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The Loose Switch Metaphor
(Mood stabiliser) medication is like using glue to stiffen the switch, discouraging the switch from flicking to one pole, and discouraging mood instability.
The Feet-need -to-be-brought -down-to-Earth metaphor
(Anti-manic e.g. "mood stabiliser", "atypical antipsychotic") medication may assist the sufferer to be brought down to Earth more gently than will otherwise be the case if they should wait, in which case they may well come plunging down and crashing (i.e. phase change into depression). This is because manic episodes are not uncommonly followed by depressive phase changes. Treating the manic phase may prevent depressive episodes, especially when mood stabilisers are used prophylactically, for relapse prevention. If the manic phase can be prevented, so then can the depressive phase that often follows, even without antidepressant medication.
The Excessive Creativity (or Too-much -is-not-necessarily -a-good-thing) metaphor
Mood stabilising medications may temper these capacities. The fact that it usually takes some weeks before obtaining maximal benefit from these medications is likely to relate to the time span for the process of these medications activating certain genes, protein synthesis and end-organ effects of these proteins. Medications may dampen the expressivity of genes that are pushing and driving the mood too far in one direction. Alternatively, they may strengthen what is usually an inadequate inhibition of the escalating mood state, by activating genes and proteins that permit inhibition of elevated mood.
The Rollacoaster Metaphor
Medication is like adding brakes to the front carriage, slowing the train down enough to permit the rider to take some of the cars off the tracks to spread them amongst other paths.
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Having bipolar
disorder is like having a loose emotional switch. Flick the switch up and
mood becomes elevated, flick down and mood becomes depressed. The
switch tends to flick from north pole to south, or between black and white,
without any shades of grey. It is as if there is an absence or a diminution
of any inhibitory process to prevent the emotional momentum from building in a
particular direction.
Losing touch with
reality is common when in the manic phase and to a lesser extent when in the
depressive phase if severe. Even when manic, the subject is often
distressed by mood instability, interpersonal friction, paranoia, sleep
disturbance, lowered frustration tolerance, racing thoughts,
disorganisation and unproductive overactivity. They may be aware that they
are functioning differently to their normal state. Often the bipolar
sufferer will be aware they are "riding too high in the clouds" and
need to be brought back down to Earth. 
Bipolar
genes may well be related to capacity for achievement and creativity,
attraction of the opposite sex, leadership qualities (e.g. increasing group
stability), risk taking & exploration. These qualities are
clearly positive human attributes that may have evolved for the benefit of
the species, and have therefore been retained by Natural Selection.
(The increased risk to developing) bipolar disorder may result from an
excess number or particular combination of the genes that code for these attributes.
In other words, "more is not always better". The
tendency towards bipolarity may result from excessive positive, normally
adaptive, capacities. 
Having
bipolar disorder is like being trapped on a runaway Rollacoaster ...
without brakes or a steering wheel. The track swings high and
low and the sufferer is taken along for the ride. 
The
heaven & hell metaphor
