My current medication mix has proved to be the best one I've taken at keeping mania away. I take a high dose of Tegretol XR, a small dose of Lamictal, and a medium dose of Seroquel XR. I do sometimes take Ativan prn for anxiety, but on my mix anxiety isn't always an issue for me. I think my Seroquel XR is helpful for anxiety, as well as keeping mania away and helping with depression.

Occasionally I get depressed, but I have found that minor adjustments to my Seroquel XR and therapy help with that. Really, therapy has turned out to be a very important part of my treatment and prevention of bipolar episodes. It wasn't always like that. I had to get to a point where I was actually able to concentrate on it. Also, a very good therapist makes a difference.

If I start to get elevated in mood I can take prn Seroquel. My psychiatrist allows me to take a certain amount of Seroquel above and beyond my regular mix. If the prn doesn't seem to help, then I call him. He is good at giving me emergency appointments.

I've learned in the past that encouraging or stoking hypomania/mania is a very bad idea. It ends up hurting you in the long-run. And what goes up and stays up for a long time often goes down and stays down for a long time eventually. Since I have bipolar type 1, I have to be careful about not letting my mania get out of hand. It can get extremely bad, usually leading to emergency appointments or hospitalizations.

When I was younger (in my 20s in particular), I could have extended elated hypomanias. It felt great, but because I wasn't medicated properly (or at all), I think it worsened the course of my illness. Now I don't have extended elated hypomanias/manias. Now when I become elevated it may be elated briefly, but then turn mixed which gets extremely ugly and terrifying. The long string of manias with mixed episodes in my thirties sort of traumatized me, and ultimately disabled me. I've been disabled for years now and still struggling to get to a point where I can become as functional as I'd like/need to be. Bipolar is not a joke or a game. It's a serious illness.

I can't take antidepressants. They destabilize me in very bad ways. I do take the small dose of Lamictal with the Tegretol XR and Seroquel XR, but larger doses of Lamictal are too activating for me. That's just me. You seem to have discovered that for you antidepressants are activating, and maybe even Lamictal (or at least Lamictal isn't an effective enough antimanic). Playing with fire!