I think your psychologist is right. You are the expert. Especially if you have taken them a lot. My psychiatrist lets me pick pretty much what to do. Or he may suggest and I go along. It is a partnership.

Anti depressants can for sure trigger hypomania. When I started my current one, Fetzima, I was hypomanic for two months and then it balanced out.

I take Remeron for sleep and it works great but for me it is useless for depression. I would rather use it than Seroquel unless the Seroquel was helping other things.

It's trial and error. Maybe dump the paxil and try the wellbutrin.

The thing is there is a huge variation in how me metabolize these meds and then how the active metabolites affect us. A psychiatrist has no may to predict. It's like throwing a dart. I think the most reliable and consistent ones are the benzo's for anxiety but they have other problems. I think ADHD meds are more reliable too. Antidepressants and atypical anti psychotics....its any ones guess and you just have to try if you are willing to play the med game.