Mine has gotten easier to navigate, knowledge is power afterall... I have a stellar memory (well the parts the lithium didn't erase permanently anyway) and my monster episodes have not gotten worse over time.
I use the term "monster episode", because I'm referring to my longer lasting or most severe depressions, not my normal bp cycles. You know those whoppers we deal with every so often...

They vary in intensity, the worst ones being after my dad and brother died, and bout of anhedonia 2 yrs later that morphed into a yr long depression.

I've had horrible ones to not so earth shattering ones inbetween, before and after those 2 nasty ones....

Logically if my bp were getting worse, the episodes would worsen consecutively. No?

Admittedly, each one feels like the worst as its happening, but once I can "see" properly again, I realize it really wasn't the worst one to date....

In conclusion, any illness/condition/problem/issue/disease will undoubtedly get worse if you take the "stick your head in the sand" stance... So while I'm not medicated, my head is not in the sand, and I'm managing my bp as best I can.