I can totally empathize with you on this one, John. I've been in a death spiral for the past month and a half myself, spinning further out of control (or so it feels) with each phase of the cycle. It all started with the anxiety attacks at work in early April, and is only letting up on me a little now that I've gone up on the antipsychotic. I've had unrelenting stress for so long that I can't even remember the last time I was fully relaxed for more than a few hours. Now this damnable disorder has cost me a good job and probably my career.

I've also got domestic issues with my elderly sister, who keeps over-medicating and falling (broke her hip Friday night and thinks she should get to come straight home from the hospital because she doesn't want to be "stuck in some nursing home" even to rehab from the fracture). She can't even stand up and get to the bathroom by herself.....wonder if the state would pay me to care for her?? Still, I can't do 24/7 duty even if I was getting paid, the woman has to pee every half hour or so, and let's face it, me + unstable bipolar + no sleep = probable hospitalization. And I don't even have health insurance anymore, so I'd be stuck with the entire bill. Just what I DON'T need.

This year has been weird. I was depressed all through December per my usual seasonal pattern, but then had a perfect January and February where my mood was completely stable. Then for some stupid reason, I started ramping up in early March and have been more or less hypo/manic since, with the latest incarnation being a condition my pdoc calls dysphoric mania....AKA a mixed episode.

Since I can at least get rid of the energy by channelling it in a useful direction (you should see how clean my house is....and I don't do housework), he said it wasn't an uncontrolled mania, but it was definitely different from anything he's seen in me before. I thought I was just depressed, because even with the excessive energy and agitation, I've been so down on myself and bawling my head off at any or no provocation. But it wasn't, and obviously his decision to increase the AP was the right one because I am doing better.

Like you, John, I HATE feeling helpless and hopeless. I'm another one who grew up with the stiff-upper-lip attitude---Lord forbid I should ever ask anyone for help!---and I've toughed out episodes in my life that were far worse than this, long before I knew what I had. Now I wish I could learn to be a little more patient with myself and get help before I land in the middle of a hot mess.