It's pretty unpredictable. When severely manic, it's usually quite obvious. Less obvious when depressed or mixed (they're the worst for me). But I am also psychotic when nothing else seems to be going on. Delusional and paranoid. Occasional hallucinations. Hearing things, seeing things. I have developed a fear of people, which is sorta connected to this paranoia/delusional thing (conspiracies, etc., a current example is the belief that there are government agents in my brand-new computer) and that has made me isolate more and that has made the psychosis worse Perfect circle!