I once had mixed states - not sure if this is also rapid cycling? could that be part of what you are experiencing? Lithium helped me a great deal. The mixed states evened out to fairly delineated manic & depressed states. Lithium does have many side effects, maybe that is why your doctor won't prescribe? For me it made my body break out into psoriasis, but I take Humira for that. Otherwise no side effects for me, although you must get your liver function monitored as it is pretty hard on the liver. Luckily for me no complication there. As others have said, don't be too hard on yourself! Can you talk more with your doc about it?