When Rachael Timmins experienced manic episodes she said she felt euphoric, but it was this dangerous mania that also saw her spend $30,000 in a month with "nothing really to show for it".
Ms Timmins had her first depressive episode at 15, but it took 19 years before she received her bipolar diagnosis.
"I completely withdrew from my family and was in a very dark place, but I just battled on just thinking I was a moody teenager," she said.
Ms Timmins said in her 20s symptoms of obsessive-compulsive disorder paired with anxiety and depression forced her to drop out of university, but she said it wasn't until her son was born that things became especially grim.
"I went to a doctor in Townsville and said, 'I'm irritable, I feel hopeless and I can't see the point in living anymore and I'm not being a very good mum anymore'," she said.
"I was in a bad way before I saw [the doctor] and I was in a bad way after I saw him."
Ms Timmins said the experience forced her to keep reaching out until she found the right doctor.
"When someone comes along and says, 'It's OK, your brain is malfunctioning', it's so validating," she said.
While antidepressants helped, she still experienced the ups-and-downs of the disorder that was, at that time, still undiagnosed.
"Mania was so polar opposite," she said.
Ms Timmins said she often went days without sleeping and was unable to make rational decisions.
"In the space of a month I spent $30k … I couldn't tell you what that money went to because I was in such a state of mania," she said.
A decade of waiting
Executive director of Bipolar Australia Susana Bluwol said the average bipolar diagnosis took about nine years to be determined.
Ms Bluwol, who has also been diagnosed with bipolar, said it was important to remember recovery was possible.
"There's nothing worse than having family who say, 'Just get out of bed, pull your socks up and get to work'."
Ms Bluwol said those misdiagnosed with depression were at greater risk of suicide.
"Research is now concentrating on making the diagnosis period shorter," she said.
"There's now lots of imaging done on the brain to see how it's reacting, and the diagnosis is made through an MRI."
Diagnosis breakthrough
Associate Professor at Sydney University and senior research fellow at The Westmead Institute Mayuresh Korgaonkar has used MRI scanning to see how the amygdala — an area of the brain that plays a key role in the processing of emotions — reacts as patients respond to sadness and happiness.
It has highlighted that key structures within the brain respond differently in a person who has bipolar or depression, with about 80 per cent accuracy.
He said about 60 per cent of patients were initially misdiagnosed, which could set them on a dangerous trajectory.
Dr Korgaonkar said patients needed to experience an episode of mania to confirm the illness, but that often presented long after depression did.
"They get put on a treatment path that is more suited for depression … when in fact depression medications are almost counter intuitive to treating bipolar disorder because they get pushed into the manic phase," he said.
The next step for Dr Korgaonkar is to undertake MRIs of people at risk of developing bipolar, before symptoms present.
For Ms Timmins, the days of extreme highs and depressive lows are behind her.
Now she uses a combination of medications, mindfulness and daily exercise to help manage her bipolar and has written a book about living with the illness.
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