Mania can be triggered by context and manifest as sustained elevated mood and energy, driving significant risks and life shifts.

“mania after 9 11. he had no particular connection he was in fact he was on a a a sailing uh trip in the mediterranean with his with his wife at the time came back home after 9 11 um and and a couple weeks later uh he was manic all these symptoms that we talked about and it was a huge problem um he was but his but he had this appropriate or at least uh aligned quality to his symptoms he he he wanted to he was you know he was retirement age but he was training himself uh to go into battle he was repelling down trees he was running through the night he was he was reading about military strategy and and then it verged into this you know very difficult uh emotionally challenging he was screaming he was hyper religious everything had become uh quite uh extreme and incompatible with with his life and so that ended up bringing bring him to the to the hospital but you know looking at this and we think okay this is this is a state of elevated mood and energy it was triggered by context and this is actually the flip side of what you're saying with the with the immigrants not only is there likely to be a set of conditions that led to these people being able to take that have the energy and willingness to take the the risk and meet all the incredible challenges of moving across countries and cultures but then you know that that's a that that's not that's not this fight or flight response of a minute when you've got a threat and you have to you have energy and then you meet the threat and then it's gone we're talking about you need a sustained level of energy for weeks months years even and to take a to take a risk and a life shift like that”