My ups have various degrees and so do my downs, and then there are the mixed which are hard to define. This does not include the various levels of psychosis I can get in either state. For me any ways, the ups are just feeling super good, motivated and inspired. Full of hope and new ideas and ventures. Once in a great while I end up in a hospital. My downs are different levels too. The past 16 years only suicidal twice, one hospitalization. For me any ways, the most challenging or difficult aspects of all this are my delusions.