She explains that she has a history of heavy drug and alcohol abuse and every time they diagnosed her with Bipolar Disorder she was drunk or high. "Can they diagnose me with something when I'm impaired like that?" She has stopped taking her medications and is experiencing 20 years of emotions which have been suppressed with either drug use or psychiatric medications. She has been clean and sober for a year and a half. She has a history of serious physical and sexual childhood abuse. She believes this is the root of her problems.
I believe she is right. I believe she is not "abnormal", she does not have a "disorder" and she is not mentally ill. She is having a very normal reaction to a very abnormal situation - childhood abuse. But none of this is important. What is important is that she knows it, but doesn't trust herself.
Just because someone has a degree or a license or a bunch of letters behind their name does not mean they know more about you than you. Just because someone takes it upon themselves to slap a diagnosis on you, does not mean it is accurate or appropriate. Think for yourself. Listen to your heart, your mind, your instincts and trust what they tell you.
After talking to this client she decided that stopping the meds all together was putting her sobriety at risk because the intensity of her emotions was too extreme to be tolerated. She was experiencing cravings and had many thoughts of relapsing back into drug use to get relief. She was also starting to feel a bit suicidal, so her very being was at risk. But instead of looking at the meds as an indication that she was "Bipolar" and therefore mental ill, she decided to view them as a tool. She originally used drugs and alcohol to self medicate the trauma symptoms and intense emotions. She replaced them with psych meds which keep her damped down and a bit numb. But this allowed her to not feel suicidal and to be able to function while she got therapy to strengthen her sense of self, process her emotions about the abuse and develop some coping skills. She decided to use the meds to keep herself together enough to work on the trauma and when she came out on the other end of the trauma work she would reevaluate whether she needed the meds or not.
Ahhhh, much better. She is now in the driver's seat of her own care. She is determining whether she needs meds or not, how they will be used and what they mean about her. She is making the decisions about what she needs, not blindly following the advice of others. That is how it should be.