Many things can cause an episode or nothing at all. Bipolar sometimes just pops up slaps the snot outta a person.

I do have a list of "triggers" that I know will put my on the Tilt O Wheel.

Not all Pdoc's or T's believe that a swing can happen with out a trigger.. All my IP Pdocs always insisted there was/had to be a trigger (whatever) I wasted no time trying to argue my point with them.

My Pdoc and T are both in agreement that "I" can and do swing out of the blue for no apparent reason.