Your Personality May Be the Key to Predicting Bipolar Disorder

Bipolar disorder is a serious, long-term mental health condition with a high risk of relapse. Personality traits, especially when combined (such as personality styles), can help predict how the illness will progress. People with certain personality styles are more likely to develop symptoms such as depression, while other personality styles may be protective. Understanding these styles can help doctors plan more effective and personalized treatments, improving the lives of people with bipolar disorder.

Bipolar disorder is a very serious and long-lasting mental health condition that affects people’s moods, causing them to experience episodes of depression and mania. It is one of the leading causes of disability worldwide. Many people with the condition end up having relapses, meaning their symptoms return even after treatment.

It is estimated that around 73% of people will have a relapse within five years, and half of those will have multiple relapses. Other studies suggest even higher numbers, reaching 90%. Furthermore, the course of the disease is often unpredictable, which makes treatment planning very difficult and compromises people’s social and emotional functioning, causing lasting harm to their lives.

Therefore, better understanding what can predict the progression of the disease and which treatments are most effective is essential to improving patients’ lives.

One avenue that scientists have explored is investigating whether certain personality traits can help us predict how bipolar disorder will progress in each person.

Rather than analyzing each trait in isolation, some researchers propose a more integrated approach, which looks at the combination of these traits, that is, the person’s personality style. This can provide a more complete and effective view of the person’s symptoms and functioning over time.

A person’s personality can be understood using a model called the Five-Factor Model (or FFM), which divides personality into five major dimensions: neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness.

Each of these dimensions is made up of more specific characteristics. For example, neuroticism is related to the tendency to experience negative emotions such as anxiety and sadness frequently. Extraversion, on the other hand, is linked to how sociable and energetic a person is. Openness is associated with curiosity and creativity; agreeableness reflects how kind and cooperative a person is; and conscientiousness measures how organized, responsible, and disciplined a person is. Of these traits, neuroticism is the one most strongly linked to bipolar disorder.

People with this disorder generally have higher levels of neuroticism, which means they are more likely to feel distressed and emotionally unstable. This trait has been shown to be relatively stable over time, even among people with bipolar disorder. This suggests that it may be a reliable marker of the disease.

A large study has found a common pattern among people with bipolar disorder: they tend to be high in neuroticism and openness, and low in extraversion, agreeableness, and conscientiousness. These traits may be useful in predicting how the illness will progress and in developing more effective therapeutic interventions.

Many studies to date have looked at each personality trait in isolation, but traits do not work alone. They interact with each other and together form personality styles. This means that the combination of two or more traits can uniquely influence a person’s behavior and mental health.

For example, someone who is high in neuroticism may be at higher risk of depression, but if that person is also high in conscientiousness (i.e., very organized and disciplined), that risk may be reduced. On the other hand, if they are low in conscientiousness, that risk may be even higher.

These combined personality styles have been studied for some time. One example is the style called “Hypersensitive,” which combines high neuroticism with high openness; this combination has been linked to a higher risk of depression.

The “Relaxed” personality style, which combines low neuroticism with high agreeableness, appears to protect against depression. Another important finding is that people with low conscientiousness combined with low extroversion or agreeableness are also at greater risk of developing depressive symptoms.

This shows that looking at combinations of traits (and not just individual traits) can give us important clues about the development of mental disorders.

This idea of ​​personality styles has also been used in other areas of health, such as in research on the progression of HIV. In one study, it was observed that men with HIV who had certain personality styles, such as being extroverted, open to new experiences and emotionally stable, had a slower progression of the disease.

This reinforces the idea that personality influences not only mental health, but also physical health. Interestingly, personality styles seem to work better together than separately: the qualities of one trait can reinforce or mitigate the effects of another.

In addition to predicting risk, personality styles can also help to personalize treatments. For example, in patients with dementia, when activities were adapted to their personality styles, the results were better: they were more engaged, happier and had fewer symptoms. This shows that knowing one’s personality style can make care more effective.

Despite this, it is still not known for sure how these styles affect the course of bipolar disorder over many years. To try to answer this question, researchers from the University of Michigan, USA, studied two large samples of people with bipolar disorder: one with 489 individuals and another with more than 2,000.

They followed these people for up to 14 years and assessed how personality styles influenced the occurrence of depressive episodes and the person’s general functioning.

They found that the more risk styles a person had (i.e., combinations of traits linked to poor outcomes), the more likely they were to experience depression or difficulties in daily life. Each additional risk style increased rates of depression by about 12% to 15% and functioning problems by about 11%.

These results were confirmed in both study groups, showing that the patterns repeat themselves. This research reinforces the importance of looking at personality styles as a clinical tool.

They can help health professionals identify early on who is most likely to have difficulties, allowing for earlier and more personalized interventions. Including personality style assessment in long-term care planning can greatly improve treatment and quality of life for people with bipolar disorder.

READ MORE:

Predictive evidence for the impact of personality styles on depression and functioning in two bipolar disorder cohorts

Kelly A. Ryan, Anastasia K. Yocum, Yuhua Zhang, Peisong Han, David F. Marshall, Paul T. Costa, Sarah H. Sperry, Takakuni Suzuki, Melvin G. McInnis, and Sebastian Zöllner 

Journal of Affective Disorders. Volume 380, 1 July 2025, Pages 746-755

https://doi.org/10.1016/j.jad.2025.03.131

Abstract:

Predictors for course of illness in bipolar disorder (BD) with replicable effect are difficult to identify. Potential predictors of outcomes for BD that could inform practice include personality traits, particularly Neuroticism. However, models typically fail to consider the joint effect of multiple personality traits. We examine whether personality trait combinations (styles) enhance our ability to prospectively predict symptoms and functioning across time in two independent longitudinal research cohorts. In a discovery sample of 489 and replication sample of 2072 individuals with BD, we assessed impact of personality styles using the NEO PI-R and NEO-FFI on depression and functioning up to 14 years. Using a model considering all ten possible personality style combinations, the number of risk-related personality styles (styles associated with poor outcomes) relative to number of protective-related personality styles (styles associated with better outcomes) showed that for every additional risk relative to protective style count, the incident rate of depression increased by 11.8–15.0 % and the incident rate for poor life functioning increased by 11.1 %. This similar pattern of increased risk styles being associated with significant increases in depression and functioning was replicated in the independent STEP-BD dataset, although with slightly lower incident rate (5 % and 2.9 %). Cross validation of performance from both cohorts showed similar predictive patterns (5–11.2 % increases). The ability to predict future depression and poor functioning from the combined effects of personality traits can be clinically useful for identifying individuals at risk for poorer outcomes. Personality styles should be evaluated when planning long-term care and developing interventions.