Mmm. I think maybe seasons. Some symptoms happen during some seasons. I'm more likely to go through a depressive episode in the late fall to winter. The hypomania is more in warmer seasons.

Stress is a big one.

When my lupus acts up in flare. Then it's kind of chicken and egg. Did the depression and whatnot cause the lupus to flare or did the lupus cause all the mental stuff to begin with.