Yes, it is not uncommon for someone living with bipolar disorder to hide their manic states from their therapist, especially during a manic or hypomanic episode. There can be several reasons for this behavior:
Denial or Lack of Awareness: During a manic or hypomanic episode, individuals may not recognize or acknowledge that they are experiencing an altered state of mood and energy. They may perceive their heightened emotions and behaviors as normal or even positive, making it challenging for them to share this information with their therapist.
Stigma and Shame: There is still stigma surrounding mental health conditions, including bipolar disorder. Some individuals may feel embarrassed or ashamed of their symptoms and try to hide them, fearing judgment or negative reactions.
Fear of Consequences: People with bipolar disorder may be afraid of the consequences of revealing their manic symptoms, such as hospitalization or changes in their treatment plan.
Desire to Maintain Independence: Some individuals may want to maintain a sense of control and independence, not wanting to be seen as "unstable" or overly reliant on others for support.
Difficulty Expressing Emotions: Communicating intense emotional experiences can be challenging, especially during manic episodes, when thoughts and feelings can be rapid and scattered.
Non-adherence to Treatment: In some cases, individuals may be non-compliant with their prescribed medication during manic or hypomanic episodes, which can contribute to hiding their condition from their therapist.
It is also possible for people with bipolar disorder to genuinely not recognize that they are in a manic or hypomanic state. This lack of insight is known as "anosognosia" and is more common during manic episodes than depressive episodes. Anosognosia can make it difficult for the individual to understand or believe that they have a mental health condition, leading them to be unaware of their symptoms and their impact on others.
Therapists and mental health professionals are trained to recognize signs of manic or hypomanic episodes, but if a person is hiding or unaware of their symptoms, it can complicate the diagnosis and treatment. Building a trusting relationship with a therapist and fostering open communication is essential for individuals with bipolar disorder to receive appropriate support and treatment. Family members or friends who observe concerning behavior can also play a vital role in helping the individual seek appropriate help.