Diet, Family Therapy, COVID-19, and Suicide Risk| bpHope.com

From new research on diet to medications that may prevent suicide, here’s what 5 new studies mean for your bipolar care. 

Your bipolar care team should give you the support you actually need, not what they assume you need. That starts with asking the right questions — and finding answers grounded in solid science. Each new research finding adds understanding, paving the way to better care. This month, five new studies tackle the kinds of questions that matter to your everyday life:

• What can make it harder to have a healthy diet when you live with bipolar disorder? 
• What’s most important to know after getting diagnosed with bipolar disorder? 
• How can you support your children if bipolar disorder runs in your family? 
• How is COVID-19 different for someone with bipolar disorder? 
• Do bipolar medications really help reduce suicide risk? 

Understanding Unhealthy Diet Patterns in Bipolar Disorder

Your eating habits aren’t determined by just one thing. Hunger, cravings, fatigue, gut health, medications, and more can work alone or in combination to influence the way you eat. 

Since many of these also relate to mental health, researchers have begun wondering if poor eating patterns might represent a meaningful subtype of certain mental health conditions worth studying more closely, according to a review of the research.

An international team wanted to explore this specifically in bipolar disorder: Could unhealthy eating be part of a specific bipolar disorder profile? And does it cluster with factors like symptoms, stress, and sleep habits? The research team’s findings, recently published in the Journal of Affective Disorders, hint at what influences eating habits in people living with bipolar disorder. 

What the Research Says

The researchers analyzed data from 737 adults with bipolar disorder enrolled in the Mayo Clinic Bipolar Disorder Biobank, drawing participants from Minnesota, Ohio, Mexico, and Colombia. They explored how factors like demographics, symptoms, lifestyle, and stress relate to diet quality, which they measured through a survey about eating habits — like how often you dine out or eat processed meats and fried foods. 

The findings were striking: Nearly 79 percent had an unhealthy diet quality. This fits with other research showing a link between mental health conditions and unhealthy diets.

In this study, researchers were able to dig deeper and understand what other characteristics tend to go along with a poor diet in bipolar in particular. They found that an unhealthy diet was linked with: 

• Diagnosis of bipolar 1 disorder or schizoaffective bipolar subtype (versus bipolar 2 disorder) 
• Diagnosis of anxiety disorders, binge eating disorders, nicotine dependence, and substance use 
• Male sex
• Younger age
• Lower education level
• Higher unemployment-related stress
• Earlier age at diagnosis
• Being a night owl
• Having obesity and hypertension

Notably, severe bipolar symptoms like psychosis or suicide attempts weren’t linked with unhealthy diets. Surprisingly, it also wasn’t tied to specific psychiatric medications, challenging the common assumption that medication side effects drive poor diet in bipolar disorder.

Why It Matters

Poor diet quality in bipolar disorder is common and doesn’t happen in isolation. It could be that screening for unhealthy dietary patterns as part of regular bipolar care could help care teams better understand individuals with bipolar and customize treatment plans.

What This Means for You

• Unhealthy eating patterns are not a personal failure. Nearly 4 out of 5 people in this study had poor diet quality, suggesting that factors beyond willpower are at play. Understanding this can ease self-blame, a first step toward more effective, compassionate support for healthy eating, a lifestyle habit that can have lots of other benefits for your overall well-being. 
• Being a night owl might affect what you eat. If you live with bipolar disorder and are naturally an evening person, you might also tend to be someone who reaches for fried and processed food, per the results of this study. You can’t change your chronotype, but recognizing this pattern could help you plan, like keeping healthier midnight snacks on hand.
• A simple diet screening could give your provider valuable insight. Poor quality diets were linked with a unique set of characteristics in bipolar disorder — including higher rates of anxiety disorders and unemployment-related stress. A brief assessment of your eating patterns — the one in this study had just 16 quick questions — could help your treatment team see the bigger picture of what you’re facing and tailor their support accordingly — whether that’s managing anxiety, connecting you with practical resources, or troubleshooting nutritional stumbling blocks.
   

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Study Says People With Bipolar Disorder Need to Know These 23 Things

In an ideal world, everyone would get access to a specialized care team the second they’re diagnosed with bipolar disorder, and this team could help provide all the information you need to know about your condition. But not everyone has that privilege, leaving people stranded without the knowledge required to start moving forward. 

