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[quote=Anonymous][quote=Anonymous][quote=Anonymous][b]It is very odd that you can't see the evidence of the illness.[/b] Bipolar is typically pretty evident since the diagnosis requires fairly extreme mood states and people's behavior changes as they move between them. You would definitely see evidence of hypo mania and depression. It doesn't sound like he has has mania as you would 100% know if there had been a manic episode. This doesn't really seem to add up to a typical presentation. Memory can definitely her hazy or be remembered through the distorted lens of hypo mania.[/quote]

OP here.  It's all very confusing for the reasons you state here.  I thought I was knowledgeable about bipolar disorder before this, and I never would have suspected he had it.  His cheating episodes were so wildly outside his normal behavior/personality that when you read about hypersexuality -- the danger, the anonymity, the homosexuality -- it sounds textbook.  But, like you said, very little else seems textbook.  EXCEPT there are some other things we've read about, particularly "loss of sequencing," that hit home big time.  The sample fights and interactions in this book he's been reading about the disorder read like a SCRIPT for the fights we've had the past couple years.  But yeah, the tricky part now is every time he's irritated or absent-minded, I think, is he manic right now?  Or is this just normal emotion?  [b]We no longer know what's his personality and what's the disorder.[/b]  And that only matters if we have hope that it can be treated successfully.[/quote]

It is not odd at all, especially with bipolar type II.  First of all, hypomania presents as decisions that many people interpret in the realm of "normal but unwise".  Overspent?  Had sex with the wrong person?  Gambled?  Staying up late?  Drinking a bit more?  Overly chatty with people?  Can't stay organized/on task?  All signs of hypomania.  All normal also.

The average time to diagnosis for bipolar is in the range of 5-10 YEARS!!!  See, for example, this article [url]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2796048/[/url]

Think about that.  If the patient and the doctor doesn't recognize bipolar, how on earth is the partner supposed to?  Especially since a big part of hypomania/mania is hidden by the bipolar person.

Bipolar is not "pretty evident' unless your first episode is a florid mania (i.e. a mania that disconnects the person from reality -- like I'm gonna be president or I can fly or Jesus is speaking to me).  In that case, you will probably be diagnosed as BP Type I fairly quickly.  But, if your florid mania is paranoid you may be misdiagnosed as schizophrenic, particularly if it lasts a long time (like months) and you don't cycle back to mainline or depressive state within a few weeks.

If your first episode of BP is depression, you will likely be diagnosed as having depression only and you may even be prescribed anti-depressants, which for a BP person are terrible -- they can make anxiety worse and flip the person into a manic or hypomanic state.  Because the person has been diagnosed as having depression, IME, the hypomania will be missed, and, especially if it is dysphoric, the behavior will be misinterpreted as depression w/ meds that aren't working or depression/asshole behavior.

Also, by definition BP Type II (depression/hypomania) is less extreme mood states than BP I.  
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