I agree with everything said and Your and Bether's posts coulda been mine.

I could write a novel about you. Short version is, i agree this mixed state stuff slash dysphoric mania thst is getting worse. I also am concerned you are drifting to the psychotic side of the ledger. Badass dysphoric mania is not far at all from psychosis, take it from one in psychosis all the time. Months at a time. Your cognitive issues support my concerns.

So, yes, to me, you sound percolatingly psychotic without hallucinations--yet. It is misery and you have to get out of this or you will end up in the ER. Spent 6 yrs in the hopital. Trust me.

Is this an emergency? Yes, it is. And Lamictal is not your answer. Yiu need a bigtime antimania med like high-dose Depakote and a killer anti psychotic--just for starters. I like Zyprexa or Trilafon in these situations. You need it now.

I only know how derm surgery works in the UK. But no GP is your solution. You need a good pdoc.

I live where you are now much of the time. The best strategy forme has been: 1, knock the sh:@out of the mania, and 2, manage the psychosis your dysphoric mania has spun up. Depakote is likely to be your best sleep solution, in my experience. Sleep meds do not address the cause. Lowish dose Seroquel is a total joke for what you have.

Hugs and love. You must take action. PM me anytime. I have a schizophrenia support grp on snapchat. I cld chat there w you also.

Stay strong. Get meaningful help now.