I think I started developing bipolar when I was 6 and an incident happened that was traumatic to me and affected my life for a long time. Had a suicidal depression at 10 and another at 13. The mania didn't show up till much later, and I still don't know what triggered it. Then I had my first mixed episode at 53, which is when I was diagnosed BP. It was probably genetic; my mother had many symptoms of it when I was growing up but she went undiagnosed and untreated. She self-medicated with alcohol, as did I from age 17 to 33.

I really believe in kindling theory. My BP got worse and worse over time, and by the time it manifested itself I was almost too far gone to be helped. I spent a considerable amount of time manic, but the depression was worse and those mixed episodes were hell. (I say 'were' because I haven't had one in years.) Now that I'm on the right cocktail, I do very well for the most part and it seems like all that other stuff never happened. But I'm ever vigilant for s/sx of my disease because I never know if or when they'll return.