New research looks at mindfulness therapy, anxiety, and daily habits — and what they may mean for bipolar care.
Key Takeaways
- Focusing on your relationships and managing stress may lower your risk of developing bipolar disorder, even if you have a higher genetic risk.
- Anxiety can make bipolar disorder show up in more complicated ways, so it’s important to talk with your doctor to make sure your treatment plan addresses both issues.
- Mindfulness-based cognitive therapy can help manage tough impulses and improve focus. This is based on research in teens with bipolar; evidence in adults is still growing.
When bipolar disorder enters your life, you become part of a community bound by shared understanding.
But spend any time in that community, and you’ll notice that bipolar disorder isn’t just one thing. Bipolar disorder looks like teens who struggle with self-harm. It looks like adults who manage anxiety alongside mood episodes. And family members who wonder what a relative’s diagnosis means for their own health.
Here are three new studies that explore how each of these experiences of bipolar disorder shapes important aspects of care and treatment — and what the findings might mean for you.
Can Mindfulness Help Teens Who Self-Harm?
Mindfulness-based cognitive therapy (MBCT) may be a valuable add-on treatment for teens with bipolar disorder who self-harm, according to a new study published in Psychiatry Research.
MBCT is a type of talk therapy that combines cognitive-behavioral techniques with mindfulness to help people manage difficult thoughts and feelings without getting swept away by them. A review of the research suggests that MBCT can benefit some people with bipolar disorder. The research team was curious about whether teenagers with bipolar disorder who self-harm could be among them, since self-harm in adolescence is a serious warning sign of future complications. For these young people, if MBCT were effective, it could potentially make a real difference for the rest of their lives.
To find out if MBCT could help, the China-based researchers enrolled 149 teenagers (ages 12 to 18) with bipolar depression who were hospitalized during a depressive episode. All had a history of nonsuicidal self-injury (NSSI), behaviors like cutting or hitting that aren’t intended as suicide attempts. All the teens took quetiapine (Seroquel) and lithium. Half also received two 90-minute MBCT sessions per week for eight weeks.
When the researchers compared the groups, they discovered that teens who attended MBCT showed significantly greater improvements across several key areas than those on medication alone. Their depression and anxiety symptoms went down, their impulse control went up, and their attention and executive functioning improved, too. They also had greater reductions in proBDNF, a protein that tends to rise during manic and depressive episodes and fall as symptoms improve, suggesting the therapy may support the brain’s own recovery process.
What This Means for You
- If you’re curious about adding MBCT to your treatment plan, talk to your care team. While this study focused on teens with bipolar disorder, the challenges the therapy addressed — self-harm, mood symptoms, and thinking difficulties — aren’t exclusive to adolescents.
- MBCT works best alongside medication, not instead of it. In this study, the teens who added MBCT did better overall, but all participants continued taking quetiapine (Seroquel) and lithium.
- It’s not for everyone. Some people can find mindfulness practice distressing, particularly sitting with painful emotions. In this study, five participants (almost 7 percent) discontinued MBCT during the study at the research team’s advice. A therapist experienced in both bipolar disorder and MBCT can help you figure out whether it’s a good fit.
- The cognitive benefits may matter as much as the mood benefits. Participants improved in memory, attention, and impulse control — areas that bipolar disorder commonly disrupts, not just during mood episodes but in between them, too.
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The Challenges of Managing Bipolar Disorder and Anxiety Together
For many people with bipolar disorder, anxiety isn’t a separate problem. It’s part of their daily reality. Now, a new study published in the International Journal of Bipolar Disorders suggests that having anxiety doesn’t just add more symptoms to manage; it may fundamentally change the complex clinical picture of bipolar disorder itself.
Researchers in the United States, Mexico, and Chile analyzed data from 2,225 adults with bipolar disorder enrolled in the Mayo Clinic Bipolar Disorder Biobank. They looked at how people with both bipolar disorder and anxiety disorders — specifically generalized anxiety disorder, panic disorder, social anxiety disorder, or phobias — differed from those with bipolar disorder alone in symptoms, medications, and treatment outcomes.
Nearly 2 out of 3 participants had at least one anxiety disorder. People with both conditions had higher rates of rapid cycling, suicide attempts, and substance use. They were more likely to be prescribed antidepressants and less likely to be on lithium or valproic acid (Depakene).
That finding caught the researchers’ attention since those are two of the mood stabilizers with the strongest evidence base for bipolar disorder. It may also help explain another key result: People with both bipolar and anxiety disorders appeared to have poorer treatment response to lithium and other mood stabilizers than those without anxiety, suggesting these medications may be less effective for this group. The researchers aren’t sure why. It could be that something is biologically different about people with both conditions. Or it could come down to practical challenges — difficulty sticking with therapeutic doses of the medications, poor sleep, or the compounding effects of anxiety itself — all of which can make mood instability harder to control.
