I wish that I could clearly answer a question like this one. The reason I have a hard time doing so is because of medication.

For example, I had a very tough time last week because of having to change my therapy sessions from in office to teletherapy. My mind was severely upset, and I couldn't stop it. Things got worse. I began constantly ruminating about the issue. Even in my sleep (after being knocked out by meds) I was ruminating over the situation.

By the 3rd or 4th night I was having hypomanic symptoms. Constant sounds in my mind, including a whirring sound, like a machine whirring. The whirring never stopped.

Without meds, I believe (I am sure, actually) that I would have continued on into a hypomanic, then fully manic, episode. But I spoke with my pdoc, told her what was happening, and she increased my AP. It was a small increase. Even so, within a day my mind was quiet again. I was able to have an online session with my therapist and worked things out pretty well.

I'm sorry, I'm not doing a very good job of explaining. I think what I'm trying to say is that in my experience, episodes can just happen or they can be triggered. Either way, the end result is bound to be really bad/disastrous - unless medication and possibly therapy interventions occur.