As I have regular pdoc appointments they can tell my mood state just by looking at me ( how I dress and respond to questions etc). As mentioned I can wake up depressed one day with no trigger and that can be more frustrating than having something obvious trigger it. Stress really is my only trigger and it doesn't matter if it is excite able good stress or tough distressing stress, either way sends me into an episode ( usually depression, occasionally mixed and less commonly hypo). Most of the time I deal with it but when it gets to the point I'm Sui it's time for inpatient because I am dangerous and impulsive during episodes.