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Even once a person has been stabilized on the meds, though your sil may still be in the med trial stage and not truly stabilized, it is still possible to have breakthrough episodes of depression, mania, or mixed. This can be caused by environmental factors such as stress, sleep, or sunlight. Additionally as time goes on the body reacts differently to the meds and dosages must be changes or meds may be changed, added or removed, altogether. I hope that this might help.
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It is said an Eastern monarch once charged his wise men to invent him a sentence, to be ever in view, and which should be true and appropriate in all times and situations. They presented him the words: "And this, too, shall pass away." How much it expresses! How chastening in the hour of pride! How consoling in the depths of affliction!
---"Address before the Wisconsin State Agricultural Society". Abraham Lincoln Online. Milwaukee, Wisconsin. September 30, 1859.
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