What about neither? What if it was actually an evolutionary adaptation? Perhaps the downs are necessary to replace the calories and sleep lost during the ups? Perhaps it's no longer adaptive in industrialized nations but then again my own pdoc said CEOs and entrepreneurs are bipolar and successful. If the ups reach to psychosis, then that would be maladaptive. If the downs reach suicidal ideation then that would have been eliminated from an evolutionary perspective unless that mostly manifests past reproductive age. That's just my guess of why it's still prevalent and the drugs are needed.

I'm just trying to figure everything out before I turn to meds that might my affect my organs negatively and undo thousands of years of evolution.