What I do know is that I managed without meds until I was 24 and was pretty functional. When something bad happened, I would become depressed (truly clinically depressed, not just sad) but there was always a reason for the episode. Fast forward 10 years. When I tried to stop or reduce my meds, my life would fall apart whether there was a trigger or not. The depression would be incapacitating. (I'm bp 2, so I just had hypomania not mania, which was uncomfortable and embarrassing, but not dangerous). So, my general impression is that I'm getting worse, but fortunately I can be pretty well managed on meds.