Didn't you used to take an AD? One of the weird ones maybe Vibryid? (I only remember this because I'd never heard of the stuff but you may not be the person I remember was taking it). Would that be an option to try?

I used to use ADs on and off as needed and then we found one that I could raise and lower the dose as I needed (imipramine; it comes in 10 mg pills so I could take 5 or 10 depending how I felt). When I stopped working I went on to an MAOI, Emsam and have been on it constantly since 2009. I did need to adjust my other meds to help keep things level but it works fine and if I get manic from it I am allowed to lower my dose myself. It's a patch so that can turn into some creative scissor work but I've been able to make it work whenever I needed to adjust.

Can you call and try to get into pdoc sooner? Can you therapist help with that?