I know exactly how you feel. In those times in front of a therapist or doc, it's natural to want to put on the best face you can - just like you would for anyone else you respect and/or feel is in a position of authority.

I'm not sure when it happened, but at some point over the last 20 years of dealing with MH issues, I was able to open up to my docs. It might have been me just not giving a crap about what they thought of me, but I became totally transparent with them. Today I have no trouble expressing the reality of my experiences. They know all the dirt, my history of addiction, hypersexuality, depression, and psychotic mania. They also realize that I'm a high-functioning father, husband, and engineer. There's a lot of my life that looks good from the outside in, but from the inside out at times it's rotten to the core. Working with my docs today is a very efficient thing. We've established that there are mood, ADHD, and addiction issues. Knowing that, we can work on a path forward rather than skirting around issues.

One thing to realize about doctors and therapists is that they've heard it all before. They're trained to have experience in most all areas, and you're not going to shock them with anything you've done. They're just waiting for you to open up and show the real you. Put it this way - if you were really able to handle life on your own, you wouldn't be in their offices in the first place.

Regarding the length of your episodes, it's not uncommon to be in a hypomania state for months. My diagnosis is rapid-cycling, as defined by four or more episodes in a year. It's certainly possible to be ultra-rapid cycling and switch moods faster than that.

I have no clue if you're bipolar, cyclothymic, or anything else. It's not clear if your episodes are caused or related to alcohol or substance use, either. I know when I'm not completely sober that my moods are incredibly more complicated and almost impossible to separate from the substances. I seek highs, and seek ways to get myself out of lows. In the past I've self-medicated all over the spectrum, including abusing meds I've been prescribed. At present I think I have a handle on that since I've not done it for almost two years, but it's always a danger and if I slip back into it then it's guaranteed to cause more problems than it solves.

Good luck with your therapist next week. My suggestion would be to be brutally honest, even disclosing the things that you're not comfortable with. That's the quickest route to getting help.