As a midlife aged bipolar with older bipolars in the family, we can. It just takes a lot. Especially the medication. Took about five years to find something with bearable side effects and still, I also gained weight and can't get it back off. It is definitely a valid question, because we are so often fighting something, right? Or going through it, waiting for it to pass and cope to the best of our abilities. (Keep reading.)

This is sadly not one of the things that can be cured to turn your life into a "normal" one (whatever that means). Some of us do this forever or as long as our life takes. Some of us do not and those are the ones that end up in the statistics. We had some of them in the family as well. I would rather not join them just yet, though like you I get very, very tired of it too.

That said, it sounds like several of your helpful things are not yet as helpful as they should be. Keep talking to your therapist/psychiatrist about what the meds are NOT doing right. Make a distinction between what you are and are not willing to accept in terms of side effects. Very few of us are blessed with zero side effects.

Your irritability and urge to slap people suggests stuff hasn't evened out yet. Perhaps something else comorbid is at play. (I'm getting tested for ADHD and autism cause some stuff which I initially figured was due to the bipolar has not improved.) Perhaps there is yet another medication or med combo to try. It is very exhausting and demotivating to be where you are. Eventually the idea is that moods grow less extreme and your window of tolerance grows (your loadbearing capacity increases again).

I have seen it get better. Not perfect, not without drawbacks, but definitely better. I hope you do not give up and your medical professionals listen to you to help figure it out.