Hi FluffyDinosaur. It definitely is a matter of trial to see what works. In my case, Seroquel XR has been helpful for me for both ends of the mood spectrum, including mixed states. Sometimes an increase does the trick, and sometimes a decrease. It's funny how that works for me. I will say that I do also take a small dose of Lamictal in addition to my Seroquel XR and my moodstabilizer (Tegretol XR). The Lamictal has always been activating for me. Like many, I have had bad luck with antidepressants (including Wellbutrin), so depend on moodstabilizers more geared towards lifting my mood (like Lamictal). I remember about 9 years ago feeling exactly as you describe. My psychiatrist decided to add on the Lamictal, since he knew it had been activating in the past. Since Lamictal must be added slowly, from small doses, it was surprising for me to see that when I reached only 75 mg, that a positive change was happening.My psychiatrist then upped it to 100 mg, and I started to become hypomanic. Instead of reducing my Lamictal, he decided to increase my antipsychotic, and that seemed to make things "just right", like Goldilocks experienced.

I'd like to add another thing. I firmly believe that after a series of episodes, or a particularly severe episode, the brain needs time to heal. Sometimes medications alone cannot do the trick, or at least not for a while. It takes various strategies to heal the brain again. Therapeutic strategies help. Exercise. Healthy eating. Pushing oneself to slowly do more and more.

I don't really like the expression "Fake it Till You Make It", but there is something to that, in terms of building up endurance and "clearing the clouds away". A person that injures their legs cannot immediately run a marathon. It takes recovery exercises and effort, a little more at a time, to build back up to marathon abilities. No one debates that for physical injuries, but many don't see the same need for psychiatric injuries.