My psychiatrist didn't call

Wednesday she told me to call her secretary Thursday evening and leave a message with when I was available for her to call. I'm not to put my Emsam (antidepressant) patch back on until I talk to her. And she never called. I'm sure something happened because she doesn't usually do this (and please don't say negative things about her; I'm thinking a few but really she is a very positive person to have in my life and I couldn't have a better fit with a dr.) There's a small chance she'll call tomorrow although unlikely.

So I'm continuing with the high dose Seroquel and valium that sort of works and sort of doesn't and no antidepressant. The Emsam hangs around for a while so I'll still have a small amount in my system but it is possible that by Monday I'll be at crash and burn and then we'll have new problems.

The mania hasn't been so much fun today and I realized that I'm paranoid when I was walking the dog and people were walking behind me and I was sure they were talking about me. And they weren't at all; they may have been talking about the dog a little but not me at all. I even chatted with them and they were perfectly nice but the paranoia kicked right in.

What I hate most is that I sat around all day anxiously waiting for a phone call that didn't come. I don't handle that kind of waiting well when I feel this manic. I keep wondering if I was supposed to email but I'm pretty sure I had the directions about calling and leaving a message correct.

I feel like when you are a kid and you turn in circles as fast as you can until you fall down and then are giddy with laughter. I feel that same boost although I also feel exhausted tonight. My stomach isn't handling the med change very well and so I've had very little to eat.That hasn't helped much.

I just want to know what is going on in my life....i hate feeling powerless to the illness.

Sounds kinda like you don't need the antidepressant right now if mania is going on. She probably wanted to wait and see how it goes without the AD adding to the mania.

Right but because I'm mixed I do have depression and a history of getting suicidal rapidly. The plan was to reassess and determine if it is safe to start a little of the antidepressant back again because the levels totally crash. If I remember right I'm due for a big crash about Sunday and that is just as likely to flip the depression to the top and mania down than it is for anything else to happen. Hard to tell; I've not combined this manic with the MAOI before so it's hard to know how that works for me but I do know we specifically talked about getting the AD back before I could swing down; when that happens it is very fast usually and includes enough SI that I'd be hospitalized without a doubt. We've been cutting back the patch and taking days off for weeks but it would be better to be on a miniscule dose than to have nothing in my system when it finally all washes out.

I'm going to write an email to her. Either she gets it or she doesn't and if it's annoying to her then life will go on. (She'll really understand, I just get paranoid that people will get mad if I think I'm pestering).

If your snacking on Klonopin and Valium plus a pretty big dose of Seroquel and your still in a hot mess, I would think that going IP to get stabilized would be the way to go.

Just my opinion, I'm no Pdoc.

Inpatient is probably a very real possibility. It is best though if it isn't an emergency for me to go in through my dr because it ensures me placement on the mood disorders unit (which is smaller and nicer than other units but you have to be accepted to it) and also lets her tell the hospital psychiatrist what she has been doing and why. So far it's not an emergency, this is actually how these things go for me. So nothing is a surprise to her or my therapist, they've done this all before with me. I've had to go inpatient a few times but have stayed out through many episodes this bad or worse just because for a long time this was my life. Or worse. And I was working. This is the worst it has been in a long time and it is horrible but it's be far not the worst ever.

I'm open to admission and if I feel like I'm in any danger over the weekend I'll get there.

I sent her an email including questions that asked if this was heading IP-ward so maybe she'll get that and be able to answer. Or I survive a few more days and make absolutely sure I talk to her Monday. If worse comes to worse I'll put a part of my AD patch back on. I'm not supposed to but I was also supposed to get some clearance on that so I'll just make a decision and if it is wrong it comes off easily.