Wander, what are you hoping (or expecting) your tdoc to say when and if he responds? Do you expect he'll defend himself? Apologize? Beg for your trust? Other? Perhaps he's trying to figure out his best approach. Either way, you've left your cancellation message.

If you are hypomanic and experiencing some irritable periods, I can say from my own experience that talking to me when I'm irritable/hypomanic is not easy. This is especially true when I'm wound up. It's often better for people to just leave me alone to calm down a bit.

It's possible that your tdoc may consider your cancellation final, but many won't necessarily. I've resigned from jobs only to have the employer told that I did so when ill. They ignored my resignation. I've threatened my psychiatrist that I would leave him, and he just said nothing and then the next week all was forgotten. I have also screamed at a tdoc over the phone and ignored warnings not to leave an Intensive Outpatient Program. The result of that was her stopping our therapy relationship. It kind of works like friendships of some people with bipolar. Some friends are understanding and stick with you, others don't. C'est la vie for people with a mental illness.