Yes imo. I was just bp II for most of my life. Then in 2011 I went into a hypo and then a full blown mania and then a psychosis. Since then, before I got my meds correct I would go into manias and mixed episodes. The drs confirmed this. Mind you, before 2011 I wasn't on bp meds. Just meds for sleep.

But yes, I do believe it can get worse.