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A mixed episode is characterized by the criteria for a manic episode in conjunction with those for a major depressive episode (depressed mood, loss of interest or pleasure in nearly all activities)

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Patients should seek medical advice if headaches are accompanied by: Neurological symptoms : Vision changes, weakness, numbness, difficulty speaking, confusion, or loss of consciousness Severe nausea and vomiting : Particularly if unable to maintain adequate hydration or take medications for more than 24 hours Signs of dehydration : Markedly decreased urination, dark urine, dizziness, rapid heartbeat, or dry mucous membranes Fever or neck stiffness : Which may suggest infection requiring evaluation Changes in headache pattern : New characteristics in patients with pre-existing headache disorders New onset after age 50 : Headaches beginning later in life require evaluation Severe, persistent abdominal pain with or without vomiting : May indicate pancreatitis, a rare but serious side effect of GLP-1 medications requiring immediate medical attention Healthcare providers may recommend several approaches when evaluating persistent headaches