So researchers in Japan brought together patients, families, and healthcare professionals to identify exactly what people with bipolar disorder need to know right away to get back to what matters most. The result? A focused list of nearly two dozen need-to-know items, which were recently published in the journal Health Expectations. 

The hope is that someday this list could be shared in regular health appointments to guide conversations with people who are stabilized after a new bipolar diagnosis.

What the Research Says

The researchers used a modified Delphi method, a scientific way to build expert consensus. Both experts by training and experts by experience weighed in. The 11-person brain trust included five mental health professionals, three people living with bipolar disorder, and three family members. 

Researchers started by compiling 126 potential items from trusted sources. Then, through two rounds of individual ratings and group discussions, they narrowed it down. This resulted in 23 essential pieces of information that everyone agreed were so important that not knowing them would make it difficult, if not impossible, to “have a social life while controlling the symptoms.” 

The resulting list is focused on serving people actually living with bipolar disorder and uses language that’s easy to understand, even if you don’t have a medical background. The items fall into nine topics: self-management, treatment, family response, symptoms, course of illness, diagnosis, risks and causes, life impact, and social resources. You can see the full list in the published study, but here’s a sample of what professional and lived-experience experts say you need to know:

• It’s normal to have mixed feelings about a new diagnosis. “It is difficult to accept the diagnosis and prepare yourself for treatment. It is natural to experience complicated feelings before you are able to accept bipolar,” according to one tip on the life impact of the condition. 
• You might be tempted to quit your meds, but if you do that, you’ll probably feel poorly. “There may be times when you wish you could stop taking medications for various reasons, such as that the side effects are painful or they do not seem effective, or you may want to reduce doses because you have gotten better. However, some medications can make you feel sicker if you discontinue abruptly, so please tell your doctor what you want, rather than making decisions on your own. It is also a good idea to ask in advance when to reduce the amount of medication and what to do if you have doubts about your medication, such as side effects. If it is difficult to talk to your treating psychiatrist, you can also seek advice from pharmacists, nurses, or mental health social workers,” per a tip on treatment.
• Plan for future care when you feel stable — but be aware that thinking about mood episodes can be triggering. “When manic symptoms and depressive symptoms become pronounced, you will not be able to see your condition objectively. While your symptoms are stable, you should talk to your family and people around you to discuss what symptoms are expected, and when they appear, what responses you would want them to take, as this will help keep the waves of symptoms calm. Although it is helpful to look back and write down what triggered the worsening of your symptoms in the past, so that you can learn what the signs are, this may also upset you. Please consult your doctor to decide on the appropriate method and timing to reflect,” according to a tip on self-management. 

Why It Matters

This 23-item list is designed to be something healthcare professionals can actually use during routine appointments when specialized bipolar disorder programs aren’t available. It can help make conversations easier, ensure nothing important is missed, and give people with bipolar disorder, their families, and their healthcare providers a shared foundation.

What This Means for You

• Your perspective on what’s important might be different from your doctors’ — and both matter. In this study, people with bipolar disorder and their families prioritized practical, daily-life information (like how lifestyle changes help manage symptoms) more than healthcare professionals did. That doesn’t mean either group is wrong. But it suggests you might want to take care to ensure the conversations with your care team include your priorities, too. You’re the expert on what you need to know to live the life you want.
• Staying well is about more than just taking meds. The essential information in this study goes beyond sticking with your prescribed medications. It includes recognizing your warning signs, maintaining regular routines, managing stress, and knowing when to reach out for help. 
• You don’t need to know everything about bipolar at once. Feeling overwhelmed by information after a new medical diagnosis is normal. You don’t have to become an expert on bipolar disorder overnight. But there are essentials you need to know right away to help set you on the right path. 
• Loved ones have a key role. About one-quarter of the items focus on what family members can do. The guidance strikes a balance between self-care and practical support for the individual with bipolar disorder, starting with a crucial reminder: Family members must prioritize their own well-being first.

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This Short Therapy Might Help Your Kids Someday

Children of people who live with bipolar disorder are more likely to have a mental health disorder themselves. They have a 60 to 90 percent increased risk of bipolar disorder alone, according to some estimates. While formal diagnoses often don’t arrive until adulthood, signs of mental health problems — like emotion dysregulation — can start much sooner. 

Typically, a formal diagnosis is required to unlock treatment. But by then — by definition — the condition has disrupted life, often in significant and painful ways. 

