Jeez, that sounds pretty dismissive of him. I'm really sorry it went that way. The stuff you're describing sounds a lot like it could be attributed to menopause plus life stress, to me. Especially those night sweats. Got them while pregnant. Yech.

A few thoughts:

- Re: lithium... that's not exactly a little thing. I think you are entitled to seek a second medical opinion about it before doing that. That's not "fighting", that's taking care of your body.

- Re: pushing the mania diagnosis... I get the impression he's been implying that it's something like that for a while? I wonder if he is doing the (very human, but pretty damaging when you're an MD but I see it all the time) thing where he doesn't want his "professional opinion" to be contradicted, and isn't really thinking about this new information you're giving him? Or whether he ought to be referring you out to someone with more expertise? I don't want to make any judgments based on so little, but I do wonder.

- Re: not wanting to leave because of the good stuff... I really, really hear you on this. Really. Is there some intermediate step you can take -- are you able to see a second T/pdoc in the meantime who has more knowledge in this area, or at least doesn't have a history with you that may cloud their judgment? Depending on your insurance situation, you don't have to quit your current T. Maybe for "second opinion" on the lithium, you can look up a pdoc who has a special interest in women's health, and you can kill two birds with one stone -- consult about the lithium/BP diagnosis, and get some feedback on menopausal mood symptoms.

- Re: his home stress... I think it's cool that you're considering the human dimension of being a T. In the end, he's a person doing a job, and sometimes personal stress makes it harder to do that job. BUT. When your health is at stake, there's no excuse to phone it in. If his home stress is preventing him from doing his best work, he's got to take responsibility for that. Also, and this is not a criticism of you or your T, but how do you know he's experiencing a lot of stress at home? Is this something you spend a lot of time on in therapy? My T sometimes tells me if he's under a lot of stress, but only because I can tell when he's under a lot of stress and it will bother me and make me worry if he's frustrated with me, so he just tells me it's not me. But we don't get into detail, since the therapy hour is something that's for me.