Change is a trigger for me: the change of seasons, for instance. I don't have Seasonal Affective Disorder, it's more just change in general. My first manic episode ever years back started as euphoric mania in the summer, and turned into terrible mixed, dysphoric mania that started in October and cycled from mixed mania to depression throughout Fall and Winter. It was a really dark period for me, and it still concerns me to this day. Since proper meds, the episodes are usually shorter, but still intense. I cycle more often.

I've been on all kinds of doses of Seroquel from high to about 300 mg as a low, along with other mood stabilizers. I was on 300 mg this summer to try to reduce side effects and deal with the symptoms and mood swings without raising it. Plus, I wasn't at high risk then. I reserve being on high doses when I'm especially bad, like during this past winter. 600 mg and more helped quiet my mind enough to pull me out of a manic mixed episode, but it took some of the life out of me, made my hands shake, my appetite went way up.

I recently saw my pdoc and she pretty much left it up to me whether to raise the Seroquel or not. I told her I had 400 mg pills left just in case, and she didn't express any concens.

I guess this means I have the permission to raise it from 300-400 mg if I need to. I don't know if I should wait to see if things get even worse before going to 400 on my own. Currently how I'm feeling: crying more often, very negative thoughts about myself and the future, anxiety, trouble sleeping, mind races during certain parts of the day, depression, more impulsive, some mixed features coming out.

Do you think a medication increase is worth a try? I've been trying to cope without raising it for a while now, and I usually wait until I'm in crisis, which isn't the best thing.