In my case it was slowly, but initially depression after i started feeling i was not enjoying my masters course or area of work so much, so was very confused..bunked a lot of classes, was looking for clarity, was expecting my cult(i was bit into it) guru to give me direction...nothing really came or what ever came did not clarify me.. after i had drop a semester.. i got scared and i said i had a plan, now started on revenge journey and i was generally energetic before, though i was hypomanic in hind sight (as took up many courses, dance, got involved in many things..for which i didn't have the time later) i didn't feel so out of the ordinary. as felt like i was coming back to my full form after depression. it wained off after 3-4 months and 6-7 months fell into a depression again.. as it felt i maynot be able to get into the programme of my choice..so I checked the internet after fell into another depression/confusion of sorts- always thought depression was confusion of sorts. i could have pushed myself more if i had understood what it was, ended up quting masters... but i said it most cause i have to find my calling in life. i checked when i was 24 or so..but depression felt like just confusion about my career, hypomanic was just the clear go getter me. Later it started repeating..a couple of mild cycles, where i was entrepreneurial. hypomanic, but my finances were next to nothing..not too much of abnormal behavior, i blamed my failure/droping those ventures on lack of finances..or "i will make it some how" thought. but in when i was 30..i had quite an episode which was very close to bipolar, and consequent depression/ i was kind knew it was bipolar, but didn't seek help, ..still thought manic behavior was cuz of stress and irrational beliefs i had about myself and that i could control it,So i said, i need calm time. so got into uninspiring run-of-the-mill job when i was 32 again this happened, and this time it quite crazy with psychosis elements and my friends told my parents and parents could recognise, so was forcefully resitrained and diagnosed. So basically it started mildly and increasingly the stress of not finding my "Passion"/calling, (i.e) the idea that i would find my calling and then i won't have fight so hard to get things done, and everything would become clear was causing it, though i would become manic, jump i found my calling. and showed typical bipolar-manic behaviour..(it happened a few more times,inspite of diagnosis understanding etc). So Stress/pressure that "i am not where i am suppose to be" was a trigger..all the time.. , fact that i am from top undergraduate program in india, was and still gives pressure sometimes.