Speaking personally, I manage alone for the most part. I gather lots of information and create coping tools. When younger I was on meds for everything from depression to hearing voices. They didn’t really help. I’m not advocating this to anyone but I found life got easier when I decided to take control of things. No more meds, a lot of reading and creating coping tools helped. I’m still in the system with a very understanding doctor who will get me an appointment with pdoc at the drop of a hat. And will prescribe an antidepressant for when I am experiencing Dissociative Distress - my term for when I become overwhelmed from time to time by it all.