Thank you everyone for all of the feedback! It seems that it is common for Bipolar to get worse as we age. I hadn't thought about the menopause/perimenopause before, but that makes a lot of sense to me. I've been having perimenopausal symptoms for about 5 or 6 years now. One of those symptoms is that I get hypomanic the week before my period. Then depressed the week of my period. And that timeline of 5 to 6 years coincides with my worsening symptoms, which has been the last 4 years or so.

Thank you everyone for responding! You all have bring a great deal of experience and good advice!