Are you frustrated with the essence of the message, or the way she delivered it? Perhaps she could have expressed her displeasure in a more calm way. Do you think you would have accepted the message then?

I can see her being upset. She has the very difficult job of trying to balance your meds to theraputic levels. That often takes a lot of time and trial and error. It must be frustrating when a patient decides to tinker with the levels on their own. I'm glad you were honest though.

I'm not sure what she means about being responsible if you have a negative result. People experience negative results on meds all the time and I've never known a pdoc to be reprimanded for it or held accountable in any other way than perhaps feeling bad about it. She may hold herself personally responsible, but she shouldn't put that on you. I feel the issue is more that getting your meds right is like executing a complex chemistry experiment. The scientist works hard to control all of the variables to give them the best chance at achieving the expected result. You dorked with the variables without her consent and now she has to rework the plan.

I do think in the future you could consider running changes like this by her. Waiting a few days is not a huge deal unless you're in an emergency in which case you should see an emergency doctor for that. I would keep the appointment and explain why you wanted to change your meds so she can know clearly what kind of effect you were going for. Then she can decide if your change was correct or if another alteration is warranted. Don't worry too much about her slapping your wrist. Just go get the help you need now and maybe consider changing docs if she continues to treat you poorly. An apology might go a long way toward clearing the air, but it is obviously not required. It is your body and ultimately your decision how to treat it.