I wish it were that simple.

If at any point in time a bipolar person experienced either a full blown manic episode or a deep depression, it would be easier to diagnose.  In my experience it has simply not been that distinctly polar, or black and white.  Some of the most helpful insights into bipolar that I have found are from a Doctor Jim Phelps, online at PsychEducation.org .   I cannot vouch for his standing in the psychiatric community, and there appears to be many differing opinions about bipolar within the psychiatric community.  But as I review my own experience, there is much that resonates with what he has to offer.

One of the most helpful things that he has identified surrounds the different waves that people with bipolar experience.  The basics are as follows:

One's symptoms are controlled by three separate 'waves', and each can cycle independently of the others.  Those distinct waves are mood, energy, and intellect.  In a classic manic phase all three waves top out with elevated mood, increased energy, and heightened ability to think, create, and pull everything together.  When all three bottom out with a dark mood, decreased energy, and clouded thought patterns you have a major depression.

But those waves do not cycle simultaneously.  For example, if the energy curve is up, but the others are down, the person experiences an "agitated depression".

It is also the case that many bipolar people experience a "mixed state" where they may experience a variety of symptoms that cross over the spectrum from manic to depressed.

Now to the crux of the issue as to my current situation of being evaluated, tested, and having the insurance company determine whether I am 'disabled'.  What is most irritating is that often in this process they want to make an evaluation on the basis of a snap shot. "How are you feeling today!"  Ok, well, today I might feel mildly depressed, or generally normal, or ready to take on the world, or in the fits of despair.  Depends on the day.  Someone who is bipolar cycles back and forth between manic and depressed states, and much of the time in between those extremes one may feel relatively normal, healthy, and functional.

"How do you feel today?"  "Fine."  "Then you should not be on disability and need to get back to work."  OK, but last week I might have been having suicidal ideations and next week I may be ready to save the world.  You cannot make a comprehensive diagnosis based on anyone of those states without considering the others.  Bipolar is a spectrum of experiences, not a unified state of being.  That's one of my major problems with the insurance companies that want to evaluate my situation based on the observations of a psychiatrist who has only seen me for one appointment.

My mother used to quote an old adage, "if you don't like the weather in Montana, wait five minutes and it will change."  That applies to being bipolar.

http://psycheducation.org/diagnosis/mixed-states/rapid-cycling-and-mixed-states-as-waves/