Saw my program pdoc, she agreed with my program T that the cutting urge was probably a symptom of my hypomania and upped my Topomax. I have one more appointment with her on Tuesday before I discharge from the program. I have an appointment Wednesday with an outpatient T, and from there I'm supposed to get a referral for a new pdoc, but my program pdoc gave me enough meds that will hopefully carry me til I get in with the new pdoc. At least I'm not feeling so flippy emotionally anymore, so I think the Topomax is working.