Intrusive thoughts and anxiety are a major issue for me. My mood stabilizer prevents most hypomanic episodes, but it seems like that just gives my brain too much "down time" to think. Thinking isn't usually good for me. I will rip myself up, down, left and right, replaying old embarrassing moments, self flagellating for the smallest mistakes, or creating whole episodes of misery out of nothing. I've started taking an anti-psychotic, which seems to help with the ugly and paranoid thoughts, as well as anti-anxiety meds for when I get ramped up.