So quick disclaimer, both my wife and I are on the Autism spectrum, we both figured this out far too late in our 20s and have been working to re-frame our mindsets about it to understand ourselves better.
Recently, she reached out to a Psychiatrist for adhd and PMDD symptoms and was immediately clocked as ASD and prescribed zoloft to help long term with PMDD syndromes.
The first night was absolute hell of mood swings and discomfort so I was looking more into SSRIs, previously all I knew is you cant just stop taking them and they make certain people's dicks stop working.
Strolling into the zoloft subreddit is an absolutely crazy experience, half the posters are like "i'm going insane is this normal?" and they receive responses like "yeah just wait 12 weeks of these symptoms and maybe you'll be cool". The other half of the posts are people post 12 weeks being like "this shit cool", but there's a weird confirmation bias where the people who got off of it are not lurking in the zoloft subreddit. Every once and a while you'll see someone necro-bump a year old post about someone giving it time and they'll be like "oh yeah sorry for the late reply, the drug was incredibly bad for me and I had to get off of it".
My wife was experiencing this out-of-character rage at certain things, but also felt a weird control over said rage and began looking into posts about that and apparently its common? Weird rage too, like being frustrated with fellow ASD people. I started connecting the dots and thinking about people in my life who were on these and holy shit, they're absolute seething assholes to us, is this why? What is this drug???
And this doesn't even touch getting off the drug, apparently the withdrawal is absolutely demonic for many many days. Then you have serotonin syndrome, the endless list of side effects that you have no idea if you'll experience or not because doctors don't give a shit and blood panels for drug reactions are too expensive to bother with.
All this stuff basically points to "neurodivergent people are being tortured with the promise of a semblance of normalcy in order to cope with our capitalist world, and all the "normalcy" is, is the ability to control your emotions externally despite them being wildly out of control internally".
Rip me apart for this all you want but i'm leaning towards crank status being anti-anti-depressants. All this to say I'm prescribed stimulants and i'm grateful I can just take days off or just not take them when I'm happy to be my autistic-adhd self.(I know not all people can do this with ADHD, my heart goes out to them, but it's more an issue with existing at baseline rather than going off wrecking havoc)
psyilocibin therapy needs to become more widespread because SSRIs are far more terrifying than seeing god and your subconscious.
I can also say from personal experience that manic episodes aren't explicitly reserved for the neuro-divergent. Nor are they something you're necessarily going to know about just by being friends with someone. Extreme anxiety and stress can provoke all sorts of negative and self-destructive responses.
I knew about my friends' episodes only years after they'd broken up. I've had a few experiences with my wife - who has generally always been a very friendly and loving person - that I don't exactly brag about to other people because they're fucking miserable and traumatic and not fun to remember.
That's totally aside from the question of medication. But I note it to say that you don't always know what's going on under the surface. And if somebody gets on a mood stabilizer, I would not assume your knowledge of their habits to be exclusive to their experiences. Having said that, you only need to go through the history of - say - lobotomies to know that overreaction and overmedication and extreme interventions aren't unheard of either.
In a better world with a better health care system and an economy that sees physician consultations as a beneficial hygienic service rather than an annoying bit of maintenance overhead, I would like to believe we'd be having continual back-and-forths with our physicians as part of long-running and population inclusive medical science studies. And, as a consequence, we'd be regularly revisiting the impact different medical decisions are having on patients. We'd expect that we could either provide adjustments as necessary or speak with some meaningful authority when we say "This is about as good as we're going to get it given the resources at hand" and consider ways of mitigating discomforts on the side.
But that shit cost money. So instead we're going to give Jeff Bezos another yacht while we tell everyone else that quality services are unaffordable.