Bipolar disorder, comes in different variations, it is almost a stereotypical thought for someone to think Bipolar means all go from depression to manic episodes, some can have mild, hypomanic episodes if any at all, and then have deep depressive ones and vice versa.
The DSM-IV describes the criteria for which DX fits, and that is not always 100% but pretty close. Psychologists and Psychiatrists have used this manual for years as a guide, helping them with Dxing.
Doesn't mean "all" do, nothing is written in stone, but is one of a pretty universal guide manual.
Sorry for straying, getting back to one of the many answers to possible question, is yes,a person can be Bipolar and not have extreme mood swings.
I had been DXed with clinical depression, given AD's but over time they fizzed out, other life events seemed to trigger things, then later I was DXed as Bipolar-II (mild) and ADD (mild) which I suspected my whole life.
After being on a mood stabilizer and recently Concerta, I'm doing well.
Unfortunately, things can take time to get it just right, but when it happens, and it will, it's great to feel back to "normal",getting through life on a better track.
Lithium is an excellent med., Lithobid is really good, sort of like a time release function, little more costly than the other formulations of Lithium, but worth it.
It has the longest track record, and is not dangerous as some people have been mislead to believe. My oldest brother has been on Lithiium for 30+ yrs. Lithium was the best med he ever was prescribed, like a success story.
He was DXed with Bipolar-I and had some pretty violent manic episodes in the past, including depressive ones.
I had been on Depakote,didn't do well with it,switched to Lithobid, which was great but being that I suffer from deep depression and not mania, my pdoc suggested I give Lamictal a try, and it's been great. When I was on the Lithobid, my depressive side wasn't addressed as well as with Lamictal. At first with an AD added while on the Lithobid, things seemed balanced, but even the same AD alone didn't work anymore, for me AD's pooped out. Another thing that most likely proved I was suffering with Bipolar and not clinical depression. Too bad, in the begining I hadn't gone to a pdoc, cause the GP kept saying I was depressed and would just write scripts for one kind of med after another.
Most mood stabilizers should always be titrated gradually, it reduces the chances of nasty side effects and helps the doc come to the most effective therapeutic dose, using the lowest dose, rather than go gung ho and find the patient may not need a high or higher dose.
I wish you lots of luck with this, I know it's extremely frustrating, but don't give up.
Welcome to PC you will find a lot of supportive people here, and info. too.
Take care,
DE