A mixed affective state, formerly known as a mixed state, mixed-manic episode, or mixed episode, has been defined as a state wherein features and symptoms unique to both depression and hypomania occur either simultaneously or in very short succession. This includes episodes of anguish, despair, diminished pleasure in enjoyed activities, feelings of guilt or self-loathing, excessive impulsivity and suicidal ideation, racing thoughts, heightened irritability, agitation or restlessness, increased goal-directed activity, increased talkativeness, or decreased need for sleep.