At 21, she moved into her own apartment where things began to fall apart.

Warning Signs.
Typically frightened of their own thoughts and convinced they are utterly alone, young people often hide their symptoms for as long as possible.

Suzanne Vogel-Scilibia, now 47, had become accustomed to suicidal thoughts by the time she started high school. She felt sad most of the time, gained a great deal of weight and believed the radio was sending her messages.

"I knew there was something wrong with me, but the key was not to let anybody else know," she says.

She told her parents she had fallen down a flight of stairs when she had, in fact, tried to hang herself in the garage—an attempt which failed when the metal bar to which she'd tied herself collapsed.

Now a psychiatrist and board president for the National Association for Mental Illness, Vogel-Scilibia was 15 years old when her cycling began. But her symptoms had emerged years before: "In preschool I presented hair-pulling— trichotillomania—and I had a lot of social anxiety and school phobia."

Such early manifestations are common. But part of the riddle of bipolar disorder is a variance in the age of onset and the absence of a definitive checklist of initial symptoms.

Cycling can vary, from depressive to manic in one day, or sometimes with episodes of each lasting for months at a time. Until Vogel-Scilibia's diagnosis at the age of 27, her cycling pattern was seasonal.

"I hibernated in the winter and came out in the spring—like Smokey the Bear," she says.

The Lowest Low.
One morning just before Christmas in 1999, Mary answered a call at 6 a.m., groggy and disoriented. It was Kristy. Mary snapped awake, knowing instantly that her daughter had entered a manic cycle.