For years I saw pdocs and took meds I thought were helping, but I was misdiagnosed and my bipolar disorder was completely out of control. In my case, it took something terrible for change to happen, but I'm still here, and it did.

Even though you realize your BP is out of control, I know change is hard…

The meds we have to take are scary because of the potential side effects. Not everyone experiences them, and not all meds to treat BP are linked to weight gain. Your pdoc might not just throw another med at you, but decide to add and increase the new one while phasing the Geodon out. It's hard to anticipate what they're going to do, but you have veto power, and they can take your concerns (such as the weight gain) into consideration when coming up with a med plan.

Even though you have a long-term relationship with your pdoc, I don't think you will make real change unless you make a change there first. She's judgmental and unapproachable, and that seems to make it harder for you to reach out for help when you need it. I feel like she should have identified you as a rapid cycler, and made the connection with your drinking, much earlier than she did, especially given your long history together. Familiar isn't always better.

I think if you can get better med control and find a new partner in your care it would make a big difference in your life. Once your bipolar disorder is under control, it will make it much easier to work on the other issues you are concerned with… it was for me