My first reaction is to chafe at the "dangerous" label for those of us who are meds compliant. I recently had to change pdocs due to mine leaving his position. I had a thirteen year relationship with this doctor and the trust level between us was high. He knew my triggers and so did I, working through a few manic breakthroughs despite the compliance. Now with my new doctor, I feel I have to prove myself all over again, that indeed I am a "good girl." Doctors so often believe their medications are the only things between us and despair or delusions, whichever way the pendulum swings. I don't think the medicine is my only grip on my sanity. But I am not eager to find out how big a role it plays. I'm a 21 year player (since diagnosis) in this game and a vast majority of those years have been happy, productive and stable. Except for a few close friends who are aware, most of my acquaintances wouldn't guess I'm someone with a major mental illness. I take the medicine. I don't always like it, but I really hate spinning out of control and ending up in the hospital. What it comes down to for me is the people I trust to care for me, doctors and family, wouldn't trust me if I didn't play by the rules. So I do.
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I have found that if you go to a Medical Doctor and they lay a diagnosis on you... and then hand you a bottle of pretty pills... for say anything... and for some reason you don't agree OR you don't follow their direction to the absolute letter... they get really peo'd. This especially for psychiatrists and I've worked with... let's see... 9 in the last 5 years alone, not to mention untold numbers since I was 10 that I've seen as a patient.
You came to them, they didn't come to you. You wanted meds and they gave them to you. You don't want to take them but you want them to help you. They can't help you if you don't take the meds they prescribe you.
It's not up to them as to whether you enjoy the side effects or not. It's up to them if the side effects cause medical and/or health harm and to that degree they are responsible BUT just cause you don't want to be semi-comatosed at work.. has not one thing to do with them.
You came to them. The didn't come to you and you complained of X symptom and they wrote out a script. You don't want to have X symptom, then take Y drug. You don't want Y drug, then struggle with X symptom or here... let's try L drug.
See.. the symptoms of Bipolar are what you feel. It's how YOU FEEL or what YOU are experiencing. Unless it's lithium toxicity that can be measured with a blood test of the lithium levels... there is not one medical test to determine the symptom you feel, or the experience you are experiencing. You tell them this is what is happening and they write a script for it.
YOU are also the only one that can tell them if the pill (or multiple pills as many have) are HELPING or if they are not. Only YOU can say whether the meds help. Now your loved ones can report that YOUR BEHAVIOR has improved or you seem more stable... and yes, the docs go by that (sometimes more than the patient's report)... but, it is ultimately how YOU are that determines the pills.
However, suddenly upon diagnosis of Bipolar, you can't deal with life, you can't deal with stress, you fear all your emotions and each emotion is more deeply recognized and must be alleviated, and you no longer can work any job though you've maybe worked for 20 or 30 years up till then. It's okay... there are pills for all that also.
Way back in the day... Bipolar was just Bipolar I in it's severe form. There was no other version of Bipolar.
If you had Bipolar, you had Bipolar and if you had Bipolar, most times you were taken to a hospital and medicated. They medicated to render you manageable and docile. They still do, it's just in an outpatient form cause there are several versions of Bipolar now and not everyone who has Bipolar requires institutionalization/hospitalization.
So what you said about the psychs getting their internships in the psych hospitals and seeing us at our worse and not wanting it out in the "real world" is fairly true and accurate. There is a generalized image of one with Bipolar and it's the image that MOST all treat. We are all lumped in the one image and most of us are treated as that image.
Wait till you get the nurse that tells you "that Bipolars are notorious for not taking their medications and you know that you'll be worse off if you don't take your medication so take the medication like the doctor told you to cause he knows best and you don't." While you are explaining the eyes swelling and your leg is jerking and twitching.
This is why being the "good little girl cause the doc knows better than you." isn't always true. If the doc doesn't "see me", then how does he/she know me? and if he/she doesn't know me, then how can he/she know best how to treat me? and if he/she totally disregards me as "one of those Bipolars", then I am truly lost aren't I?
You are very right when you say that there is no test for the symptom we may be feeling. Many psychiatrists seem to lump their bipolar clients into the category that says we don't know our own disorder. Many of my own doctors have labeled me with a "lack of insight" until I proved myself. I shouldn't have had to do that. But they operate within the paradigm in which they, with no firsthand experience of what they are supposed to be treating, are more aware of the debilitating potential of the disorder than their clients who often have a much more profound understanding. I think the most important thing an individual with bipolar can do is to find a pdoc who is smart enough to work together with clients rather than doctoring upon them and against their better judgment.