I've gone without meds or diagnosis for a bit over a decade. For the most part, I have good coping/management skills for myself. It definitely involves avoiding what triggers I know I can so that I'm more prepared to handle the ones I can't, trying to eat regularly/healthy, having a veerrry strict sleep schedule/night routine, and a lot of attempting to make myself do the things I don't want to when I'm in an up or a down.

I've recently decided to go about with getting the diagnosis and trying meds, because I'm at a point in my life where clearly I'm just not able to do enough to keep it from starting to affect my work. So I will stay on the meds until I think I have my outside triggers under control (I know it's been triggered and what it is, and it's obviously too much for me to manage on my own!) and then the plan is to go back off them. When will that happen? Who knows. But eventually it will.