I apologise to all if this is triggering and for the length of this post, but this has been something that has been playing on my mind for a long time and I really feel like I need to discuss it to get it out of my system. I have suffered with suicidal ideation many times over the past 12 or so years. Sometimes death is all I can think about to the point I can barely function, and at other times I have just had fleeting thoughts which I don't even batter an eyelid at. Up until 18 months ago I wouldn't have described my suicidal ideation as severe or chronic, because it has never really lasted for long in the past as I was mostly very impulsive so I never really gave anything much thought. But 18 months ago I did go through a very dark depression that lasted for the majority of 2015. It got to the point where all I could think about was how, where, when and the aftermath. I would replay my death over and over in my head. I would write mental suicide notes to the people I loved over and over in my head which escalated to the point where I was writing everything on word documents. I would replay the aftermath over and over. I knew that I couldn't act on my ideations at the time because I had bills and debts to pay but I had a rough timeline in my head but no set date as such. I noticed that ideations worsened when I was taking medications which stabilised my crazy moods, but I just felt numb and totally devoid of any emotion. I never really felt anything better than "okay", and quite honestly "okay" is not a good enough feeling for me to convince me to live. I wanted to feel like me again, so I stopped taking my meds 5 months ago. Within about 6 weeks I felt relatively normal and I have actually felt some positive emotions and dealt with negative ones productively. I always knew the risk I would take in that I knew I could become manic or depressed at any time. I am actually quite surprised that I have staved off depression for this long. I have had a couple of hypomanic blips that I have needed to take PRN medication for but my self management has been going well. The ideations significantly improved. Although they did not disappear completely, I could handle the fleeting thoughts and never really paid much attention to them. Things had been going well up until about 2 weeks ago when hypomania hit me. This has happened for a couple of reasons. One reason is because I do normally have a high period around May time anyway, and the second is that I have got a big job change coming up in just over 2 weeks time. Because I have Bipolar Disorder I am a creature of habit and routine, so I don't like change. I am of course very excited to be changing jobs because I want my career to progress and I think I will enjoy and be good at my new job, but change frightens me. I am comfortable in my current job and I know what to expect. I know the ward, the people, the speciality etc. But I am absolutely petrified of having to work with new people in a new environment. I understand most people have these anxieties, but for me, change is a really big thing and I think it is unsettling me a bit. I was beginning to get racing thoughts that escalated in me hearing them out loud in many different voices so I took my PRN meds to help with this. I think I am coming out of this now as I am a lot less agitated and wrathful. But during this period and currently as I type this, the suicidal ideations have started to hit me again in full force. I am not sure if this is just temporary as I come down from hypomania or if it is the start of something more sinister like a depression brewing. I sincerely hope not and hope that it doesn't last. But I suspect this is going to last until I at least get settled in my new job. But I really don't think I can handle the suicidal ideations again if they reach the intensity they did previously. They are hitting me pretty fast. All I can think of is how I will die, when, where, etc. All the same things as before. I have my method, I have my place, I have my plans financially (I would just need to physically put these into motion). I just don't have a date. I can't do it yet because I have things I need to do first. As I type this I do not feel particularly unstable. I feel "okay" but I still feel like "me". I understand that it's probably not a good sign that I feel like this unmedicated, but I don't think I can bare being medicated again knowing that being devoid of "me" and emotion and feeling nothing better than "okay" will make the suicidal ideations worse and I fear that if that happened I would attempt prematurely causing more mass devastation than I initially intended. Obviously I know that my suicide will hurt everybody I know and it's not a decision I have considered lightly at all. I have thought about everything and of course, I know it's going to hurt. But I am not sure I can be condemned to a life of constant mood cycles off meds or taking meds and feeling nothing with no guarantee they can stave off the cycles forever. I do honestly feel like this illness is terminal, which is partly why I decided to come off meds because I thought "fuck it, if I am going to die anyway I at least want to die being me and feeling free". This is still very distressing for me. My heart wants to live, but my head is all kinds of fucked up. I just don't know what to do. I haven't been entirely honest with my psych about not taking my meds, but I think if I told him why he would probably understand my reasons for doing so. I have thought about writing an honest letter about why I feel the way I do and why I stopped my meds but I don't see what good it would do. The options are carrying on unmedicated with the very likely possibility I will hit a mania or depression and I can't cope with a depression like the last. Or taking my meds and still having this mindset. I just cannot honestly see a way out of this. The other issue is, none of my plans are imminent so it's not as though they can hospitalise me because I am not a current suicide risk. Sure they could hospitalise me, pump me full of meds and I would stay compliant, but it's not going to change anything. I don't know what to do, and I am scared. I thought I was getting past this. I honestly did. I should just be thankful I have had nearly 6 months respite from feeling completely terrible 24/7 and that I have had the chance to live, and live as Alex, the funny, caring, compassionate, kind, ambitious and thoughtful person that I am and that people love. I'd rather go out this way, than some mind numbed minion that just pushed people away towards the end and die feeling completely alone. What would you do in this situation? What can I do?