What you talk about sounds excruciating.

As for your last sentence, I think it can be both. In the sense that some of what you're feeling might be 'within your (personal) normal' and some of it BP. The issue is figuring out what might be best treated with therapy (including emergency appointments) and what might be best treated by med changes.

Precisely. Your observation is excellent, Gaby. My experience is that therapy certainly helps, but that my meds need to be in order first.

I think, as people with Bipolar Disorder, we have access to a great many prescriptions; meds that others don't have access to because they don't have such a diagnosis, so it's easier, in a way, to go the med route when very intense emotions arise. In other words, pdocs, I think, will often readily prescribe changes in meds (additions, increased doses) when we indicate we need it. Whereas those without such a diagnosis kind of have to sit with their feelings and/or consult a therapist (who might teach them how to sit with their emotions).

So true! I have spoken at length with my T about this subject. She's firm about clients with BD being as stable as possible on meds when she works with them (us). If we aren't stable, she says it's very difficult to do the necessary work in therapy.

How to distinguish between intense, excruciating emotions and BP episodes? That's a hard one. I think 'know thyself' is very helpful: do these emotions arise usually only under certain circumstances? In other words, have you been 'triggered' by something? Or is this part of an arc of an episode, sometimes triggered, sometimes not, but persistent, often even after the trigger goes away?

Interestingly, for me - both. Which supports the assertion that the "allergic reaction to emotions" is both (for me) BD and just...me - and maladaptive coping skills I learned in childhood.

I don't pretend to have all the answers. I so wish there were T's out there who specialize in, or at least have a lot of experience with BP. I do believe that they are best suited to help us figure these things out.

Your insights are truly amazing. I'm carrying them with me. Thank you, Gaby.

Best of luck on your journey.