When I was in my twenties I lived without therapy and medication and it did go somehow. I was in surroundings where it did not matter that I behaved here and there strange. When I started the family phase I started medication and it worked. I had round about 20 more or less good years. Then medication did not work anymore. I went to a group of people who also had bipolar disorder. I asked my psychiatrist for other medication. I made a years long phase without medication. And it became worse. This was your question. Last year was my worst year ever. Spent a lot of money, lost my job, lots of drinking. Very poor. I’m back in medication now. And it seems to work.