Ultramar- I did consider the end of IOP as the trigger too. I have been there for two months and I am used to it as my routine. Most of the people I connected with have been discharged already, but a new man came in who also has bipolar 1 and I have really connected with him as most of the people there have been addicts up until now (the evening program combines dual dx and mental health). I think a combination of all those things might have been the destabilizing factor.

I cannot take time off work because I was hospitalized at the beginning and therefore used all my paid days off. But I seem to be feeling better today so far (even on the hypo side of things) so we'll see how it goes.

I appreciate all the replies. You guys are right, the car accident probably started things rolling in a bad direction and work just exacerbated the issue. I just have to carry on and hope the med increase works. Thanks so much everyone!