This year my anxiety disorders have almost taken precedence over the bipolar, what should have been probably a mild mixed mood this spring that could have been easily managed turned into a major one because the anxiety was like pouring gas on a smoldering fire. By the time I got meds on board to help with the anxiety I was on the down swing of the episode so then we had to deal with the lingering depression. Mixed episodes are already uncomfortable, the anxiety makes it almost unbearable. You have GAD so you know what I mean. Treating that as aggressively as the BP I think is important, it is for me. As for therapy, we are doing CBT but I don't have the ongoing issues you have in your life, its more for maintenance and watchfulness. My therapist can spot my moods pretty quickly and suggests I make emergency appts with my pdoc when she sees the need. They are in the same office. But yes, having the extra letters tacked onto our BP diagnosis makes things harder to deal with everything else in our lives. Both of my sons have adhd, they're grown now, but I remember how hard it was raising them, esp my oldest who was in sp ed. I wasn't diagnosed with anything while I was raising them, I dealt with school and drs and all that as best I could so I know how hard things must be for you, I feel for you and commend you for all you do. I'm not too sure I coped all that well back in the day, basically I just did what I had to do and slept when I could. I didn't know I had something that could be treated back then. Now that I'm 'retired' I have very little stress, I take lots of meds and I see my drs regularly.