5mg is not that much more than 3mg especially if you were prescribed 10mg as starting dose.

I was on Zoloft for a while many years ago and I know that gave me nausea at the dose I was told to start on, but I remember taking it down and going up very slowly.

Have you ever thought about CBT for some of these issues? 3 of us here have various degrees of obsessive compulsive behaviours. I'm good these days. Daughter struggles and she does the same thing to the nails as you're doing right now. Actually when my son was little he used to bite his nails so badly they'd bleed. I tried all sorts of things to stop it including putting that liquid they sell for nail biting that is bitter. In the end he just had to put bandaids on all of them to stop them bleeding more.

Just curious but have you always had this problem or is it relatively new? I was wondering if maybe some other med you might be taking needs tweeking.

I understand the concerns you have about the SSRIs and mania.

You're in a bit of a pickle really aren't you.