New studies spotlight a sweat-based lithium monitor, how mood stabilizers affect thinking, and first-of-its-kind research on perinatal mood in fathers living with bipolar.
In the thousands of years since physicians first documented cases of bipolar disorder, understanding about the condition has come a long way. But new technologies and ideas are unleashing possibilities that scientists can only now explore for the first time.
Here are five recent studies — on smart patches for monitoring lithium levels, mood stabilizers and brain fog, peripartum mood episodes in fathers, an app that analyzes speech to track mood, and psychiatric advance directives — that harness the latest thinking and help push bipolar management into the future.
New Wearable Sensor Could Painlessly Track Lithium at Home
Key Takeaways
- A new smart patch may let you check lithium levels with a quick, painless sweat test instead of blood draws.
- Early results show the patch’s readings closely match standard lab sensors, even at low levels.
- Continuous, at-home checks could help catch highs or lows sooner, supporting safer, steadier treatment.
- The patch is still experimental and needs larger studies before it’s ready for everyday use.
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Need to check your lithium levels? There’s an app for that — and a wearable. No needles required.
A new scientific paper published in the journal Device details an innovative smart patch — printed using technology similar to that used for making novelty toys and household decorations — that can track your lithium levels on the go using only sweat.
What the Research Says
Lithium is one of the best medications so far for bipolar disorder. But if you’re among the one in four people living with bipolar who take lithium, according to estimates from a recent study of lithium use in a large healthcare system, you already know that it’s not a simple medication to be on.
If your lithium level is too low, it won’t help. But if it’s too high, it could hurt, leading to vomiting, tremors, and other symptoms of neurotoxicity. This means everyone who takes lithium has to have their levels monitored regularly, usually every week or two when you start, and then every few months once your dose is set.
Since many factors — including weight and diet — can affect your lithium levels, you’ll probably need additional monitoring at other times. At a minimum, this means periodically disrupting your day to get blood draws. At its worst, you might drive hours to reach a lab or not be able to start this gold-standard medication at all.
A research team from the University of Southern California in Los Angeles wondered if new printing technology could be used to create an innovative type of lithium monitor, one that you could use anywhere, at any time.
The research team knew that blood isn’t the only biological fluid that’s suitable for measuring lithium. The level of lithium in your sweat, for example, seems to work, too, according to one related study.
So they decided to print a patch that can read the lithium levels in your sweat. Here’s how it works:
- You stick the patch on your forearm, like you would a bandage.
- You use a special app on your smartphone to tell the patch to heat up, producing a tiny amount of sweat.
- Within minutes, the smart patch measures the lithium concentration in your sweat and sends the results back to the app.
The smart patch’s lithium readings corresponded to those from an expensive, commercially available lithium sensor. The results suggest that the lithium smart patch was accurate for detecting even low levels, noting small changes, and wasn’t thrown off by other similar salts.
The results are encouraging, but the lithium smart patches aren’t ready for prime time yet. In this study, the research team tested the lithium smart patches on six people (three with bipolar disorder, three without). Before the lithium smart patch is ready for a broader rollout, it would need to be tested on more people.
Why It Matters
This lithium smart patch is the first of its kind. Because it uses sweat, it’s noninvasive and pain-free. And since it’s produced using advanced inkjet and 3D printers, it can be made and used virtually anywhere at a lower price point than most other medical devices. Having a way to continuously monitor lithium levels means easier optimization, translating to increased stability for the millions of people living with bipolar disorder who may benefit from the medication.
What This Means for You
- Lithium monitoring could get a whole lot simpler someday soon. The lithium smart patch is like a cross between a continuous glucose monitor and a fitness tracker. It enables quick, convenient, and painless lithium monitoring, a complete 180 from how things stand today.
- Optimizing lithium levels means optimizing bipolar treatment. Lithium is an important medication for treating bipolar, but it can be difficult to get the dose right. The lithium smart patch could alert you right away if your lithium levels are too high, allowing for quick correction that avoids the dangers of lithium toxicity. Likewise, if your levels are too low, your prescriber could increase your dose, ensuring you get the full benefits of the medication.
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How Mood Stabilizers Impact Brain Fog and Cognitive Function
Key Takeaways
- Research suggests that for most adults, mood stabilizers don’t worsen brain fog or overall thinking.
- Everyone’s response can differ, but any cognitive side effects are usually mild, and careful dosing helps keep risk low.
- Thinking problems are much more likely linked to bipolar disorder itself, so treatment shouldn’t be avoided out of fear of mental fog.
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When you decide whether to take a new medication for bipolar disorder, it’s important to weigh the risks and benefits so you can understand the tradeoffs you’re making.
