How long have you had the Mirena? I know it is very low hormones, shouldn't be enough to do anything but nothing has ever de-stabilized me like that thing did. I had it in 9 long, suicidal months and finally we decided to remove it to see what happened. 3 days later I was better. Not all better but better.

My pdoc and gyn were both shocked and discussed it (they work at the same hospital) and both immediately found another case of bipolar and Mirena not playing well. So now they are much more cautious with using it with bipolar patients there.

If it's newer or correlates with the instability at all you may want to think about removing it to see if you improve.