It's a cyclical disease, obviously, and stress can of course be a factor in exacerbation of symptoms--if you actually have bipolar disorder.

I went to a rather competitive medical school with untdiagnosed/untreated bipolar disorder and, without getting into it, my performance did not suffer. It just was beginning to sort of really show itself during my internship (1st year after med school--very, very stressful, insane hours). I stayed in that surgery program for a total of 3 years, then left for a different specialty where people were actually happy. But I left, ostensibly at the time, because I was very unhappy in the program. It was abusive. Physcially. Emotionally. On and on.

Again, my performance reviews during those three years indicated I was performing at a high level in the program. But I was miserable. Why do I tell you all this? Because in retrospect, there is zero question that what was really happening with me during those early sugery years--forgetting about all the abuse stuff--is that my bipolar disorder was starting to rear up and fully display itself on the down pole and probably also, some mixed stuff.

So, med school for me was super fun and easy. Surgery residency was hell for everyone, way, way, way more stress and sleep dperivation and then--bam!! Symptomatic.

So, with your new stressors this year, I urge you to keep a super close eye on everything to do with symptoms of bp 1 or bp 2, since they are not sure about the dx. And stay away from all non-prescribed drugs. You might even kep a mood log. Make notes about your sleep. How is that going? Sleep can be a super sensitive and early indicator of problems. If you start to notice something kind of off, you need to reach out early and often to your team and let them know. The eariler things are caught, the simpler it is to manage--almost always.

Those are just my 2 cents. Wise people here will have other thoughts. I wish you a ton of success this year! You can totally do this!! Very exciting what you are embarking on!! Be well!!!!