Which of the following is TRUE about manic-depressive psychosis?

Mood disorders often have seasonal patterns. Acute episodes of depression are common in spring and fall, whereas mania appears to cluster in the summer months. Suicide rates also show a peak in the spring and a (smaller) peak in the late fall. Higher rates of hypothyroidism, greater use of antidepressant medication, and changes in reproductive status and gonadal steroids may account for the greater prevalence of rapid-cycling bipolar disorder among women. Cyclothymic disorder consists of hypomania and less severe episodes of depression. Manic episodes typically begin suddenly, with a rapid escalation of symptoms over a few days, often, they are triggered by psychosocial stressors. Ref: Loosen P.T., Shelton R.C. (2008). Chapter 18. Mood Disorders. In M.H. Ebe, P.T. Loosen, B. Nurcombe, J.F. Leckman (Eds), CURRENT Diagnosis & Treatment: Psychiatry, 2e.