metaphor of vanilla ice cream with fudge swirled through—or features of mania or hypomania are present during an episode of major depression, which would be chocolate ice cream with marshmallow swirls.

“It gives us more clinical information about how to treat, about prognosis, and so on.” This is not actually a diagnostic category.

This specifier can be applied to either a manic or depressive episode to indicate a break with reality, such as hallucinations (seeing or hearing things which aren’t there) and delusions (believing things that aren’t true).

Hearing voices, receiving special messages, taking on a different identity (often that of a religious or famous figure), and being convinced of a special mission (again, often religious) are common psychotic symptoms.

Therefore, we want to minimize the potential damage by developing an understanding of ourselves and how we affect our loved ones.

I will attempt to provide meaningful information for the loved ones and friends that are watching a special person in their life go through this.

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