Saucygirl, I am similar to you and cashart in terms of stress and seasonal triggers. Sometimes I am even triggered by "positive" stressors. Also like you both, I have a lot of breakthrough hypomanias. I have a long history of full blown mania, as well, but between family and mental health team (like cashart's) and improved insight, my hypomanias/manias are now often caught early, which is important.

I absolutely use prn medications in the case of breakthrough hypomanias and manias. You can see them in my signature below. Also, if my hypomanias/manias continue despite, my psychiatrist raises my base Seroquel XR dose, but sometimes the prn use doesn't always necessitate that. I think that those of us who do have frequent hypomanias/manias benefit greatly from the use of prns.

My medication cocktails did change a lot during the worst years of my bipolar illness, but not as much these past 8 years. In fact, I have been able to have some meds in a previously behemoth cocktail removed. These last few years, only my Seroquel XR dose is manipulated, although the starter dose of Latuda was added maybe 7 months ago. My psychiatrist hasn't changed my Latuda because it likely wouldn't be as effective for mania control as my Seroquel XR.

If hypomania breakthrough is an issue for you now, please discuss that with your doctor. Maybe one of your medications is activating, or something else?