I have had issues like you describe, but things improved over time as (what I say) "brain healing occurred from episodes". That isn't to say that I haven't been affected long-term (or maybe permanently) from years of severe episodes. My guess is that my disability stems mostly from the trauma I experienced from episodes and their triggers. My goal is to prevent severe future episodes and the number of any level episode. Fight the kindling effect.

I have experienced bipolar episodes off and on (mostly on) for about 34 years now. The course of my illness worsened as I aged, and surely because I wasn't properly treated until my late 30s. That's a long period of brain beating! My current meds seem to be the best of the lot, but they don't take away all damage. I have learned that therapy is crucial. I am also better at utilizing it than in the past.

I have accepted that I will likely never be able to do some of what I used to be able to do. I could boo-hoo into my pillow every day about that, but that does no good. I'm past that. But it is not all bad. I have capabilities and wisdom now that I may not have had without my bipolar experience.

Whoops! I didn't read TishaBuv's post until after I wrote the above. Well, I agree with Tisha's pdoc on the damage.

Medications can contribute, but I often feel they are blamed too much and often.