I have found that my trigger is discomfort .When I'm only in pain I can handle that, but layer a couple more discomforts on top, and I lose it. If I'm in pain, hot, and sweating, watch out! because I have apparently reached my limit. If I'm fatigued, cold, and hungry for long enough, that's another set of discomforts I cannot handle.

I usually try to separate myself from any family members I happen to be with, If I can, so that I don't go off or scream at them. I've gotten pretty good about not having meltdowns in public, though.