What causes this? It's all about the D.
The only way to get a diagnosis is to seek help; in order to get help you need a diagnosis; those who get a diagnosis and seek help are often either dismissed, experience denial (from others), or drugged; the dejection can lead to death by despondency.
Did you know that the Diagnostic and Statistical Manual (DSM) is only 67 years old? Six years old in its current version, aka DSM-5.
What triggers her?
She woke up.
That's been my answer for a decade and a half.
90 year old grandpa...
74 year old grandma...
49 year old father...
19 year old best friend... texting words like "hope you get better," & phrasing the word "disability" within quotes in texts to her. No wonder she doesn't respond.
Denier relationships are real and this little history lesson is the reason why. Denier doctors are real and interacted with at random intervals. Denial doesn't help her, me or anyone here on the daily.
You become less angry when you realize it's truly just ignorance.
...or version of the DSM.