Brief history. I saw my psychiatrist about 16 years ago for 4 years. Then I thought I was cured and stopped seeing a pdoc altogether. When my symptoms returned almost 3 years ago, I went back to him. When I got pregnant with my third child I was uncertain about some of his decisions (even though I liked and respected him a lot) so I sought a second opinion. The pdoc I saw then was AMAZING! I don't think I can ever replace her, ever. I adore her for her professionalism, openness, thoroughness, I could go on and on. But, she relocated to a practice over an hour away. So, I went back to my previous pdoc who I have had a longstanding relationship with and who I also trust. Today was my second appt back with him and I came in depressed and suicidal. We agreed last time that we would work on lowering the dosages and amounts of my medications. We started by lowering my lithium from 1800 mg to 1350 mg. And today, he told me that decrease was not creating the depression and that it would stay but given the circumstances, he would not decrease or lower anything else this time. Then he told me he wanted to add an antidepressant. This is something that I have read should not be prescribed to a bipolar patient (especially one who has previously, when I was young, had a manic reaction). Also, the pdoc I was describing earlier, the one I adore, never even mentioned it even though I was so depressed I was admitted into the hospital. I am eager to take it but I am also concerned with what will happen. Do I trust him and take it? Also, when he asked me if I had thoughts about hurting myself and I said yes, he asked me questions as to be expected. I have discussed this with him many times in the past but this time it was so awkward and uncomfortable that I actually laughed while discussing my thoughts of suicide. With the other pdoc, I was a motor mouth and would tell every pertinent (and often impertinent) thought in my mind. Will I just get used to him again (again, I have respected and trusted him for many years) and accept that my old pdoc will never be replaced? They are SO different. What do I do?

PS: Sorry this is so long!