In therapy - do you feel it's taboo to be an 'expert' on BP?

I see a therapist regularly and saw her today. I had a manic episode a few weeks ago but hesitated to label it as such when I was speaking to her -- I just described it to her and let her say "that sounds like it was a manic episode."

BP is something that I live with, it's something I've researched a lot... why am I so afraid to seem like an 'expert' about it? I feel like my therapist has to tell me what state I'm in, that I'm not qualified to say so. Can anyone relate?

I see both sides of this question ... I have fought my dx for years .... I played wth my meds ... but over time I have accepted it ...

it really does not matter what you dx is ... symptom relief and quality of life does ...

peace my friend ... Tigger .

——-well, maybe it was hypomanic or maybe it was actually ok in the context of your life. Patterns are really more significant. If you keep acting manicky, be careful, cut back your stress, activity level, etc. I find that I get in a LOT MORE trouble when I’m hypomanic than if I’m depressive because In depression we’re isolating.

I think that if you recognize it as a manic episode, you should say so. I don't think that seems too "expert-y". I can understand not wanting to come off as a know-it-all, but that's a pretty basic thing. Besides, it can show insight, and from my experience, that's a positive, and their reaction to it has been positive. I think it helps them to know how to approach your care when they are aware of your level of insight.

I'm so sorry you're hurting so much, annielovesbacon I agree with what all the others have already wisely said better than I ever could. You've been given some great advice in this thread. I'd suggest to try to follow it if you can. I think you're absolutely qualified enough to speak about it. After all, you DO have Bipolar. You're experiencing it first hand. Who better than you can understand whether or not you were having a manic episode or not? I wouldn't worry too much about it. Just use whathever terms you feel like you're using. Your therapist is there to help you. If there are some mistakes, he will be able to help you correct them and understand them better. Do not be afraid to speak up. That's what therapy is for, right? Perhaps you could discuss this with your therapist. If you feel like you're having doubts, I feel like this is something worth talking about to him/her. Hopefully he/she will be able to help you. Just be honest. Just try to do your best. That's all you can do after all. Don't worry about making some mistakes if it happens. Speak up as much as you can. I hope you'll be able to get the help you need and deserve. I'm so sorry, I know it's hard. I hope things will get better soon for you. Remember that we're here for you fi you need it. Feel free to PM me anytime. Let me know if I can do something to help you. I'm so sorry you have to deal with this

I am proud that I know as much as I do about bipolar. I am the one who ultimately knows myself best. That doesnt mean I know everything or that I do not miss patterns but I educated myself enough to feel comfortable speaking about it. In fact I think knowing as much as I do about my bipolar and how it affects me and my experiences is actually helpful with therapy because we can discuss it in the context of whatever is going on. Its just like cancer or some other disease. If you had a certain form of cancer you would research the hell out of it so you could play an active role in your own recovery. The same is true for mental illnesses, IMO.

I'm the same as you.... I describe how I have been and let the professionals tell me what state I'm in. In Scotland it seems they don't believe in mixed episodes. So I just describe it and take it from there. Same with my anxieties I prefer they tell me where I'm at.

I dont like sounding cocky in general so I tend to try to speak simply and slowly at first... but the longer Im left to talk the faster I go because I become less controlled by this idea that “you must not sound pretentious, there is no excuse for it besides showing off- and there is no reason to show off except if you are trying to prove something- WHICH YOU ARE NOT”.

Anyways. As I said the more I speak the less... inhibited I am by all those thoughts so... the more of a “pseudo expert” I sound. I dont like it really- generally I just want to blend in. I think Im scarred a bit because people tended to look at me funny for having esoteric interests so... Ive tried to blend in more.

But Im at my core- a very independent person who cant always keep my opinions in check. So. Really. You can get me going pretty quickly about all sorts of things if you know which buttons to press. Including- if you say something about my mental illness that I disagree with. For a short amount of time I can bite my tongue and not say anything- but after about 20 minutes or so... well. I let loose my opinion- even if it is wrong.

So. No I dont think its bad- but I also think its important to seek outside opinions- because no matter how much you think you knlw you probably are dealing with some level of bias just because it is very hard to objectively judge yourself when your frame of reference is just locked to your own experience. You need outside sources to help you with that.

I have felt this a bit. I do not want to sound like I am self diagnosing mostly, or limit giving information because I have pre-filtered it by labeling it. At the same time, I do know a lot of the terms and sometimes know why they (therapist/psychiatrist) are asking me specific questions to screen for things. I did tell the psychiatrist I thought I had OCD symptoms and he confirmed that's what he was screening me for.

i'm 72 yr. old female, bp2 and have lived with this diagnosis since mid-30's. have been in therapy over the yrs., but not specifically for bipolar and currently under the care of psych nurse tho i've been under the care of psychiatrists for many yrs. medicare now limits my options but i must validate what you have written above. i have educated the hell out of bipolar; i know every one of my stressors and triggers, know what/when insomnia will prevail and at one time in therapy my therapist asked me to please provide her with as much information as i could so she'd be in a better position to understand other clients with bipolar. i truly believe that i must know as much as possible about this mental illness as i've been married for 33 yrs. and my illness definitely impacts my marriage. over the years, my mental illness has changed; sleep never was an issue but now it primarily is; 30+ yrs. on only 450mg of lithium ruined my thyroid, i had parathyroid surgery and when my kidneys became affected, it was my decision to quit lithium for good...long ago no one knew what the long-term effects of lithium would do but the focus was always (erroneously) on my low lithium levels, without taking into consideration the effects on the creatine aspect of damage to kidneys from lithium... twice my psych nurse wanted me to try another mood stabilizer and i would document every side effect even hourly when a new mood stabilizer was introduced: who would know better than the person ingesting a new med and how it affects that person???? and both times i quit those 2 mood stabilizers (tried at different times, not simultaneously) i also have had ulcerative colitis for 50 yrs., have the most understanding gastro, who allows me to have control over the amount of a particular med. which has some really bad side effects, and under his guidance and my personal knowledge of my body, i am taking less than the lowest required dose to keep me in remission, and i haven't had a flare since i started this med in 2002. i provide this for informational purposes only.

