@bpcyclist: Thank you! I'm currently on 1000mg lithium and 150mg Seroquel (at least I was before I tried reducing it).

The Seroquel seems to take away most of the manic features, and it takes the edge off the despair, but it still leaves me feeling tired, empty, unable to concentrate, and unable to enjoy anything. I'll try to feel better by listening to music, reading a book, watching a movie, but then I end up just stopping after a few minutes because I don't feel any joy from it, it's just a chore. Also, all media (entertainment as well as news) are like a minefield of triggers for anxiety right now. The anxiety seems to be a constant regardless of meds.

If I try to taper off the Seroquel, the depression gets worse and the despair and SI start to come back. Also, some of the manic symptoms start to return. The first ones I noticed were insomnia, impulsiveness, and irritability, which resulted in reckless driving, starting fights, and so on. Also, I started to get things like "feeling presences" again. I started to increase the Seroquel again before the agitation got too badly out of hand so I don't know how far it would have gone if I'd gone completely off the Seroquel.

I'm hoping a new therapist won't be necessary and that it will start to feel normal again after a while. I'm trying to focus my anger on the policy of the practice where she works rather than on her personally. I really used to love her and I would hate to give that up and have to build up a new relationship all over again. Hopefully in a few weeks/months I'll get some of my confidence in mental health care back and it will stop feeling like quicksand.

I've heard that higher doses of Seroquel can actually be less sedating than lower ones, so maybe I can still try going above 150mg to see if I'll get some of my energy and motivation back.