Sounds like mixed to me too with a lot of mania. I am diagnosed bipolar 1 with mixed features, and for me, the stupid mixed state rarely leaves unless I am in a complete manic or depressed state. I tend to be a bit hypomanicky because of not taking all the prescribed dose of Seroquel, but honestly, I have iron anemia too and just couldn’t do a thing, I was so tired.

I would suggest calling your pdoc, seeing if you can get an urgent appointment. Mentioning lack of sleep pretty much guarantees my pdoc will call me and get me onto his schedule ASAP. I always get more manic the less I sleep, so sometimes I get prescribed extra meds for sleep until I am sleeping better and the manic phase has passed.

But the last time I had an episode similar to what you are describing, my pdoc wanted my in the psych hospital ASAP. I only avoided hospitalization by having H come in with me to appts, promising he would call if I didn’t sleep enough , and pdoc appts every other day or so and calls in between.