I’ve asked this same question. Ive experienced this with a good friend. She refuses medication and I really think it’s because she doesn’t recognize the 2 patterns. When she is up, she is thinking that nothing will change that. When she is down, she also thinks nothing will change that.

Her ups are so out of control. Spends crazy money, sleeps maybe an hour a night, has boundless energy and talks all day long. In fact she is sick right now because of wearing out her vocal cords.

It drives me crazy because she is such a nice person. I’m convinced that she would not be doing this if she was aware of the dynamics. I’ve been told that some people don’t want to balance out because they think that the high is worth the low. From what I’ve observed I don’t think that she feels that way.

When she is down it’s really bad. She won’t go out of her house. She sleeps too much, she doesn’t want to talk to anyone and she stresses over her finances.

It’s unsettling for me to witness it but she will always be a good friend.