Bipolar disorder (BD) is a chronic and recurrent mood disorder characterized by alternating episodes of mania, depression, or mixed states, interspersed with periods of remission. These episodes can severely impair interpersonal relationships, occupational functioning, and overall quality of life. In 2019, approximately 40 million people worldwide were diagnosed with BD.
BD is a lifelong chronic condition despite pharmacotherapy and lifestyle changes. Traditional psychiatric care has primarily focused on symptom reduction and relapse prevention, often overlooking broader psychosocial aspects such as interpersonal functioning and life satisfaction. Recently, recovery has come to include living a meaningful life despite illness-related challenges.
Psychological resilience has gained prominence within this recovery framework. It refers to the capacity to adapt positively to adversity, shaped by both internal traits and external supports. Core elements include effective coping, adaptability, and recovery from stress, which support functional outcomes in mental illness.
Given the strong link between stress and relapse in BD, resilience is thought to play a critical role in illness trajectory. Research consistently shows that individuals with BD have lower resilience than healthy controls, and resilience is associated with fewer depressive symptoms and better quality of life.
Importantly, resilience is modifiable and can be enhanced through psychosocial interventions. Studies highlight the benefits of resilience-building programs in reducing depressive vulnerability and improving life satisfaction and emotion regulation. Among these, CBT effectively promotes cognitive and functional recovery in BD by targeting maladaptive thought patterns and building adaptive coping skills.
Despite growing evidence, few CBT-based interventions target resilience in individuals with BD. However, resilience is linked to key psychosocial competencies such as problem-solving, self-efficacy, assertiveness, and self-management. Based on this, the current study implemented a CBT-based Psychological Resilience Enhancement Program designed to strengthen adaptive coping and functional adjustment in individuals with BD.
Considering the substantial personal and societal burden of BD, enhancing psychological resilience is a critical therapeutic goal. This study aimed to evaluate the effects of a CBT-based intervention on psychological resilience and quality of life in individuals with BD.
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A randomized controlled trial with a pretest-posttest-follow-up design was conducted between May 2021 and April 2023. Twenty-two participants were randomly assigned to an intervention group (n = 10), which completed an eight-week CBT-based resilience program, or a control group (n = 12), which received standard care. Psychological resilience and quality of life were assessed at baseline, post-intervention (week 9), and follow-up (week 21) using the Connor-Davidson Resilience Scale (CD-RISC) and the Brief Quality of Life in Bipolar Disorder Scale (Brief QoL.BD).
The control group simply continued treatment. In Türkiye, standard treatment consists of medication use, prescriptions every three to six months, and outpatient check-ups for laboratory tests such as drug levels. In the study, however, patients in the control group were interviewed, their questions about their illness and treatment were answered, and their general condition was assessed. Treatment adherence levels were determined based on their remission status. It consists of a total of 12 individuals with bipolar disorders
The intervention is based on the assumption that individuals with high psychological resilience cope better with psychosocial stressors, return to normal life more quickly after stressful events, adapt more easily to new situations, and can continue their lives even under difficult circumstances. An individual diagnosed with bipolar disorder who increases their psychological resilience will both prevent the triggering of attacks and gain skills to manage the symptoms of the illness. The program was designed focusing on areas emphasized in resilience theory, which can be developed and modified through education and life experience, and which also fall within the scope of cognitive behavioral therapy. These are internal locus of control, self-management, cognitive evaluation, social skills, social support, positive mood, stress management, and problem-solving skills. The intervention was each targeting specific therapeutic goals using relevant CBT techniques in 8weekly
Sivas, Sivas 58000, Turkey (Türkiye)
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