I personally think it is foolish for any doctor to be making predictions about how a patient will turn out. There is so much variability and a big factor is how a person responds to medication and how compliant they are with taking them, in addition to doing all the other things that make for mental wellness.

I believe I have had a loss of cognitive functioning as a result of each manic episode. Or maybe I just have chemo brain. But this cognitive fog has not impacted my mental health bipolar-wise. I just make more mistakes doing simple things and cannot do anything complicated.

I don't think though that my bipolar is going to get any worse than it has been in the past. I hit 'rock bottom' in my last episode and have avoided getting psychotic symptoms since then by taking an AP and by making sure to get enough sleep. I have a fitbit to help me keep track of that. If I am not getting at least 7 hours then I take an extra olanzapine until my sleep is ok again. Maybe this is the 'special sauce' that will keep me sane.