A trigger can be damn near anything. Routine is just so important in the Bipolar world. If sleep goes a bit off , or missing a dose or a few of medications or too many commitments and Doctor appointments, Longer work hours or days etc etc ..

I think this is why "self care" is so important for all of us everyday.. Even when things are running along smoothly dont forget the meditation to keep your self grounded, exercise , healthy diet, making time to just do something you enjoy.