Imagine if treating bipolar disorder could be as personalized as cancer care—tailored not just to symptoms, but to the core traits of who a person is. New research from the University of Michigan suggests that personality testing might unlock that future, helping clinicians better predict who is at greater risk of depression and life struggles—and who is more likely to thrive.
Key Points at a Glance
- Researchers identified personality styles that predict risk of depression and life difficulties in people with bipolar disorder.
- The balance between protective and risk-increasing traits is key to predicting outcomes.
- Personality traits are not fixed and may be modifiable through therapy and self-awareness.
- Findings were validated in two large cohorts, enhancing clinical confidence in the model.
- Study opens the door to more personalized, data-informed mental health care.
While medical care for physical diseases like cancer or heart disease has become highly personalized—driven by genetics, biomarkers, and data—mental health care still largely relies on a one-size-fits-all approach. But a new study led by researchers from the University of Michigan’s Heinz C. Prechter Bipolar Research Program could help change that. The key? A deep look into personality.
Published in the Journal of Affective Disorders, the study shows that certain combinations of personality traits—or “personality styles”—can help predict how people with bipolar disorder will fare over time. It’s not just about traits in isolation, but how they interact within each individual, providing a roadmap that clinicians could use to tailor support and interventions.
Lead author Dr. Kelly Ryan, a neuropsychologist and professor of psychiatry, believes these findings mark a promising shift. “We don’t yet know exactly why some patients are more resilient to depressive episodes, but we now have evidence that personality may play a role,” she says. “With this knowledge, we could eventually personalize treatment based on individual risk profiles.”
The study draws on data from over 2,500 people with bipolar disorder, including detailed personality tests and long-term tracking of depressive episodes and life functioning. Specifically, researchers used two well-established tools: the 240-item NEO Personality Inventory-Revised (NEO PI-R) and the shorter NEO Five-Factor Inventory (NEO-FFI).
By analyzing personality scores across traits like neuroticism, openness, conscientiousness, extraversion, and agreeableness, the team identified 30 distinct personality styles. Some of these were clearly linked to better outcomes—fewer depressive episodes and improved daily functioning—while others predicted greater challenges.
Unsurprisingly, high neuroticism—characterized by emotional instability and negative thinking—was consistently associated with worse outcomes. But that was only part of the story. Protective styles often involved low neuroticism paired with traits like openness or conscientiousness, offering a kind of psychological buffer.
What makes this model especially promising is its replicability. When tested on a second, larger group of patients from the STEP-BD trial, many of the same personality patterns held true. This cross-validation strengthens the case for using personality assessments as predictive tools in clinical practice.
Even more compelling: personality traits, once thought to be immutable, are now considered changeable. That means therapy or even guided self-awareness could help patients shift toward more protective personality styles. For instance, someone low in openness might benefit from activities that stretch their comfort zone, such as trying new creative or nature-based experiences.
The model could ultimately inform everything from early interventions to long-term care strategies. By identifying patients at greater risk of poor outcomes, clinicians could target them with more intensive support—or focus on developing traits that build resilience.
Dr. Ryan envisions a future where personality-based insights are just one part of a broader, data-driven mental health toolkit. “Understanding a person’s psychological makeup could help us move from reactive care to preventive and proactive support,” she notes.
Funded by the Heinz C. Prechter Bipolar Research Fund and the Richard Tam Foundation, the study also benefits from the legacy of psychologist Paul T. Costa, co-developer of the personality tests used. With mental health care long overdue for a precision medicine revolution, this research may be the push it needs.
