What do lady macbeth actions in act 5 scene 1 suggest about her state of mind

She is insane for the guilt of her involvement in the death of Duncan.  When she says "Out damed spot out I say."  she is replaying washing Duncan's blood from her hands.  

I know I mispelled a word but the profanity filter stopped me from submitting.

You look through the lens

Answerborromini;