Sometimes we need not talk. Have you considered writing down these thoughts and either sending them to your psychiatrist by email/text/even snail mail? Or printing them out and just handing the document to them? I've done that in the past.

Your doctor WANTS to know about your breakthrough mania and how it's affecting your medication compliance. Having breakthrough mania is not a "bad behavior". It's illness. Your doctor needs to know so that they can deal with it. Open truthful communication is admired and ultimately does you good.