I have been unmedicated since April and VERY stable, BUT I have a huge arsenal of coping skills and have radically improved my lifestyle and involvement in life in the last year. It took literally YEARS of intensive therapy to work through the PTSD issues that complicated my bipolar issues (personally I think the PTSD issues were causing me much more severe problems than my bipolar ever did). This has only worked because of having worked through my history and learned healthy coping skills. I am much more self-aware and pro-active the absolute minute I feel myself becoming anxious or depressed or energized in any kind of hypomanic way. It has taken very conscious and conscientious work to get to this point and stay there.

If at some point those skills fail me, I have no problem with contacting my pdoc again and using meds to stabilize (I do think meds will probably only need to be temporary fixes/adjustments for me now. My Pdoc agrees.) He has always been aware of what I have been doing and how I am doing, and he is supportive. I think he was obviously concerned at first that I would relapse, but it has been 9 months now of solid stability, so he certainly can't argue with the results he is seeing.

I think you DO have to be willing and able to do the hard work in therapy and make aggressive and deliberate changes in how you live and approach life in order for this to have a chance to work. You can't continue to do what you've always done (if that has always had poor results) and expect better results miraculously. It just doesn't happen that way.