What if there was a way to get ahead of things — before kids suffer major mental health setbacks? A new pilot study published in the International Journal of Bipolar Disorders shares encouraging results from a brief family-focused therapy designed to do exactly that.

What the Research Says

French researchers recruited 25 kids — ages 6 to 16 — who had at least one parent with bipolar disorder to try a new family-focused therapy. The approach was adapted from a program originally designed to help people with early-onset bipolar disorder. Importantly, the children didn’t need to have symptoms themselves to participate.

The research team streamlined the therapy to work better for busy families. Instead of the typical 12 to 21 sessions, this version consisted of just four three-hour sessions spaced about every six weeks over six months. This gave families time between sessions to practice what they’d learned.

Parents and kids also had their own, separate group therapy sessions that touched on similar topics, just in age-appropriate ways. Both groups learned about bipolar disorder, tips for regulating emotions, communication skills, and how to solve problems.

The research team used established surveys to get a picture of how the kids were doing before and after the therapy. 

Although the study was open to kids regardless of their mental health status, many were already struggling. At the beginning, about 84 percent of the kids met criteria for a mental health diagnosis (mostly ADHD, anxiety, or depression), and 60 percent had difficulty with mental, social, or school functioning, according to their surveys.

The surveys were repeated at 6 and 12 months to see if there were any changes. At six months, not much had changed for the kids. But by 12 months, one finding stood out: Average scores on the Child Behavior Checklist–Emotional Dysregulation Profiles dropped from 191.76 to 176.88 — a significant improvement. Lower scores reflect better emotional and behavioral self-regulation, meaning the therapy measurably helped. The researchers suggest that emotional dysregulation may be one of the first areas to improve, potentially paving the way for more changes over time.

These results are encouraging, but it’s important to note this was a pilot study — essentially a promising first step. These findings suggest that it’s worth testing the new family-focused therapy with more families on a larger scale. Only after more research will experts be able to tell whether this program should be widely recommended for families where a parent lives with bipolar disorder. 

Why It Matters

This study contributes to the growing evidence that brief, family-focused preventive interventions can make a significant difference for youth who are at-risk for bipolar disorder.

What This Means for You

• Your children might benefit from support even before they develop symptoms. This study suggests that preventative family programs can reduce emotional dysregulation in children whose genetics put them at a higher risk. You don’t need to wait until your child is struggling to seek family-focused support, which helps the whole family become more resilient together. 
• Brief, structured programs may make a difference. Parents and kids might understandably balk at the idea of starting a new mental health therapy, imagining years of intensive work in front of them. With only four total sessions, the therapy in this study was designed with sensitivity to time-strapped families. The best part? This minimalist approach actually helped.
• But change still takes time. The four sessions were sufficient to benefit the kids, but the benefits didn’t appear immediately. The improvements weren’t visible at six months and only became clear at 12 months. This adds nuance to the findings, supporting the idea that a small amount of time with expert therapists is enough to send families on the right path, but integrating the skills can’t be fast-tracked. Learning new ways to work as a family is a process. Be patient with yourself and your kids.

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Bipolar Disorder Linked to More Severe COVID-19 Outcomes, Study Finds

When COVID-19 hit, experts quickly learned that certain medical conditions — like diabetes and heart disease — made the virus more dangerous. Increasingly, scientists understand that mental health conditions affect whole-body health just like other medical diagnoses. Does that mean certain mental health conditions increase your risk for severe COVID-19 outcomes, too? 

An Iranian research team set out to answer a crucial question: Do people with bipolar disorder and psychotic disorders fare worse when hospitalized with COVID-19? 

Their results, recently published in The Journal of Neuropsychiatry and Clinical Neuroscience, could help change the approach to COVID-19 care for people who live with bipolar disorder and psychotic disorders, potentially saving lives.

What the Research Says

Between April 2020 and October 2023, the research team examined medical records from more than 7,000 adults hospitalized with COVID-19 in three Iranian hospitals that provide free care to laborers, government employees, and their families. 

To get a clear picture of the impact of psychiatric disorders on COVID-19 outcomes, the research team decided to compare two groups of patients: Those with bipolar disorder, schizophrenia, or other psychotic disorders (896 people) and those without any diagnosed psychiatric condition (6,474 people). 

