I got a provisional BP-NOS diagnosis along with Major Depressive Disorder at my first visit, which was a 90-minute consultation. My pdoc spent most of that time coming up with reasons why I might not be bipolar (I'd gone in having printed out several online tests and quizzes that showed I had BP tendencies) because I was depressed at the time and didn't have a strong family history of the disease. So I was surprised that he gave me the provisional dx, although he said he might change it back to MDD depending on what he saw during the next couple of visits.

I was a little improved by the second visit, but on the third I bounced into his office and all he needed was one glance to know I was hypomanic. That's when the MDD diagnosis went away. Eventually I ended up with Bipolar 1 because of a couple of severe manic episodes that were triggered by work stress.

I sometimes question that because I've never completely lost my $#!+, like walking down Main Street naked or thinking I was God, but then I have experienced some pretty serious impairments as a result of the mania AND I've had psychotic symptoms with some episodes.