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As the person gets older, and if they go untreated, the differences between the highs and the low become greater over time.  their is a high suicide rate involved if untreated, and usually occurs in the High manic phase (which is surprising) due to the fact that they do not want to head back to the low depression stages.  If u have any more questions feel free to ask.

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Actually, when they get to that late stage, the episodes become more and more mixed, mania and depression simultaneously, which is the period of greatest risk for suicide. My uncle went through that...three weeks of wild swings and mixed states, before he finally put a gun to his head.

 

Untreated, the fatality rate for bipolar disorder is about 25% (used to be 50%, because people in asylumns would often starve to death when manic). Compare that to a disease like...oh, say yellow fever, which is only about 20%, as I recall.

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