Thanks for your reply. He also takes Wellbutrin which he had taken previously in combination with Cymbalta and Lithium. My understanding is that Lithium was prescribed due to his irritability. And it did help but I think, as you noted, at some point things stopped being effective and,
along with our move across country and the need to secure new medical insurance and practitioners, he self-weaned off meds and there was a gap in his therapy. He’s back on schedule, as I said, and he’s basically functional but struggling. I have asked him what I can do to help but he really doesn’t have any answers - I get a lot of “I don’t know” as well as “nothing seems to help.” So it’s that attitude that concerns me because it sounds so despondent and hopeless - and yet on the flip side he continues to do his course work including going to an internship placement, continues to volunteer with some community organizations of interest. It’s as if he just isn’t meeting his expectations of how he wants to feel, if that makes sense.