I am sorry for the long wait to see a new pdoc. I was almost there myself (old pdoc retiring). Her co-worker gets good review, but he has a long waiting list. Between my old pdoc and the staff, I got worked in my sooner.

You have to be careful on anti-depessants with bipolar. My pdoc has given them to me in past once she made the bipolar diagnosis, but she never kept me on them longer than 3 or 4 months because I'd just swing the other direction and change to mania. Anti-depressants pick me up quickly, but they also inevitably steer me toward mania.

If you do use Paxil, it's best to do it under a doctor's care. You don't want to get manic either. I see you take Lamictal. It is used as a mood stabilizer but it does have some anti-depressant properties as well (and has the added benefit of not steering you toward mania). Your dosage of Lamictal is rather low; I take 300 mg of it daily, so it definitely can be upped. I would try that first rather than risk a manic episode.

I'm sorry you are having such a difficult time. Can you call or see your old pdoc in the meantime to ask about adjusting your meds? In a pinch, I've had to use my primarcy care physician short term to prescribe psych meds (bringing her the old empty bottles ) before I could get in with another pdoc. Do you have other issues too like anxiety?