Absolutely, although my T has never talked about it in terms of self-injury, he does feel like I am sabotaging my recovery if I mess with my meds in any way without first talking to my pdoc. And he's right. He feels the same way if I purposely don't get enough sleep. And he really gets aggravated if I try to do a marathon grading session. All of them really mess with bipolar disorder by triggering hypomania.

So I do call my pdoc first. Fortunately I have a pdoc who returns calls promptly.

But self injury? I wouldn't go that far; neither would my T or my Pdoc.