In the most severe episode i've ever had

My Psychiatrist diagnosed me over 3yrs ago with Bipolar 1 w/mixed episodes and panic/anxiety disorder. I have been this way since i was a teen and i am now 35.I have not had an episode in over 9mths now. My doctor changed my mood stabilzer to lithium a couple a months ago b/c Neurontin had started making me sick and i am wondering if it is possible that the lithium could have caused me to have a more severe episode. even my worst episode was never half this bad and i tried to commit suicide that time. I am scared. I am able to control my episodes most of the time or avoid them completely, but it is not possible this time. I've tried. this episode is refusing to stop. We went on vacation a month ago and my RAGE ruined it, the rage finally faded a week later and since then i am in a severe state of depression. I am just tired of everything and cant make myself care anymore. I am tired of coping with this disorder and not sure if i even want to try to anymore. Could you please give me some advice? Is there another Med out there that would help? I am allergic to Lamictla, Tegretol,and Abilfy. Have taken Depakote, Neurontin, Prozac, Paxil, Wellbutrin and most of those types of meds with no luck.

[Roger Gould, M.D.]

I can't advise you re another medication but I am sure your doctor knows what is available and can try them out with you, but that is not the real issue here...since you have had control before, and some good success stopping these in early stages, it would seem to me that you are a very good candidate for psychotherapy, something relatively intensive, not just follow up visits for medication...I suggest you do that with your psychiatris if he or she is trained that way, or ask for a consultation/referral.  Psychotherapy and medication work much better than medication alone.