31/F

Been struggling with mental health progressively getting worse since age 25. Started with GAD, severe panic attacks, then MDD. Assumed it was Pre Menstrual Dysphoric Disorder and regulated it with birth control however I have been on Mirena now for quite some time and my mental health has gotten progressively worse in the last few months. There are some reasons behind it however I have been actively in therapy for almost 5 years now, and I have been seeing a psychiatrist for a few months now that is in the same hospital as my GP. Psych has a list of all my past medicine changes (it was a lot of hopping every two months) and has had me on Venlafaxine ER for about 6+ months now moving from 75 to 150mg. As I got progressively worse I thought I had bipolar but I shift moods too often and I found out about BPD and have felt more understood. Right now my Psych has me listed as GAD and MDD however my moods have begun to shift severely and when manic I am having issues spending money shopping online just to get a hit of dopamine that lasts for a few hours and then I come down. Then when the boxes get here I get that hit again but then when I check my account I hit hard into anxiety and depression. The only saving grace is writing in my journal when I get severely overwhelmed. However, I don't know If I should give my psych my journal because its like 30+ days of just my brain-vomit. I am also afraid of him taking it and not giving it back or something. I don't know what mental space I will be in to be able to best advocate for the help I need (and getting off Venlafaxine ER cause withdrawals might kill me) how might you handle getting the proper help?