My primary care doctor started giving every patient a written questionnaire at the beginning of each visit, to screen for suicidality. It was the same basic questions you mention in your article. When their office sent me a feedback survey in the mail, I explained that these questionnaires don’t help prevent suicide. If you want your patients to tell you what’s going on in their emotional lives, you have to make a habit of listening to the patient every time they come in your office, I said. They stopped using the questionnaires and started making a point to connect personally with the patient at each visit. Yes! Progress! Your experience with the system sounds horrible- and typical. For your information, SSRIs can cause mania in anyone- not just someone who has bipolar depression. They can CAUSE the tendency to mania. Who knows if you had any tendency toward mania before you took an SSRI. It’s not just that SSRIs are bad for people who have bipolar. They can CAUSE it. I guess you learned the hard way, not to go off of psychiatric drugs quickly, or cold turkey. The safest way to go off of them is VERY slowly. A friend of mine went off of them safely and successfully, by taking about 2 years per drug, to gradually reduce the dosage. She gradually reduced the dosage of drug number 1, and over two years, reduced it to zero. Then she did the same with drug number 2. So it took 4 years to go off of two drugs. But it worked. No relapes, no withdrawal symptoms. It’s understandable after your experience, that you don’t trust the system that’s purported to be there to help you. I don’t trust them either. For good reasons. WTF. I have found that it’s more successful not to expect them to be any good, and not to expect them to be helpful. I seek out individual people who I can trust. I don’t trust the system in general. I rely mostly on self care and on good friends. Basic physical self care goes really far, especially for the problems that get classified as “bipolar.” I mean things like good nutrition (especially green vegetables for folate, magnesium, and B vitamins; omega 3 fatty acids, enough protein, and avoiding chemicals and simple sugars as much as possible), regular exercise (it doesn’t have to be high intensity or long, though it can be- mostly the consistency of doing something every day is what makes the most difference), a regular sleep cycle of sleeping enough and at the same times each night, and getting outdoors during daylight hours, go really far toward taking care of the brain biologically. Then there are your emotional needs, which are also very important. I took psychiatric drugs in the early 1990s. I found that consistency with these things made the drugs less and less needed, until eventually I didn’t need them. That doesn’t mean that will be true for everyone. Different things work for different people, and it’s fine to do what’s right for you. You have options of who you choose to work with and of what things you do or don’t do, to take care of yourself. Long term, you can do what you want; you don’t have to accept a choice someone else has made for you. Short term, it’s safest to make small changes, very slowly, starting with adding positive lifestyle changes. Whether you continue to take the psych drugs long term, is your choice, and it’s no one else’s business. If you do ever choose to go off of them, just do it very very gradually. One of the tricky things about psych drugs is that their effects change over time. They can appear to work, and then years later, it becomes apparent that they’re causing problems. Mental health professionals have varying amounts of competence in helping with this. I think Robert Whitaker’s “Anatomy of an Epidemic” is an excellent read, and so are Grace Jackson MD’s “Rethinking Psychiatric Drugs: A Guide for Informed Consent” and just about everything by Johanna Moncrieff, MD. The point is to fully inform yourself so that you can make the best possible choices for yourself in the future. As for emotional needs, I might be unusual in this, but I don’t look for my emotional needs to be met by “peers.” I just find that there’s too much dysfunction and abuse in those settings. Nor do I rely on any organizations of any kind. I rely on friends who are actually my friends, where the friendship stands on its own and the person and I truly care about each other and there is no possible intermediary who could mess with it (such as a leader of an organization). There’s a relationship between self care and friendship. If both people are taking good care of themselves, the friendship goes better, because neither person is asking the other to fill a hole that is caused by lack of basic care of oneself. It’s a balance. When people do “self care” in the form of “I don’t have time to spend on the friendship because I am too busy with self care,” that makes it pretty hard to be friends. Theres a middle ground where both people take good care of themselves and make time for each other. In the early days when I was taking psychiatric drugs and then shortly after I went off of them, I relied a lot on the arts for my emotional life- especially music, and also dance. I sang, I played instruments, I danced- a lot. Arts were the main emotional outlet in my life. I got away from that later, and now I’m going back to it. It was very helpful to have an emotional outlet that wasn’t dependent on other people- that I could do by myself, sometimes, and share with others when they were available. Music is that. A more recent development is that I found out I have celiac. Knowing that and taking care of it, has helped me a lot. There are many medical conditions that have mental-health effects.