Q. I am a 30yr old female who has been in a manic state for a week. Every day I wake up and I get higher and higher. I was diagnosed eight years ago and had one hypomanic state then and four years later was hospitalized for another one. Now this time around it is the worse it has been. I was put on lithium 600mg a day last week by my GP who has never seen me like this. Questions...

1. Can going inpatient help stabilize me faster (Dr. told me it would be another week before I saw any results) I am a high functioning individual who has to be at my best for work and this isn't my best. I am thinking and talking too fast for me to work and it is impairing my job performance.

2. Besides Lithium is there any other medication that I can take to help slow me down a bit?

3. What do I do in the meantime to keep functioning.

  A. All very good questions.

1. Going inpatient may help stabilize you faster because the doctors can more aggressively treat you. That said, if you are not sick enough, your insurance will not pay for inpatient care, and you may have to wait until you get more ill to go in. Its bizarre, but how insurance works.

2. There are lots of things besides lithium that will help. Anticonvulsants (Depakote, Tegretol, Lamictal, Neurontin, Topamax), antipsychotics (Risperdal, Zyprexa, Seroquel), and even antidepressants (in some cases) can help alleviate mania. Talk to a psychiatrist about treatment options.

3. In the interim, functioning will be difficult. You really need to be treated aggressively and quickly to abort a manic episode. Get to a psychiatrist as quickly as you can. Start with your GP, they can help, but get to someone that does mania for a living for best results.