How do you know when you need a med change or you just need to use coping skills? Obviously the more extreme symptoms of mania need meds. Right now I am rapid cycling. I will sleep for 3 days straight, only getting up to use the bathroom, and then I'll be up and go spend $500 on clothes and crap. I've been experiencing a lot of agitation, urges to SH and brief bouts of suicidal ideation when I'm up. The pdoc at PHP is telling me I'm highly medicated (1500mg of lithium and 120mg of Cymbalta) and that I need to use my coping skills. I told her I'm not functional and it's consuming me trying to control my agitation. I feel like my meds aren't working and I've missed 4 days of PHP because I couldn't wake up and get out of bed. Thoughts? Opinions? Personal experiences? Any meds that helped you out of rapid cycling? This has been going on about 4 to 6 weeks now.