In the past, I read the following statement made by a psychiatrist in an article on www.bphope.com (the website for bp Magazine):

"Researchers at the University of California–San Diego calculated the ratio of time that people with bipolar II spend in depression versus hypomania at 40:1. Even in bipolar I, they found, the depression-to-mania ratio is 3:1."

Do you have bipolar type 2 or 1? And do you feel that the above quoted ratio seems almost right in describing the amount of time you've spent in depression vs. hypomania/mania over the course of your life? If you've had bipolar disorder for a long time, have you noticed any shifts over time in the amount of time you spent in depression vs. hypomania/mania?

Reference:
https://www.bphope.com/ask-the-docto...ar-depression/

[UpDownAround]

I am type II and that was accurate for me when I was not getting good treatment; mostly depression than would give way to a week or so of hypomania maybe twice a year. Since I have been on lamictal I find I am just about as likely to go either way but spend most of the time "stable" (quoted because I still have a head fog that doesn't go away).

Bipolar 1 here and I don't have enough data. I only found out I had bipolar 1.5 years ago, though I've had symptoms all my life. I don't know how many times I've gone manic because I didn't know it was mania until a doctor pointed it out to me. I would say the depressive episodes have lasted longer and felt worse in general. I assume there was more of them. I don't know.

[emgreen]

The article doesn't cite any methodology, so I don't know what to make of it. It does state:

"The mood swings between depression and mania that characterize bipolar disorder typically occur along a continuum, with a high frequency of days with mood swings that are not necessarily extreme enough to count as an episode of major depression, mania, or hypomania."

Since episodes exist along a continuum, & the article doesn't state exactly how to identify mood swings severe enough to qualify in their study, I'd say we don't have enough info from the bphope article (thus wrote the smart arse ). I'm sure the actual study guesses more accurately than I'm giving it credit for.

I'm BP I & I WISH the ratio was 3:1...if I could manage to stay out of trouble, that is. As I've grown older, I've noticed that depression is the dominant symptom that kicks me in the nether regions. Depression sucks...That's the result of my real life study.

Thanks for posting this, BirdDancer. It's food for thought.

UpDownAround, you make a good point that post diagnosis (post start of treatment) can change the ratio a bit for some. At least it has for me over time.

I have bipolar type 1. For the years before my diagnosis, I can only guess how much time I spent hypomanic. I really lacked some insight to the hypomania back then. I can clearly point to depressions and full blown manias, though. When trying to add up time hypomanic I really have to think about my behavior, including tendencies to have anger outbursts, tendency to self-medicate with alcohol more than other times, times with particularly amazing productivity, bravery, impulsivity, and grandiosity. Obviously there was plenty of time when I was more in the "normal" range, and yet felt like myself and did well. Actually, I felt a lot of the "bad behavior" I now identify, was just me.

So...though I can't come up with any firm numbers, I will say that, pre-diagnosis, I believe my time in hypomania plus mania (hypomania, especially) probably exceeded my time in depression, at least by a bit. If I compare depression to full blown mania, then I'd say that depression time outnumbered my full blown mania time at least 3:1 or maybe even 5:1, as a guess.

In my early years after diagnosis and treatment, my moods were VERY unstable. Despite medications I became manic, a lot. Especially manic with mixed features. I think that the majority of 3 years (1 leading up to and 2 following medications) I was often manic. I had about 7 manic hospitalizations in those two years, and spent most of that time after them in Intensive Outpatient Programs not quite stable. Then I fell into a 1.5 year period of mostly depression where I had 3 hospitalizations and was home on disability for almost a full year depressed. After I came out of the depression I was very often hypomanic for a couple of years. My psychiatrist even told me he thought hypomania was my "baseline". That surprised me and made me question all of the years before that I thought such moods were "normal".

After that couple of years often hypomanic I felt between mildly sub-baseline to moderately depressed. That lasted for about 5 years. Then I felt mostly stable, but with other issues like anxiety, phobias, and some dissociation. For the last couple of years I've been mostly stable, with only a few short depressions of 4-6 weeks each. I have barely even felt hypomanic during these last 2 years.

So though I still think my time hypomanic/manic outnumbered time depressed (unless you zero out mixed episodes) in my very early years of bipolar treatment, my time depressed started to really outnumber my time hypomanic/manic during these last 7 years, though true stable time grew significantly. Why? I think part of the reason is because I finally quit drinking alcohol. Another reason is because I was put on a seriously large sedating cocktail that curbed my hypomania/mania.

[Wild Coyote]

Thanks for the article and topic.

BPII here. I think the time I spend in depression is more than double 40:1. My depression is very much, and most often, treatment resistant. I live in hell, so to speak. Depression is omnipresent, all enveloping.

Love to All!

WC

[Pookyl]

My ratio has been evolving over the past 3yrs. About 2:1 I think??

[winter loneliness]

Yes. I believe that is true. Bipolar 2 spends much more time being depressed.

For myself, I am frequently hypomanic and sometimes manic.

[annielovesbacon]

I have bp 2 and I find that pretty accurate for me. I can count on one hand the number of hypomanic episodes I have had. Depression is such a constant in my life that I feel like it's my baseline.

[scatterbrained04]

I'm BPII....not sure about 40:1, but I definitely spend a lot more time in depression or mixed episodes. I don't even worry about hypomania. I think I spend a lot of time in mild to moderate depression at this point, and it doesn't even register to me that I'm depressed. Like right now, I've probably been moderately depressed for the last 3 months, and I didn't even know it until someone kept telling me I seem "off".

[UpDownAround]

@BirdDancer,

Oddly enough, in agreeing with me you actually point out something I wasn't considering which is that I was probably hypomanic more than I realize/remember because I didn't have anything remarkable that stands out in my memory to be able to tell that many episodes were hypomania in hindsight. My wife says that the annoying aspects of it were more frequent than I think.

[99fairies]

Looking back now, I was cycling since I was a teenager. I was hypo most of the time. Once in awhile I would crash and stay in bed for a few days. But then I was back up for weeks if not months.