I'm fairly new to the diagnosis of Bipolar I. My GP, my psych NP, and my therapist all agree, as do I, that I am in a nice long bout of mania. My psych NP is handling med management. I have been on 10 mg of Saphris/ morning and night. 50 mg Topomax. 150 mg Lamictal. And 800 mg Tegretol. 2mg Clonopin. I'm sleeping maybe 4 hours a night and am in rages and melt downs of crying, alternating. This is all happening fast. I just got back from seeing my GP, about an unrelated knee messup, and she told me that I should not be working [I've only worked 4 shifts since Nov. 2013], and then she changed my meds to 20mg Saphris at night, 150 Topomax, and left the rest the same. I'm not sure what to do about my PNP. He doesn't return my calls. I guess I'm happy that I can get into see my doc easily and she seems to really care about me. I see my T tomorrow. Does anyone have any thoughts on any of this? I feel like I have three people in my life [well, my partner, too] and I am not always sure we are marching in the same direction. In fact, I'm pretty sure we are not marching in the same direction. I feel overwhelmed and hopeless.