At the 2015 meeting of the American Academy of Child and Adolescent Psychiatry, researcher Jeffrey R. Strawn reported that among children at high risk for bipolar disorder (because of a family history of the disorder) who are prescribed antidepressants for depression and anxiety, adverse reactions are common. These reactions include irritability, aggression, impulsivity, and hyperactivity, and often lead to discontinuation of the antidepressant treatment.
Younger patients at risk for bipolar disorder were more likely to have an adverse reaction to antidepressants. Risk of an adverse reaction decreased 27% with each year of age.
Resilience is the ability to cope with adversity. While its role in anxiety disorder, post-traumatic stress disorder (PTSD), and unipolar depression has been investigated, there have been few studies of resilience in bipolar disorder.
A recent study presented by B. Cha et al. at the 2014 meeting of the International Society for Bipolar Disorders found that even euthymic patients with bipolar disorder show low levels of resilience (as rated on the Connor-Davidson Resilience Scale). Patients with a history of prior bipolar episodes had greater impulsivity (measured on the Barratt Impulsion Scale) and lower resilience than participants in a control group. Impulsivity in bipolar disorder was associated with lower resilience. Higher Clinical Global Impressions (CGI) scores, greater number of prior depressive episodes, and more impulsiveness were associated with lower resilience scores.
Both high impulsiveness and low resilience may be trait-related phenomena even in patients who have recovered from bipolar disorder. Number of prior depressive episodes is also associated with more cognitive impairment on multiple tests of executive functioning, attention, learning, and memory. Therapy aimed at problem solving and coping skills might help build resilience.