That is called a mixed state. Dysphoria. They are defined by the DSM in brief in your exact words practically.

If you are on an antidepressant (other than Lamictal which is a stabilizing agent) generally it is safer to lower them, because they are activating. Usually the treatment is to up the moodstabilizer you are on, add a stabilizer, or add an antipsychotic. the latter option works the best for me ... calms me right the heck down. the sooner you are treated, the faster you will respond.

The best stabilizers for mixed states are Depakote and Trileptal. Lamotrigine is a good adjunct also because of its antidepressant properties.

Fewer individuals in mixed states respond to lithium than to the above two agents, however, per my reading, those few who do respond to lithium fare better - symptoms are resolved faster.

As far as AP's... my standby is olanzapine (Zyprexa) for a short term treatment, but it should not be given if you are already at a risk for diabetes, and as it is, i only use it for brief periods because it does make me gain weight fast. Seroquel also works but not as well. in both cases, moderate to high doses are needed for acute and breakthrough dysphoria typically (15-20mg Zyprexa, 600mg Seroquel given at night, or 400 at night 200 am). Here Geodon is not available but i would think it should be effective and does not carry the high diabetic risk Zyprexa does. I don't know the dosages offhand.

I would discuss these various options with your doctor if you are not on such a regime already, or if you are on lower doses.

i do hope you feel better soon. Mixed states are the worst of bipolar. Be safe. Post when you can if you need to vent. I can appreciate the frustration... an understatement even?

~ waves ~

p.s. looks like we cross posted... sorry i wasn't faster... trying to give you some info here.... chin up... it WILL resolve. it WILL, ok?