I don't know! It's all so confusing. I remember when my son first started on meds, they were AD's, and I felt worried they weren't helping. And the docs said that AD's making someone worse are a possible sign of BP. But he has since had manic episodes without being on any meds. They haven't wanted to dx him BP since he's under 18, but I've pushed for it because of our family history and to try to keep him safe with the right meds and therapy, and school accomodations.