I can relate. I don't really want to act like I know more than a legitimate specialist in psychiatry, but I get that I know more about MY "flavor" of bipolar than s/he does.

You are the expert on YOU. That makes you the expert on your bipolar disorder and I think it is really important to be able to identify where you are. My therapist and I don't always agree (and then we just agree to wait a week because we'll know for sure by then) but I always have an opinion and because I've been encouraged to learn my warnings I've gotten a lot better at getting help ASAP when things shift. Last summer I felt things shift rapidly and knew I was heading for mania without much time hypo so I emailed my pdoc at 3AM asking if I could increase my AP for a few days to try to stop it. She wrote back at 9AM to do it and this stopped the mania immediately and the only side effect from the 4 days increase was fatigue that lasted about a week. I've caught 2 episodes in a row that fast and I haven't had a major episode in a long time.

FWIW both my pdoc and therapist have strongly encouraged me and helped me to know my own illness.

No I think it’s good to be an expert on yourself and how bipolar affects you. A good therapist will appreciate that you demonstrate insight. If s/he is threatened by it I’d get a new therapist - that’s just me

Thank you everyone... I really appreciate your insights. Like yellow fleurs said I think I am afraid of self-diagnosing or maybe even being embarrassed if I say something authoritatively that my therapist would disagree with. Which is a silly fear since that has never happened! I plan to try to be more open about what I know about my illness and more assertive, especially when talking to my psychiatrist. I usually take the "well she's the therapist/he's the doctor so they know best" approach but I see now that isn't always true. Thanks everyone.

No. Education is power. It can make clinicians uncomfortable at times, but who cares. I think in general they prefer patients be knowledgable, even if it sometimes makes treatment more challenging. I have worked with people at times, albeit it rarely, where I'm clearly more educated than they are. I once had an intern (unintentionally) talk down to me, but was bc she didn't know what the F she was doing. I politely reminded her I have significant healthcare experience, am 10 years older than you, and no offense, but you don't know what you are talking about. I know my body and mind better than anyone. I would much rather know what is going on physiologically and psychologically than be totally in the dark and at the whim of others who don't live inside my body and mind. The more I've learned, the better I've been able to take care of myself, even during unwell times. People don't always like that and in rare cases may make a clinician uncomfortable with their own knowledge, etc, but who cares. lol. In an ideal treatment situation, you learn from each other.

I have a habit of researching the s*** out of my illness. This can be a bit obsessive but I do learn a huge amount from the peer reviewed medical studies I read. In fact I can see that my pdoc is following the evidence by the book, while being open to take the occasional shot in the dark. He also seeks second opinions when he’s stumped. This really comforts me as it shows he’s not arrogant. He’s also not arrogant enough to be bothered by my knowledge. In fact he encourages it. As long as I don’t get obsessed of course.

My T is similar. Evidence based but also intuitive. Generally I know where he’s coming from but occasionally he surprises me. He encourages me to know all I can about my illness as long as it’s from reputable sources.

Then comes my personal experience with my illness. My pdoc and T both know they can come up with labels but in the end I am the expert on what I go through. They both seem willing to learn from me. I’m so glad they take the time to try to see things from my side. My pdoc is often rushed but we have had a chance to chat about this. Right now I’m about to talk at length with my T in depth about my recent mixed episode with psychosis. This will really help me process the trauma.

Sorry I rambled. I’m hypomanic.

hve suffered with the same issue. I have been reading papers all week on bipolar. I'm a psychologist of another kind so I can't claim to be an expert on clinical issues, but I can critique. There is a lot of "woo" out there with therapists and thier techniques are often not evidence based. I don't know. I think it's good just to be able to talk. I just try not to do it and be arrogant. I'll change the subject it I have to.

Apart from a semester of a psychology degree at uni 25 years (which I know doesn't count), I am much less trained than you. Still, having studied a bit of science at uni, I am easily able to read evidence based research, as most of us are able to do anyway. Don't be afraid to bring up things you have read with your T. If they are anywhere decent at their job they shouldn't be put off by this. You will not come across as arrogant. It may help you discuss certain issues better. Yes, there is a lot go woo. I steer clear of it now and focus on peer-reviewed studies. My T and I regularly refer to such studies, and I find it very fruitful.

I've read some cool peer reviewed stuff this afternoon. Particularily about seasons and personality and bipolar. If you are highly open to experience as a personality trait you are more likely to suffer from BP. This is a trait I always thought of as a gift. And then there is the neurotic trait side. Not the fun one.

And science training is science training. We need more of it.

It's cool that your T refers you to evidence based stuff and that you can share info about studies. I can refer to papers too.

I can refer people to a SERIOUS legit personality test if anybody thinks it may be fun or useful.