Any psychotropic, or drugs used for this purpose, can take several weeks to kick in. Blood work is important because they check for therapeutic lithium levels in the blood. It is hard to know, at first, how much of a given drug will produce a therapeutic level and there may be some adjustment of this medication before that level is found.
If you go with him to the doctor, mention what you see as anxiety and ask if lithium will help to cover this. It may very well be that once more the BP is better treated, the anxiety will subside some. When one is in the "spin" that BP produces, it is pretty anxiety producing. If one is depressed and has been for a long time, it feels like it will never end. I have been there and done that, and it produced high flying anxiety to the point of panic attacks. Once the BP meds started to kick in, the anxiety was a lot better.
I really don't like medications, myself. I think it is too easy to over medicate a complex illness. Hang in there and see if things will improve. If they don't, see if it can be medically treated with meds. By being close to your fiance, you are going to be the best judge of improvement and of his moods. Try to help him view you as a partner in combating this illness. I see that you have some illness of your own. If you can build a partnership of mutual caring and looking after one another in times of need, you stand to do really well. Hopefully, this right now is temporary and things will improve here shortly. Hang in there, visit us and don't let yourself feel alone, you are not.
The Lady Dragonfly
Yes, it was me...I know because I was there when I did it. Lupus sufferer, bipolar II sufferer. Currently on Indocin for chronic pericarditis related to lupus, and cherishing every deep breath without pain. Currently in graduate school for mental health counseling, class of Fall 2007. Vegan and loving it!