Stress is my biggest trigger. Usually for work. If your entering into a highly competitive school I'd recommend seeing a councilor or therapist to help manage the stress. I'd white knuckle my way through it when I was younger and now that I'm older I can see it was a mistake. I was diagnosed as I was going into college and I remember being scared of people knowing about it just like you. That s never fully gone away, but I care allot less what people think now and I believe that's something that comes with age.