How long have you been treated for Bi-polar, and which type do you have? They always say that the meds take a few weeks to kick in, however, a close family member of mine suffers from bi-polar, and the medication hasn't really changed much for her. She's been on almost every treatment option in the last 10-15 years and nothing makes her completely "normal" But, really, what is "normal" anyways?
The only reason I can think of for your shrink speaking to you like that is because they have no idea how to handle a person with bi-polar. They are taught that while you're experiencing a Manic cycle, you feel fine and so you decide you don't need the meds. But then, your moods cycle again and you go back into the depression phase, which, in their opinion, would have been prevented by the meds. But with Bi-polar, every cycle is different, and as you said, no one really knows how to treat the underlying condition. The sufferer is left still feeling "crappy", albeit less crappy than they were.
I do believe the use of anti-depressants and other "mood drugs" has been running rampant in the last decade or so. But so has incidence of depressive type disorders. It reminds me of the chicken and the egg argument...Which came first?
She's 53 and she will self harm if she doesn't take them. Really upsetting that people consider self harming to be a
"young people's" thing. 
