However, most people cannot regularly work 48 hour shifts except under duress. (IE, their life, job, or crisis depends on it.) Many can do it once, but need a significant break afterwards.
If someone is regularly cycling like that, it very well could be a coping mechanism for bipolar.
48 hours, even once, is a serious problem.
I know it’s not healthy, but I have unresolved issues that remain unresolved after 10 years trying to get help. At least it’s not alcohol. But that’s also perhaps why people don’t see the distress.
I work to forget.
I'm still suspicious whether it was actually 48 hours straight with no rest because -- no matter how brilliant someone is -- I would be extremely leery of the code written toward the end of that session.
In my case one had genuine clinical manic episodes and was open about his mental illness; another seriously burnt out; older friends in the games industry spoke of multi-month post-launch vacations (back in the late 90s) to cool off.
(And that was best case, if your infrastructure and deployment scripts were up-to-date. Most people's weren't; probably the ratio is only slightly better today.)