<s>[INST] Hello doctor, I have bipolar 1. Rarely manic, depressed 2 to 3 times a year. I have felt good since last four months. This afternoon I suddenly got very depressed, hopeless, ideation. I also have racing thoughts, cannot sit still, very irritable, heart racing and cannot stop crying. I have never felt like this. The doctor is not available and the suicide hotline was no help, she did not know anything about bipolar. I take Latuda, Wellbutrin, Seroquel. Ativan and Atarax for anxiety. I was fine 2 to 3 hours ago. Now every time my son asks me a question I feel like screaming, so I am hiding in my room. I do not want to scare him. I do not know what to do. I have never felt like this, having so many thoughts so suddenly and without warning. [/INST] Hi. These symptoms are probably due to drugs side-effects called akathisia which includes almost all the symptoms you mentioned. This can occur without any warning and also change in any drug dose or schedule. Take Ativan one tablet (1 or 2 mg) now and can be repeated after one hour if symptoms persist. Propranolol is also helpful but you cannot get it without a prescription. If you have fever also then you need to rush to the emergency room. </s>