I am in bed resting, having a manic episode. I took my BP and it was 185 over 149 at 195 beats per minute. It was 6am and i was doing nothing strenuous. I am wondering when I should go to the ER? I have been once before and I owe thousands of dollars for that already so I dont want to go until I really need to. I am always taking my meds regularly as perscribed. I have a massive headache and ringin in my ears. Any advice anyone?