The research team used statistical analysis to uncover how the group with psychiatric conditions differed from the group without. Here’s what they found: 

• They had more underlying physical health issues. The group with psychiatric conditions also had higher rates of physical health conditions like diabetes, respiratory disease, and smoking than the group without. 
• Their COVID-19 symptoms looked different. COVID-19 seemed to affect the group with bipolar disorder, schizophrenia, and other psychotic disorders differently than the comparison group. Typical symptoms — like weakness, diarrhea, and headache — were less common. While more unusual symptoms — like vomiting and rash — were more the norm.
• They waited longer to seek help. People with psychiatric conditions waited about six days from their first symptoms to go to the emergency department, while people without came in around a day sooner. 
• They had higher inflammation levels. People with psychiatric conditions had higher blood levels of C-reactive protein (CRP), an inflammation marker. 
• They had higher ICU admission rates. About 44.5 percent of those with bipolar disorder, schizophrenia, and other psychotic disorders were admitted to the intensive care unit (ICU). In comparison, about 21.8 percent of their peers without a psychiatric diagnosis were admitted to the ICU. 
• They had higher mortality. Of the people with psychiatric conditions, 39.2 percent died in the hospital, compared with 23.8 percent of people without any mental health diagnosis.

Importantly, even after accounting for all of the other factors, having a bipolar or psychotic disorder remained a predictor of both COVID-19 severity and death, suggesting something about these conditions is an independent risk factor. 

It’s likely that there’s not a single reason that explains these worse outcomes. Instead, a perfect storm of many factors may be to blame, the researchers conclude, which future research can hopefully clarify.

Why It Matters

This study adds to the growing evidence that bipolar disorder is deeply connected to physical health. By uncovering the link between bipolar and psychotic disorders and worse COVID-19 outcomes, the findings and related results (including another recent study on long COVID and mental illness published in JAMA Network Open involving 1.6 million people) suggest that people with these conditions may need tailored strategies to stay safe from complications. 

What This Means for You

• You may be at higher risk for severe COVID-19. That’s not news anyone wants to hear, but it’s important information to have. Knowing you’re in a higher-risk category can empower you to take extra precautions, such as masking in high-risk situations and taking signs of infection seriously.
• Pay attention to unusual symptoms and seek care early. COVID-19 infection might look different for people who live with bipolar disorder, these results suggest. Perhaps because of that, people with psychiatric conditions in this study waited longer to seek care, which may have contributed to worse outcomes. If you notice any concerning symptoms — even if they seem atypical — don’t wait. Days matter.
• Manage your overall health. Although risk factors like smoking and diabetes did not explain all of the outcomes the research team found, they certainly contributed. That suggests that taking care of your physical health, including quitting smoking and managing your blood sugar, may be one way to protect yourself from severe illness. 

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Long-Term Use of Meds May Reduce Your Suicide Risk, Data Suggests

Deciding to stay on psychiatric medications long-term is a serious commitment. You’re taking on a daily obligation and potentially bothersome side effects. So you need a good reason to stick with a prescription plan. New research published in the Journal of Affective Disorders offers perhaps the most compelling reason of all for people living with bipolar disorder: These medications might save your life. 

What the Research Says

Psychiatric medications for bipolar disorder — including lithium, valproate (Depakote), and certain atypical antipsychotics (such as risperidone, quetiapine, and olanzapine) — are all approved for people with bipolar disorder because the evidence shows that they work to stabilize mood symptoms. 

But the question remains whether these medications help reduce the risk of one of the most serious complications of bipolar disorder: Suicide. 

Some research suggests that these medications (especially lithium) are protective, while other studies haven’t shown a substantial benefit. Korean researchers wanted clearer answers so that people who take these medications and those who prescribe them can better understand whether they help reduce the risk of suicide. 

The researchers designed a study that looked at people who only had bipolar disorder (other research sometimes lumped in people with bipolar disorder and people with major depressive disorder) over the long term. They analyzed health records from everyone in a national health database who had a diagnosis of bipolar disorder and had prescriptions for lithium, valproate, carbamazepine, or atypical antipsychotics over almost two decades. Drawing on a national population like this makes it less likely that concerns that pop up disproportionally for a particular group — like post-traumatic stress disorder in Veterans — will influence the results. 

The goal of the statistical analysis was to see if there was a link between medications and suicide incidents. 

