My first inpatient hospitalization was one year after being diagnosed with bipolar disorder at 32. I refused medications and quit the pdoc when he diagnosed me, because I thought I was fine, when in reality I was growing manic. About 8 years before, I was once taken to a hospital in Taichung, Taiwan because of severe depression (I wasn't going to work because I was so depressed that I couldn't leave my bed). My insurance coverage was only for emergency hospitals. My boss and a few Taiwanese teaching assistants dragged me there. I was given bags of numerous pills and sent back to my apartment the same day. Clearly the pills included an antidepressant and/or other stimulating medications. I quickly became manic, quit my job (losing hundreds of dollars breaking my work and apartment rental agreements), and started traveling around Asia on my own as a 24 year old woman. That mania didn't lead to any hospitalization or doctor visit. It passed after about 4-6 weeks of wild behavior, though.

Prior to my diagnosis, I was the typical case of a bipolar person going to a GP (or other MD) only when depressed. They'd give me an antidepressant, which I took only for a few days to a week before having a mood switch. My two worst episodes before Taiwan were one at 15, where the school ordered therapy, which my parents sent me to only twice. Another during college where the health center sent me to the university pdoc. I saw him once. He gave me Prozac, which I took for max two days. Again, I'd have a mood switch that didn't lead to hospitalizations at the time.

The pdoc that diagnosed me was one my GP wanted me to see. At first he only saw depression and anxiety, but he had me attending group therapy. After about three weeks in the group therapy he himself saw me getting manic.

At 34, my manias grew exponentially worse. Seven of my 10 inpatient psych hospital stays were for mania (some psychotic and many with mixed features). They we're my worst episodes of my life.