I feel good and she won't like it.

October 26, 2011 4:10 PM

My psychiatrist diagnosed me with bipolar disorder and some traits of borderline disorder. She prescribed meds that have me bouncing off the walls, even with a mood stabilizer. I feel great but I know she won't like it.

When I'm in a manic phase, which lasts days or sometimes hours, I feel good. I do things, I finish things. I can be productive. It's true that I sleep very little, but I don't mind, as long as I am able to function, to do things like take showers, clean my house, play with my kids, etc.

On our next appointment I would like to pretend that I'm ok without showing her that I'm all excited and chipper because I fear that she'd take these magic pills away and I'll fall into depressive blob state.

(I take Depakine, Elavil and Abilify)

My question is:
Is it unethical to lie and pretend that one is not feeling so good? Is it going to be bad for me in the long run? Should I tell her the truth?

posted by buck:fuller to health & fitness (16 answers total)

Yes. Possibly. Yes.
posted by Specklet at 4:15 PM on October 26, 2011

I don't know whether it is unethical or not but yes you should tell her the truth. She's working for your best interest here and being open and honest with your doctor is the best way to find a middle ground between blob and mania. It is possible but it requires work on your part to face your diagnosis and work towards health.
posted by kanata at 4:16 PM on October 26, 2011

Mania might be good for you (subjectively), but it might not be so good for those around you, including your family. I have lived with a bipolar/borderline, it can be not fun.

You should tell your therapist the truth, as this is a complicated relationship that you hope to benefit from, and you don't want to weave a tangled web from it. You don't want to turn her into your dealer.
posted by carter at 4:18 PM on October 26, 2011 [3 favorites]

The goal is to have a reasonable emotional response to life's challenges and gifts. Not to make you into an excessively happy person. It's about reestablishing a decent baseline of mood so that you can get things done, but not lose sleep or be constantly on edge (high or low) about everything.

I think you should be honest and expect a change in your medication. In my experience, an elongated manic period means a deep depressive period is just waiting to rear its ugly head, which I'm sure both of us can agree, is not what you're looking for.
posted by sunshinesky at 4:22 PM on October 26, 2011 [12 favorites]

Yeah, if you could be guaranteed this sort of hypomanic state that you're describing, that would be one thing, but the danger here, especially since this is medically mediated, is that you're either going to proceed into a full blown mania (which can be very unpleasant at the extreme), or that you'll crash. I would talk to my psychiatrist about this.
posted by OmieWise at 4:48 PM on October 26, 2011 [2 favorites]

People with bipolar frequently go untreated for way too long because mania and hypomania can feel awesome, and they understandably don't want to let go of that. And the longer bipolar goes untreated, the harder it is to successfully treat.

You can't arrange it so you get only manic episodes, unfortunately. The lows come with the highs. If you don't manage the mania, the depressive blob feeling will eventually come back with a vengeance.

It's just as important to be honest and upfront with your psych now as it is when you're depressed. Possibly even more so.
posted by Metroid Baby at 4:59 PM on October 26, 2011 [4 favorites]

the worst thing about not telling her is that it makes you the child and her the parent. i think you'll look back later and be glad you told her the truth, not because it's "morally" the right thing, but because it's a strong expression of self-respect.
posted by facetious at 5:00 PM on October 26, 2011 [3 favorites]

Hypomania can lead to mania. It can lead to dysphoric mania. It can lead to a total depressive crash (that's usually what happens to me.) The thing is, you're unstable and right now, if you change medications, you can avoid having these things happen. You may not have that power for long, and are fortunate that you've got an appointment coming up soon.

In any case it does you nothing but good to tell your psychiatrist the whole truth every time.
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 5:27 PM on October 26, 2011 [3 favorites]

Here's a reality check: the fact that you're even considering hiding stuff from your psychiatrist says to me that your judgment is already somewhat impaired. Medical professionals can only help you if they have accurate information about you, and hiding things from any psychiatrist good enough not to dump will do nothing but harm.
posted by flabdablet at 5:42 PM on October 26, 2011 [6 favorites]

You don't have to tell her you're having a manic episode. Tell her how you *feel*. Let her decide whether it qualifies as something that requires fixing and how best to go about that.

I'm not bipolar, but I had trouble recently with not wanting to tell my doctor about some negative side effects because I was so worried about losing the immense functional positives of what I was on at the time. (Weight loss? What weight loss?. No, I haven't been nauseous--well, at least not in the past five minutes. Can we please not talk about food right now? Look, I managed to have an entire Clif bar yesterday, surely that should count--)

Going and actually talking about it led to different meds that I was even more scared of the side effects of, but it's turned out really well for me at the moment. And I don't think it's totally irrational to be nervous about losing the positive benefits of your current arrangement, but if you leave it be, then that just means you have even longer to wait before you have the treatment that really works properly and (hopefully) long-term.
posted by gracedissolved at 5:45 PM on October 26, 2011 [1 favorite]

Please please please don't lie to your psychiatrist!!! You don't have to say exactly that you're manic, but you should tell the doctor how good you feel, how much you're sleeping and eating, etc. For the bipolars in my family (myself and my mother), the higher the peak of the mania, the lower the depths of the depressive crash. Remember that mania impairs your judgement and be careful.

I don't know how old your kids are, but my sisters and are currently dealing with a manic mother. She's outright lied to her psychiatrist, and is drawing out more chaos than necessary. I'm really worried about what's going to happen when she crashes.

Please don't lie to your psychiatrist.
posted by MuChao at 8:43 PM on October 26, 2011 [1 favorite]

I think you've got some really good advice in this thread. I'm sorry if I came across as flip and not helpful.
posted by Specklet at 10:31 PM on October 26, 2011

Thanks y'all.... I wrote this late at night and now I realize how childish and silly I sounded. Thanks for your unanimous advice.

Really, thanks.
posted by buck:fuller at 10:47 PM on October 26, 2011

np. I've been manic to the point of psychosis, so I know how good it feels and how easy it is to brush aside an outside opinion about it because hell, who could know you better than you? But I also know just how much load that episode put on all the people who care about me, and how unfair it was to force them all to deal with that. So I'm happy to see you seeking a reality check and even happier to see you accepting it. Well played.
posted by flabdablet at 11:18 PM on October 26, 2011 [2 favorites]

Yeah, as someone who's lived with a bipolar person - I'm very glad you've decided to take the advice of other comments on board. You are without a doubt doing the right thing. Best of luck. :)
posted by Ziggy500 at 2:57 AM on October 27, 2011

As someone with a family member with bipolar, it might also help you to inform your close family members and friends of signs of mania so that they can help you. I am more scared of manic episodes in my loved ones than I am of depressive episodes because depressive episodes are more obvious to the general outside observer, and I feel like my bipolar loved ones are less likely to seek help during a manic phase. Furthermore, a manic phrase often results in people unconsciously helping your manic episodes by showing support and happiness for your statements of how well you are feeling and all the work you've accomplished. By educating them to watch for these signs, they can help steer you back from the abyss.

I know when you are manic it feels wonderful and the sky is your limit. I once took medication that made me manic and it felt amazing. But that high is dangerous and not just because of the eventual crash. You could going on spending splurges, sell all your possessions, quit your job, have lots of unsafe sex, etc. Think of the manic phase as a Faustian demon you cannot control. Do everything in your power to be certain that you don't feed that demon.
posted by avagoyle at 8:19 AM on October 27, 2011 [2 favorites]