I have Bipolar 1 too, dx multiple times like you also.

I get pretty bad manic episodes too, psychosis, delusions, and paranoid. It takes a long time to be able to start recognizing mania, I mean if you are kind of loosing touch there, how can you see it. but eventually you will learn the warning signals, danger alert! Yeah usually we have them, it's just taking the time to figure out what they are.

For me, the mania increases within a few days, so I have a small window there where I can intervene. if you look back at what's happened in the past you can usually see a bit of a pattern. For me it's not sleeping, not eating, feeling disorganized in thought, agitation... stuff like that. Everyone is a little different.

When you start to see these things happening then you know it's time to act. Not let them go to far or it will be much harder to prevent or stop.

When the dellusions and paranoia, or hallucinations start for me. They start out slow and build quickly, if I suspect something isn't right when it first starts, when I still have some grasp on it, then I question them, Are these things actually even possible, from what I know is? If the answer is no, or not likely then I start asking for help. I'll ask someone I trust. I'll call my pdoc, and then takes measures to try and regain control.

Hope that helps a bit,but stick around here and you will learn a lot of tips and tricks to get some control back over this.