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Fig. 2 | International Journal of Bipolar Disorders

Fig. 2

From: Resilience concepts in psychiatry demonstrated with bipolar disorder

Fig. 2

Ball-in-cup heuristic in the context of bipolar disorder. a Individual with bipolar vulnerability (symbolized with the shallow cup). Stressful life events trigger the chronic, incurable disorder (symbolized with the ball rolling from the healthy into a new (diseased) regime once a stress threshold has been passed). b Bipolar individual receiving healthcare (medication, therapy). Clinical intervention does not restore the regime prior to the outbreak of the disorder (no recovery). Instead, it ameliorates symptoms and increases personal and interpersonal functioning of the patient within the diseased regime (full arrow). Discontinuing clinical treatment (dotted arrow) eventually restores the full symptomatology. c Engineering resilience subsumed within ecological resilience: shown are stress-recovery patterns related to episodes of (hypo)mania and depression in the diseased regime. d Individual without bipolar vulnerability (i.e., in a healthy regime) recovering from adverse situations (stress). The lack of vulnerability is also symbolized by the absence of a diseased regime (gray dotted cup). Note that similar to persons without disposition to bipolar disorder, stress–response dynamics also occur in the healthy regime of patients with bipolar disorder (not shown in the figure)

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