When the research team compared different people — in all, more than 44,000 individuals’ records were analyzed — here’s what they found:

• Lithium alone reduced suicide risk by 39 percent.
• Valproate alone reduced risk by 26 percent.
• Atypical antipsychotics alone and combinations with lithium and valproate showed no significant reduction.

The researchers also analyzed the data using within-person analysis, which compares people with themselves at different points in time. Within-person analysis helps account for individual differences that might otherwise skew the results. The within-person analysis showed slightly different — but still encouraging — benefits: 

• Valproate alone reduced suicide risk by about 75 percent.
• Atypical antipsychotics and lithium together yielded around an 85 percent reduction.
• Atypical antipsychotics and valproate combined reduced the risk by about 70 percent.
• All three (lithium, valproate, and antipsychotics) cut the risk by about 76 percent.

Why was lithium helpful in the between-person analysis and not the within-person analysis? And why were medication combinations not as helpful in the within-person analysis? It could be that there’s something different about people who tend to get certain prescriptions, like that they are experiencing more or less severe bipolar disorder symptoms. 

Despite the lingering questions, one overall finding tells a clear story: Fifty-six percent of all suicide incidents occurred during periods when people weren’t taking any of these medications. This suggests that taking medications long-term can reduce the risk of suicide. 

Why It Matters

Multiple medications — individually and in combination — likely reduce the risk of suicide. Conversely, not taking any psychiatric medications is linked to an increased risk, according to the results of this study.

What This Means for You

• Psychiatric medications protect against suicide risk. The particular benefits of each psychiatric medication varied depending on the analyses. But one overall message is clear: Lithium, valproate, and atypical antipsychotics all can reduce suicide risk.
• Not taking any ongoing medications is risky. More than half of suicide incidents in this study happened when people weren’t taking any of the medications analyzed. Whatever medication regimen works for you, maintaining it consistently likely offers protection from suicide.
• The best medication for preventing suicide is personal. While lithium has the longest track record for suicide prevention, the best medication is one that effectively manages your symptoms, has tolerable side effects, and sustainably fits into your life. These results suggest that several approaches can be protective. What matters most is finding what works and sticking with it. 

If you or a loved one is experiencing significant distress or having thoughts about suicide and need support, call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24/7. If you need immediate help, call 911.

Editorial Sources and Fact-Checking

• Nabi Z et al. Effects of Lithium on Suicide and Suicidal Behaviour: A Systematic Review and Meta-Analysis of Randomised Trials. Epidemiology and Psychiatric Sciences. September 16, 2022. 
• Koning E et al. Characterizing Eating Behavioral Phenotypes in Mood Disorders: A Narrative Review. Psychological Medicine. August 25, 2022. 
• Gardea-Resendez M et al. Unhealthy Diet Quality as a Clinical Phenotype in Bipolar Disorder: A Potential Treatment Target for Improved Mood and Metabolic Outcomes. Journal of Affective Disorders. November 14, 2025. 
• Firth J et al. A Meta-Review of “Lifestyle Psychiatry”: The Role of Exercise, Smoking, Diet and Sleep in the Prevention and Treatment of Mental Disorders. World Psychiatry. September 15, 2020.
• Nagata R et al. Development of an Essential Information Set for Supporting Life With Bipolar Disorder: A Modified Delphi Study With Patients, Families, and Healthcare Professionals. Health Expectations. October 22, 2025. 
• Fongaro E et al. Changes in Emotional Dysregulation Profile Among Offspring of Parents With Bipolar Disorder: A Family-Based Intervention Pilot Study. International Journal of Bipolar Disorders. November 3, 2025.
• Sharafkhah M et al. Influence of Preexisting Psychotic and Bipolar Disorders on the Outcomes of Acutely Hospitalized Patients With COVID-19. The Journal of Neuropsychiatry and Clinical Neuroscience. September 19, 2025. 
• Vekaria V et al. Schizophrenia, Bipolar, or Major Depressive Disorder and Postacute Sequelae of COVID-19. JAMA Network Open. October 29. 2025. 
• Park SA et al. Long-Term Treatment With Lithium, Valproate, and Atypical Antipsychotics on Suicide Risk in Patients With Bipolar Disorder: A Nationwide Retrospective Cohort Study. Journal of Affective Disorders. January 1, 2026. 
• Smith KA et al. Lithium and Suicide in Mood Disorders: Updated Meta-Review of the Scientific Literature. Bipolar Disorders. September 12, 2017.