Wow, when I read your post, it felt like I was reading about myself. I am sooo sorry you are having a rough go at it, I'm curious as to what meds you are on, and how long.
The paranoia and rage I have dealt with recently not only made me angry, but impossible to live with. My Dr actually added another med for depression, bumped my Seroquel, and I feel great (no rage, no paranoia, no mean thoughts about people). Seroquel helps me sleep, and having been on it awhile, I do not feel as sedated in the morning as I usually did. My doc and I also adjust my meds based on my sedation level, constantly titrating, just as your doc is doing. The advice I think we all give eachother-HANG ON. And if things aren't right, call your doc and get help-that's what they are there for, and they should see you asap if you indicate you are not well, which is sounds like you are not. Don't downplay how you feel, tell them how bad it is.
As for realtionships, be honest with family. Explain that this is a disease, and that if you had any other medical condition, everyone would support you, I am sure. My fiance and I just had this discussion, as I scream and yell and make life miserable. My duty is to get better by taking my meds, not drinking, sleeping enough, and his responsibility is to read about BP, supporting me, and helping me realize when I go south. Help your family understand you is key-give them books, good internet sites-hey, send them to Bioplar support boards like this. I think they would soon see that what they see in you can be cooker cutter to others in some respects. Sometimes it is easier to see things in others than the ones we love. It is very scarey for loved ones to admit that a chronic illness that is unpredicatble is ravaging one they love. And about hiding it-I did it for over 15 years-hid when I was depressed, and when I was manic they just thought that I was "being me". Don't hide, it only hurts more.
Finally, it is ok to be angry Rock. We all go through it-anger, resentment, confusion, denial, sadness. Please continue to share on here (it is also great you have a therapist) to let go of all those feelings...that are so normal.
I hope I was able to help a little bit at least...please let me know. And HANG ON. It can get better, even when it seems impossible!
OH, and pathetic-NO WAY!!!! You are facing at 18 what I have faced at 30-you are a TROOPER! You are seeking help in every way possible, that is not only responsible, but brave!