Very interesting question. Mine was definitely childhood-onset BP1, though no-one recognized it as such at the time. I spent a lot of time hypomanic as a kid, then had my first major depressive episode after a breakup when I was 17. I was hypomanic on and off all through grad school and postgrad stuff, but no-one picked up on it because I was so productive and sort of pretty good at what I was doing. People just were admiring and thought I was "an animal," as some used to say, affectionately, because I got so much done.

Had another massive depressive episode in my early thirties. This was recognized and treated. It was stubborn. Then, a couple of years later, I had my first full-blown manic episode. This was, unfortunately, not treated aggressively enough. I should have been hospitalized long-term, but instead was discharged after 5 days. The mania persisted, I became psychotic and then the thermonuclear detonation of my life occurred when I had a car accident and another driver was injured. This was June of 2007.

Since then, I have moved between four distinct states: mania, depression, hypomania, and euthymia. Most of the time is spent in the first three and my baseline on lithium tends toward depressed. Off lithium, it is nearly always hypomania. I may have psychosis with all four. I have a lot of trouble with psychosis and I believe my illness is quite schizoaffective-like. The single most dangerous state for me is without question when I am floridly manic and psychotic at the same time. There is no telling what I might do when in that state. The hospital is a requirement then.