I'm glad in some respects that the Latuda helped to a degree with keeping your symptoms under control.

The sad reality is they do not stop, all together, an episode from occuring. We will swing from high to low with Bipolar, when we least expect it. Some manage to go long periods of stability then hit a depressive/manic episode whilst for some like me I have been cycling pretty rapidly.

I'm sorry that you've been having mixed episodes. They suck. They really do. Sometimes I don't know if they're worse / better than depression / hypo then I remind myself they all suck and make us feel pretty miserable in the long run. I think that we all just want that "stable" feeling, no matter how subjective and unique that term stable is for each and every one of us.

Judging by how your mood state is coming across in the post, with no disrespect meant, I'm feeling a lot of frustration and a touch of anger coming through. I merely mention this because I'm inclined to 100% agree with you; you're seeming a bit mixed at the moment.

That's a huge bugger about the insurance. I can't stand it when we are limited with our health care when we need access to it most. And I think that the therapy has definitely held you in good stead, it kept you going strong since October. I really do think that therapy plays a role for us along with the meds.

It might very well be your worry over your T and the insurance that's making you a bit paranoid about all of this, if not somewhat anxious. Does your T have any strategies for you to use whilst you manage these symptoms?

I think that it's the fear of the unknown that's hitting you hardest at the moment.

In my personal opinion, you've got nothing to lose by asking your pdoc what changes, if any could be made to your med adjustments whilst you work your head around those 2 factors to help you feel a bit at ease. If not, why not. But then again bear in mind your pdoc may say no you can't change anything. So be it. I know you can't see them until November; but could they advise you over the phone ... probably not ... what about a family doctor? Could you see your family doctor and possibly as for advice re the meds that you are on. I'm not sure.

With regards to the insurance, I'm not sure what to advise, simply because I likely don't live in the same country as you and I am clueless when it comes to how those things work.