I have been wondering that myself. In the last few years I have improved a lot by being able to go to university (p/t) and working 11-16 hours a week (although, I have about 6 months off during the the year of due to episodes). However, my PTSD was dealt with before and in those years, so I am wondering if that was the cause of my improvement. Bipolar was only diagnosed four years ago (I am 41) and I continuously have rapid cycling involving long-ish episodes that are severe. Maybe this was masked by the PTSD but it seems that, for now, my Bipolar is worsening. I do have hope that it will calm down soon enough.