I think that when to go to the hospital is when you do not feel safe with yourself anymore. Or when someone else is concerned enough to see how you are struggling.
What is the new meds you are on? They should certainly take care of the bad depression too.
My bp honey loved the manic days too. He had no idea how hard those days were on me, keeping up with him, protecting our kids. The feeling of invincibility is scarey for us looking in and we worry about bps physical safety