I agree about the mood stabilizer, something like Lamictal. I have to have the Lamictal with the antipsychotic and then usually they tinker with those when I'm hypomanic. I don't let myself get full manic, then the odds of hospitalization are way high. I agree the Lexapro set it off. SSRIs are not good for bipolar. Your pdoc did take you off the Lexapro or have you tapering it down?

Do you have sleep meds? Getting sleep (and enough of it) is key to getting me down. Can you sleep? If not, can you call your pdoc and ask about sleep meds?