Hi,

I am not schooled in the other issues so I am only responding to the bipolar:
The Effexor might be a problem.
You say that you are taking Trazadone very low dose. Has that changed?
Has the Lamictal changed?

Have you drastically changed your smoking? Cutting back could have effected mood.

-->>My suggestion is to call the pdoc on Monday. This is important.

M.