This project investigated the
influence of sub-threshold depressive
symptoms in combination with early
onset substance use on the subsequent development of mental health problems in young people.
Possibly, mania is a more purely biologically driven phenomenon than bipolar depression, with
onsets more readily attributable to medication inconsistency, sleep deprivation, circadian disruption, or behavioral activation.21,22,84 - 86 In contrast, social and familial support has been found to protect against depression in bipolar and unipolar affective disorders, but the role of these variables in manic recurrences is unclear.86 - 88 An analysis of laboratory interactional data from a subset of 44 families in this sample revealed that treatment - related improvements in family communication skills were more closely associated with reductions in patients» depressive than manic
symptoms.56 Thus, manic and depressive
symptoms may be
influenced by different constellations of risk and protective factors.