It is hard to say as I had a traumatic childhood but I was depressed and suicidal from age 9 and then it just got worse. I was a deeply troubled teenager but had some hypomanic periods then too. Had a massive breakdown at age 22 which was PTSD related but sent me manic then depressed. Had episodes of hypomania and depression ever since plus severe mixed states till my first psychotic break with severe mania which I just got out of two weeks ago. My illness just seems to be getting worse although periods of stability getting longer. Like one month or so in between rapid cycling. I am 40 now.