From the Wikipedia article on "mixed state", emphasis mine (and I've been having yet another recently):

Mood stabilizers (lithium and some anticonvulsants) and antidepressants are the traditional medications used in the treatment of bipolar disorder and major depression, respectively. Antidepressants, however, may induce mixed states and rapid cycling; hence, coadministration with an anticonvulsant and/or lithium reduces (but does not eliminate) this risk. Among the anticonvulsants, only lamotrigine (Lamictal) has strong antidepressant effects. Lamotrigine and lithium (not an anticonvulsant) are the only drugs approved by the U.S. Food and Drug Administration (FDA) for the maintenance treatment of bipolar disorder. These are the only "true" mood stabilizers in that they possess antidepressant as well as antimanic properties. Of the two, lamotrigine is the more effective treatment for bipolar depression and lithium is more effective for mania (Calabrese, Vieta & Shelton, 2003).

Now I am aware that just because a drug is not approved by the FDA to treat something doesn't mean it's not useful in that area, but I'm still wondering. One anticonvulsant, divalproex sodium (Depakote), has been prescribed as a mood stabilizer for a long time; I was first prescribed it in late 1996. I'm currently taking oxcarbazepine (Trileptal), which is based on older carbomazepine (Tegretol) which has also been used for many years. And I'm all too familiar with just how long it can take a drug to get vetted by the FDA, but it seemed like Lamictal got fast-tracked somehow.

I am not a fan of the phrase "I told you so", but I've been saying this for years: schizophrenia and bipolar disorder (manic depression) do not only share heredity as a primary cause, with environmental factors secondary, but the two diseases are related.

These should, in fact, be considered two illneses on a psychotic-affective spectrum with many shared characteristics. Bipolar disorder, and major depression at that, can have psychotic features, hallucinations, delusions and such, and many people with schizophrenia have mood swings or at least depression. Antipsychotics, especially the newer atypicals (Risperdal, Clozaril, Zyprexa, Seroquel, Geodon, Ability, Invega etc.), were originally intended for schizophrenia-type disorderss but are now used to treat bipolar disorder. However, lithium and the anticonvulsants found to be effective for mania (Depakote/valproate, Tegretol, Lamictal and so on), if used for psychotic disorders, are only prescribed for the moods of schizoaffective disorder, which sits on the middle of the spectrum.

Also, take into account that SSRIs and other antidepressants may not be all that effective for bipolar disorder, suggesting that BD, despite its classification as a mood disorder, may not be that closely related to major depressive disorder.

Though normally I wouldn't write something this personal in a public entry, I'm doing so now. I've committed myself to talking more about my mental conflicts out in the open. If someone laughs at me, so be it. Someone is in my situation and needs to know he's not alone.

I haven't gotten much composition done lately. I can't seem to get myself motivated enough, or I keep getting distracted by something stupid. I'm having one of those depressive episodes, and mine don't usually involve crying and wanting to die; they usually entail being perpetually pissed off and wanting to burn things. (No, I never burn or destroy anything.) I'm irritable and suspicious of everyone, all the while wishing someone would be nice for once. It means a hell of a lot when someone is friendly to me, even looking at me smiling. I get a lot of cold frowny stares while in public, that kind of "what the f. are you looking at" look like I'm Satan incarnate.

I have to get out more. I think the place where I live is toxic, chemically as well as spiritually. I usually feel better when I get away from home, but I have to sleep in my bed, and I always wake up miserable. It's harder to get out since I am, as they say, "mobility impaired", and the summer heat only makes things worse.

I first saw Star Wars (as in Episode IV) when I was six, and I've been curious about whether or not there really is a "Force" that one could use for good or evil. Since there are times I can barely get out of bed let alone my third-floor apartment, I'm tempted to experiment with psychic forces. I know I have precognitive abilities, or at least I think I do (this could be delusion), but I can't control them. All I really want is to know if a situation I may be in is harmful, or a person is not secretly out to screw me over, or if someone likes me and isn't just being formally friendly.

I wish I had real friends that I could talk to about things like this--people here in Austin, not just people far away I only talk to online. I wish I could sleep over at somebody's place for one thing, get away from the toxic environment I live in. I haven't dated in nearly fifteen months either, and I was not made for the single life. My last girlfriend and I had these common interest in deep philosophical and spiritual matters, which I'm having trouble finding in people, and I've always gravitated to older or at least more mature women. I just wish I knew where to meet people like this. I'm done with thrill-seeking and the party scene, and don't even try to get me on Sixth Street.

At least I should go to the park more. I went walking along the trail in Travis Heights the other morning. I walk with a cane, but I can get along on good days. I need to be in nature more; I'm from East Texas where there are a lot of trees and creeks and such, and I do miss that about living in the country. But that's another thing I wish I didn't have to do alone.

I just wish I didn't think I scare people away. I know I'm not ugly inside or out, and people of people are drawn to me. They always have been. But I also wonder if all this fear, anger and occasional despair isn't pushing me towards some sort of "Dark Side"...