For me, my reach out place is where I'm not coping anymore, when I'm resorting to unhealthy behaviours to stay afloat, but we each have our own threshold... I've never bonded with a pdoc, but never hesitated to inform them if I was struggling. 1 sent me inpatient, the other referred me to a T. Both were very helpful pdocs who listened to what I had to say. Friend desertion is rough, not that I ever had any who were part of my bp support. My dx is not a secret, but I've never had any irl support that wasn't clinical, people around me just don't get it, and trying to explain is perplexing for both me and them. I really hope you get to a better place, you've been suffering a long time now, and I know how lonely and overwhelming it gets.