The researchers concluded that having anxiety may be less a matter of managing two conditions side by side, and more that anxiety appears to shape the course of bipolar disorder itself, changing both how the condition presents and what treatment looks like.
What This Means for You
- Having anxiety may shape your experience of bipolar disorder. More than 60 percent of people in this study had both bipolar disorder and an anxiety disorder. If you’re in their company, these results suggest that your bipolar symptoms and treatment may look meaningfully different from those of someone without anxiety.
- Antidepressants without mood stabilizers may be risky. About 1 in 6 people with both bipolar and anxiety disorders were taking antidepressants without a mood stabilizer, something researchers flagged as a potential challenge. Not having any mood stabilizer may increase the risk of mood episodes, and antidepressants can have side effects that mimic anxiety symptoms, like insomnia, making it harder to tell what’s truly anxiety-related. If this sounds familiar, it’s worth bringing up to your care team. Other studies cited by the researchers suggest quetiapine (Seroquel) may be worth asking your prescriber about for managing both conditions together.
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Can Daily Habits Protect You if Bipolar Disorder Runs in Your Family?
If bipolar disorder runs in your family, it can feel like your genes have already made the decision about whether you’ll be affected, too. A new study published in the Journal of Affective Disorders suggests the full picture may be more complicated — and more encouraging — than that.
Researchers based in China examined which everyday habits might reduce bipolar disorder and schizophrenia risk, and whether they could still matter for people with the highest genetic susceptibility. To do this, the team used data from the UK Biobank, a large long-term health study, drawing on records from nearly 300,000 adults followed for about 14 years.
Understanding Your Brain Care Score
Each person received a “brain care score,” a measure of lifestyle and health factors grouped in three areas:
- Physical Health Blood pressure, blood sugar, cholesterol, and weight
- Lifestyle Diet, alcohol, smoking, exercise, and sleep
- Social-Emotional Well-Being Stress and relationships
They also measured each person’s genetic risk for bipolar disorder and schizophrenia using DNA data, then looked at how brain care scores and genetic risk related to who actually developed each condition during the study period.
People with higher brain care scores were less likely to develop bipolar disorder or schizophrenia over the course of the study. But not every healthy habit carries equal weight.
Physical health measures were not significantly associated with reduced risk of either condition in this study. That doesn’t mean physical health doesn’t matter for overall well-being, but in this study, it wasn’t the factor that distinguished who developed these conditions.
What did matter was how people lived day to day. For people with lower genetic risk, both lifestyle habits and social-emotional well-being were linked to meaningfully lower risk of bipolar disorder and schizophrenia. For those with higher genetic risk, lifestyle habits didn’t show a significant protective effect for either condition, but social-emotional health remained protective across the board.
This study shows associations rather than direct causes, and more research is needed to fully understand the impact of daily habits on the risk of bipolar disorder and schizophrenia. But the findings point in a consistent direction: That how you live — and especially how you connect with others and manage stress — may help protect your mental health even in the presence of significant genetic risk.
What This Means for You
- If bipolar disorder runs in your family, relationships and stress levels might matter more than you may think. Of all the factors studied, social-emotional health was the only one to show a protective effect, even among people with the highest genetic risk. If you’re going to focus on one area of brain health, tending to your relationships and finding ways to ease chronic stress may be the most meaningful place to start.
- Lifestyle habits offer meaningful protection, too — especially if your genetic risk is lower. While social-emotional health was protective across all genetic risk levels, people with lower genetic predisposition also saw meaningful protection from lifestyle habits, including sleep, diet, physical activity, smoking, and alcohol use.
- Your family history may help determine where to focus your brain health efforts. The lifestyle habits in this study — like limiting alcohol use and not smoking — are broadly good for health regardless of your risk for psychiatric conditions. But if preventing bipolar disorder is a specific concern, this research suggests that the habits most likely to help may depend on your family history. A clinician who knows your background can help you figure out where to put your energy.
Editorial Sources and Fact-Checking
- Wang P et al. The Influence of Mindfulness Therapy on NSSI and Serum proBDNF in Adolescents With Depressive Episode of Depressive Episode of Bipolar Disorder. Psychiatry Research. June 2026.
- Xuan R et al. Mindfulness-Based Cognitive Therapy for Bipolar Disorder: A Systematic Review and Meta-Analysis. Psychiatry Research. August 2020.
- Singh B et al. The Anxious Bipolar Phenotype: Clinical Complexity and Treatment Response. International Journal of Bipolar Disorders. February 26, 2026.
- Kinrys G et al. Comorbid Anxiety in Bipolar CHOICE: Insights From the Bipolar Inventory of Symptoms Scale. Journal of Affective Disorders. March 1, 2019.
- Cui Y et al. Modifiable Risk Factors and Risk of Schizophrenia and Bipolar Disorder Across Severities of Genetic Risk. Journal of Affective Disorders. August 15, 2026.
