I sometimes think the 1 vs 2 distinction is pointless, because some people are more able to hide their symptoms than others, and the reporting by patients is always going to be at least somewhat subjective. You could have someone with very high psychological resilience who rides out severe dysphoric mania with psychosis report that they don't feel like their symptoms are "that bad" and get labeled with type 2. You could have someone who gets some occasional insomnia and restlessness give a very exaggerated report and get labeled with type 1. You could have someone with schizoaffective disorder bipolar type try to explain their experiences in a way that leads the pdoc to go with type 1 bipolar with psychotic features and completely blow past the isolated psychosis episodes. You could have someone whose psychosis during hypomania scares get the hell out of them and makes them act intense and freaked out, leading to the conclusion that it must have been full-blown mania and that hypomania can never include psychosis. Etc etc etc.

So what it really seems to boil down to with the psychiatric system is whether or not you wind up in the hospital or get arrested. It seems to be a matter of how much 'trouble' you get into/cause, your behaviors. None of which has anything to do with what you experience inside of your mind.

Case in point: The last time I received a diagnosis years ago, I was labeled with type 1 because I sometimes lost my **** and freaked out in paranoid screaming. I still feel the same way and experience the same things to this day, but over the years I've been able to tone down my expressions of my symptoms. Now I'm more likely to just isolate and self harm than flip out at others. So now my new pdoc just wants to go with "mood disorder nos". Has nothing to do with my inner experiences and everything to do with what they can see happening. I'm sure that if I hurl the vacuum sweeper through the living room window during one of my rage states while screaming what I'm really thinking all the time, then I'll get the type 1 diagnosis. If I continue to just isolate and quietly self-destruct, then I'm I'll continue to not be taken as seriously. And it wouldn't shock me if my pdoc ends up going with the type 2 label as an expression of just how not-seriously I'm taken.