I picked once per year, though I have schizoaffective disorder, so I do have some lingering delusions between those episodes. When I do have an episode, though, they're pretty rough on me. With my depressions, I can sleep up to 20 hours a day for days on end, and with my manias I totally lose control of myself and become extremely paranoid, grandiose, etc. Luckily the manias usually respond to Seroquel and within about a week on Seroquel, I'm close to my baseline state again. If only I were better at recognizing the manias earlier and starting the Seroquel then, I could probably avoid most of them...hindsight's 20/20, though. Ideally I'd just be able to take Seroquel daily and prevent the manias altogether, but when I was taking it daily, I gained 100lbs and it started to lose effectiveness. Anyway, I'm rambling, but that's how it works for me,

Best,
Hope