I think what made my dianosis so hard is that I would SLEEP! Sometimes not much, but I would. That is where many of the old diagnosis would fall apart for me because I would show a clear speeded profile but I would conk out if I could be wrestled horizontile. If I could stay verticle I could go on pacing and shredding my hair and cursing and crying for easily a straight 24. I can forget to go to bed. Still, I don't get the days on end no sleep, but I clearly get the raging, nocturnal, anxiety powered, paranoid, restless depressions where I see things in the corners of my eyes (which i have not really mistaken as reality, thank God!) and thought I have heard voices calling my name. These are where my hypomanias end up, every time. But because "manics don't sleep," therefore I can't have had a "real" mania, so I can't be a Bipolar I. go figure.
I would never have diagnosed a patient with my profile as a bipolar II. It doesn't fit the categories at all, and the presence of the psychotic features is a bipolar I marker. I just think that some pdocs are afraid to put the more severe diagnosis on in the false belief that somehow they are helping the patient by giving the the "milder" diagnosis, and that the way the body handles the sleep is somehow the big key to it all. Keep in mind, I was diagnosed mainly ten-fifteen years ago, and much has changed. Huggs