That's a good question, something I hope to delve into next time I see my therapist. I think for me, while I always had many of the bipolar traits, it really manifested itself when I went through a traumatic time in my life dealing with unwanted thoughts (I also have OCD). Those unwanted thoughts made me hate myself and think I was a total failure. I became obsessive about religion and trying to become a better person, engaging in strict religious rituals and abstaining from pleasurable activities. Then, when I began to heal and realize most of the thoughts were caused by the OCD, I went the opposite direction and started exhibiting hypomanic traits - allowing myself to do whatever I want (within certain bounds), became more self centered, giddy, confident, feeling like nothing I did was wrong. I ran from many of the rituals I had engaged in before, even things I used to enjoy like going to church. That causes me so much anxiety now to be around any kind of rules and regulations.