I need a plan - please help

[TheWeekend]

I am bipolar. Medication has not helped. I have at various times been taking citalopram, escitalopram and various combinations of different anti depressants and mood stabilisers - the lot. Some have made me feel worse. The very 'best' scenario has been that I feel OK for a few weeks and then slide in to either mania or depression. Changing doses / meds has not worked. I have been off meds entirely since April and coped OK over the summer. But I am feeling bad again.

Just for info:

I have just finished a 12 session course of CBT. It has not helped me, I'm afraid. It was good to talk to someone - she was a nice woman - and I dutifully did all the exercises I was given. But my moods are so powerful (I have rapid cycling bipolar) that controlling them through CBT seems impossible.

I try to practice 'mindfulness', I meditate, I exercise to improve my mood and I use an online CBT programme and Moodscope daily to try to manage my emotions.

I was under (outpatient) psychiatric care for 3 months when I was first diagnosed, but since then have not had any input from the mental health team.

But I can feel myself sliding in to worse and more rapid cycling moods lately. I am disturbed by constant thoughts and memories of painful experiences in my life. I have lost my appetite and my sleep is disrupted.

I am not and have never been suicidal or had thoughts of self harm, and because of this the mental health team / crisis team arent really interested.

What do I do when I feel I am sliding in to what feels like a crisis for me? Where do I go from here? I need to gain control.

I would think the first thing to do is make an appointment with a gp and ask for a referral to a psychiatrist. As bipolar according to the NHS choices website involves imbalances of chemicals in the brain getting thr right mix of medication is important. It may be you just not had the right combination. Have you tried lithium? As often a combination of lithium, antipsychotics and an antidepressant is useful.

Oh and a crisis team are literally people who risk assess and provide crisis intervention, in your own home. They assess whether need hospital, whether family services needed etc. usually see or speak to a different person each day, no continuity, no therapy and discharged as soon as not at any risk to self or others. Any gp can refer to them as do not need to be treated by a mental health team to see them.

I have a similar situation. I suffer from mixed states and meds work only for a while. Last time I tried so many drugs but nothing really worked. I got better with time and was ok for several years. Lithium does stop mixed state but leaves me with depression.

Unfortunately I don't have any other ideas but lithium like mentioned before. When I was my worst one suggestion was ECT.