bipolar, adhd, and autistic. scared of starting medication

I 25F was diagnosed with bipolar at 19 in 2020 after a manic episode, but since the initial hospitalization, I haven’t had any manic episodes and have been unmedicated.

My mood fluctuations the past few years have mostly matched normal life stressors (more anxious near deadlines, lower energy in winter, etc.).In may, I finished college with a CS degree and now work full time as a software engineer.

I'm less than a year into the job and the stress and executive dysfunction led me to pursue an ADHD evaluation earlier this month where I was diagnosed with ADHD and autism. When I told the psychiatrist about my past mania, he said he can only safely prescribe ADHD meds if I’m on a mood stabilizer and recommended an atypical antipsychotic for that.

I’m really scared to take it. Maybe it’s superstition, but I feel like I would have had more manic episodes if I had stayed on the meds back then. I don’t want another episode, and there’s no way to know if I’ll be better on medication or off. I’ve even seen anecdotes of people having mania right after starting this drug for the first time.

I’m also worried about the timeline because I'm already at my breaking point and only manage 3 hours or less of work a day because my focus, anxiety are so bad, and he says it’ll take about 4–6 weeks increasing dosage on the mood stabilizer before he’ll add in ADHD meds.

Overall, it's not like I think I'm ADHD instead of bipolar, but what I'm suffering from currently is the adhd while the past 3 years have been the most stable of my life mood wise. I have a supportive partner, my finances are good, and going no-contact with my family helped a lot.

At the same time, I know I can’t keep living like this, but I’m scared to add medication into the mix when the last few years have been relatively stable. Even if it helps long-term, I could end up dealing with mania/depression while trying to find the right combo.

Thank you for listening, I would appreciate any advice. ❤️