My pdoc would give me options for a couple things we could try, explain why and then let me ask questions and pick. Occasionally if he strongly had a thought one way or another like "we should stop this medication" when I had a reaction to it he would make that decision, but otherwise he gave me the chance to make informed decisions. I think that was a good balance for me, because I don't want to have to make up my own treatment plan, but would not like to be told there was only one option and I had to follow it without any say. My pdoc also supported my decision to not take meds when I was more stable off of them. I think if I had bipolar 1 and was at risk for mania it might be a different story and meds may have been more strongly recommended.