Bipolar I or II ?

I think I had my first full-blown manic episode at 15, but as so often is the case in teens (especially in the past) it did not yield a proper diagnosis at the time despite being a traumatic year with almost failing a grade, being sent to a therapist, sent to a private school, deciding to "find God" and join the Catholic church, experiencing what turned out to be the most embarrassing event of my life, etc. Who knows, maybe I only reached hypomania (also with mixed features for a time) followed by a depression, but boy was that hypomania really bad, if that was the case. The therapist mostly thought I had teenage strife, and wasn't my therapist long enough to know all of the things I mentioned since I saw him only twice, and my father stole the session for himself.

I am sure that I had incredible lengths of hypomania throughout my 20s, even outnumbering depression, but though those times did yield some negative ramifications, I lacked insight that it was mental illness because they weren't THAT severe. I only recognized depression and/or anxiety at that time. GPs then gave me antidepressants that I'd take for 3 days to 2 weeks, before a mood switch.

My bipolar was only really confirmed and diagnosed when a psychiatrist I was seeing for depression and anxiety actually witnessed with their own eyes and ears a bad hypomania. I don't even think I ever told him about when I was 15, but I did tell him about my history of depression and anxiety, which is why I saw him. My bipolar 1 was only diagnosed when I was hospitalized for full blown mania one year later. Again, it was clear to the psychiatrists with no doubts.

Obviously many psychiatrists do diagnose bipolar 1 simply based on a patient's "stories" without ever having witnessed any mania, but I don't think stories are always completely reliable. Details are sometimes exaggerated, fabricated, or come across insufficiently, especially now that people try to first be "at home psychiatrists" after reading websites. People don't really always know how bad mania can get, because even some hypomania can seem very abnormal and damaging. I do think that if one has a firm diagnosis of bipolar 1 backed up with convincing medical records, future psychiatrists will firmly diagnose bipolar 1, as well. But I think that sometimes new psychiatrists without such firm evidence sometimes attempt to make their own diagnosis based on what THEY know or have seen. That can really frustrate patients who feel convinced of a certain diagnosis.

I agree with the others that the primary advantage of knowing bipolar 1 or 2 is as a starting point or continuing point for medication subscribing. Though sometimes the same medications work for both people with bipolar 1 and 2, other times the cocktails can be quite different.

I know that when my beloved psychiatrist retires, I have to relay crucial information and/or show medical records to a new doctor. Having my psychiatrist communicate with hospital psychiatrists has also been crucial. Taking a step back into cocktails that caused harm is not where I want to go.

Wow, you just raised a big issue for me. My cocktail is rickety and requires tweaking all the time, but it's the best we've been able to patch together, and it has taken years to get to where we are.

Even so, I still have episodes. They're just wayyyy more manageable than before.

I'm so resistant of ever going inpatient for fear of some cowboy pdoc deciding she knows best and unilaterally declaring some brand-new cocktail for me.

I'm Bipolar III. In addition to the usual symptoms, I have x-ray vision.

Aww, you've seen right through me!