Bipolar is really tricky -- worked with someone once who struggled with this, and all the meds (at least at the time) had such side effects that when they worked, he decided he was cured and went off them. And then, of course, his behavior turned problematic. The whole thing made him miserable, too.

Sounds like she is also dealing with strong placebo/nocebo effects, which is something I don't think we take seriously enough -- that is, how much of the success or failure of medical treatments is actually in the brain's expectations of what will happen when they take a pill, get a shot, or even have a conversation with a doctor that is or is not supportive. Makes me also wonder whether a compounding pharmacy (and I'm normally rather skittish of compounding pharmacies) could make a vitamin B12/D lotion for her to use. It would need to be in some form of carrier that would take it through the skin, and would probably be very inefficient, but maybe?

I'm now taking magnesium as a migraine preventive through the skin rather than orally (it's a commercial product). I was skeptical at first, but it seems to be working.

After a while, too, your identity can get wrapped up in your illness. Part of you wants to get better and hates the illness, but another part of you doesn't know who you are without the illness, and is terrified of dealing with that. I have no idea how to tackle that problem.