I'm sorry you ended up in the hospital, that sounds like a terrible episode. But this is a tough question: Do episodes get worse with age?

It is true that symptoms can get worse with age, but also remember you've been having severe and mild episodes since your teens. Every episode will always feel like the worst ever. But I'm not downplaying a suicidal episode. That is very very serious and I've only been there once and hope I don't get that bad again.

Maybe this can be chalked up as your worst episode ever. Just think, it's only up from here (even thought you probably can't see that right now). The fact is, I had one episode about 5 years ago and it was a nightmare, I thought this is the big one and I was going to kill myself and I thought it would just get worse and worse. But it didn't. It took a lot of hard work to pull through it. You're strong, you can do this! I can still think, OK, I survived the worst, and it feels like an accomplishment.

You can pull yourself out of this and prove you're OK with the help of meds and therapy. I haven't been that low and manic (mixed) again. I hate to say it, but it sounds like you're only experiencing major depression, not mixed with mania? When you're that depressed and manic on top of it, oh boy, so down and so irrational, it can be hell on earth and would make anyone want to do themselves in.

So, even if this is your worst ever episode, it might not have to do with age, just that you're thinking more clearly and feeling what you're going through. The worst can be overcome and it doesn't have to ever get that bad again.