Hypomania Episode Advice

Hello All, 

I’m here to kind of just write out what I’ve been going through to help me move forward. I was originally diagnosed with bipolar II in about 2017/2018. Made a lot of sense, and I “think” I was doing a good job of accepting the diagnosis at that point. Tried Lamictal for med management, didn’t like the side effects. I started seeing a psychiatrist and started med management with Abilify, Prozac and PRN Clonazepam in 2018. Did fairly well mental health wise on these. However, gained 20 lbs that I could not get rid of. Tried all lifestyle things, even tried meds with Phentermine in addition to exercise, diet. Due to this, and somewhat of my disillusion that I don’t really have bipolar disorder, I ceased the Abilify. Fast forward a few months and I became extremely depressed. Sleeping all the time, low motivation, loss of appetite. Transitioned to a new psychiatric provider due to insurance changes and began on Vraylar in the hopes that it would stabilize me, but also not cause as much weight gain. I gained about another 20 lbs during treatment with Vraylar. And once again, thought well maybe I don’t need it really? DSM criteria is so subjective, maybe I’m not really even bipolar. I went off in July 2023. Since have experienced mostly depressive symptoms, but also very high levels of anxiety. Been working with my PCP to try to figure out meds. Started Buspar for anxiety. Didn’t help much. Added Prozac back in and increased Buspar with PRN Ativan for panic. 3 days ago, I ran out of the Ativan. In hindsight a good thing, as it was masking things. Started to experience full blown hypomania. Increased goal setting, flight of ideas, distraction, talkative, not sleeping. Thankfully, I was self aware after a few days of this. I presented to my county’s emergency mental health center (as it’s weekend and my PCP is actually on vacation). The psychiatrist there scared me thinking I had serotonin syndrome, as I have been experiencing an issue with neck pain and am taking Tramadol to control pain until I get an MRI on Monday of my neck. He made me go to the hospital emergency room, where the ER doctor said she was not concerned about serotonin syndrome and that it was just hypomania. The on call psychiatrist recommended to stop Prozac. Was not comfortable prescribing mood stabilizer for me, which I clearly need. Also declined any prescription for benzo to calm hypomania symptoms in interim until I can get in with either PCP or pysch to get mood stabilizer medication. They gave me Ativan prior to discharge. Today is Sunday, my PCP is on vacation. Do I call the on call family med physician from her clinic and ask them to prescribe mood stabilizer? I want to try Latuda, my PCP and I have talked about Latuda in the past. I feel a bit better today in regards to hypomania, but I’m scared it will get worse again. Not sure best way to go about this? And I don’t know when my PCP comes back from vacation. Any advice? Thanks!