Take brain fog. It’s a common symptom in bipolar, but it’s one that pharmaceutical treatments don’t typically target. But how does taking medications like mood stabilizers impact your ability to think? Is worse cognitive function a side effect? Or could these medications actually help?
A new analysis of studies published in the Journal of Affective Disorders examined the evidence.
What the Research Says
Brain fog and bipolar disorder — the two, unfortunately, go hand in hand for many. Bipolar disorder itself seems to cause difficulty with executive functioning. But so can some of the medications that help treat it.
For example, lithium, a mood stabilizer, has also been reported to cause problems with thinking and memory in some people, per StatPearls. But the picture isn’t crystal clear. A review of the research suggests that lithium may affect some aspects of cognition and not others.
What does the science say about how lithium and other mood stabilizers impact thinking in people living with bipolar disorder?
Researchers in China decided to find the best answer they could. To do this, they set out to analyze all the randomized controlled trials (RCTs) they could find on the topic.
They opted to examine RCTs because they’re the best tool scientists have for understanding the effects of a medication. Thanks to RCTs’ design, which uses random assignment and comparison groups, the chance that any measured effects are caused by other factors is reduced, making it more likely that the treatments are responsible.
Compiling multiple RCTs magnifies their benefits, resulting in reliable evidence about whether one thing causes another, in this case, whether mood stabilizers cause cognitive changes in people living with bipolar disorder.
The researchers found nine RCTs that fit the bill. The 570 participants in the RCTs hadn’t taken any antipsychotic or antidepressants recently, but had taken at least one of five mood stabilizers: lithium, valproate (Depakote), carbamazepine (Tegretol), lamotrigine (Lamictal XR), and topiramate (Topamax). They also completed tests measuring their thinking before and after taking these medications.
When the researchers pooled the data from the RCTs, they were able to use statistics to measure the effects of mood stabilizers on distinct aspects of cognition. They discovered:
- Mood stabilizers helped adolescents living with bipolar disorder recognize emotions more accurately, although it took a bit longer.
- Mood stabilizers didn’t impact other types of cognition — attention and working memory in teens, and overall cognitive functioning in adults, all stayed about the same before and after getting on mood stabilizer medication.
- Lithium, which was analyzed separately, didn’t impact attention in adolescents or overall cognitive functioning in adults.
Future studies are needed to drill down on these findings. It could be that certain mood stabilizers impact your thinking more than others. It’s also possible that details particular to you — like your age or mood state — influence how these medications affect you.
Why It Matters
Understanding whether cognitive changes linked with bipolar disorder stem from the condition itself, its treatments, or other factors could lead to better ways to help you manage these challenging symptoms.
What This Means for You
- Mood stabilizers don’t appear to be the cause of bipolar brain fog. While mood stabilizers made the teens in the studies a bit slower to react to emotional content, their accuracy in identifying emotions greatly improved. The data didn’t show an impact in other thinking domains for teens, and adults didn’t exhibit any meaningful changes in cognition at all. This suggests that bipolar disorder itself could be the culprit of any cognitive symptoms you notice while on mood stabilizers.
- Worries about worsening brain fog shouldn’t stop you from trying the mood stabilizers your prescriber recommends. These results suggest problems with thinking aren’t a likely side effect of common mood stabilizers used to treat bipolar disorder.
- Whether they’re caused by mood stabilizers or not, thinking difficulties are still a problem for many living with bipolar disorder. These can be frustrating, but strategies like breaking down complex tasks, creating routines and structure that help you focus, and developing a reminder system can help you manage bipolar brain fog.
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Dads Have Peripartum Mood Episodes, Too
Key Takeaways
- Over one-third of dads with bipolar disorder have a mood episode during pregnancy or the baby’s first year, about half the rate seen in moms.
- For fathers, episodes most often begin during pregnancy and can be depressive or elevated in mood.
- Knowing the risk means dads can plan ahead — stay in treatment, track mood changes, and seek extra support to protect their family and themselves.
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According to one analysis of studies, more than half of mothers who live with bipolar disorder will experience a mood episode during the perinatal period, which extends from pregnancy up to one year after birth.
But what about fathers living with bipolar disorder?
Although they don’t give birth, dads also undergo a huge life transition when a new baby arrives, one that comes with enormous changes to lifestyle, sleep, and identity that could challenge anyone’s mood stability. A new study published in the Journal of Affective Disorders provided first-ever insights into how fathers who live with bipolar disorder fare during the perinatal period.
What the Research Says
Welcoming a new baby is a deeply meaningful experience that presents mental health challenges for parents. For example, while postpartum depression in mothers gets more press, research suggests that about 1 in 10 fathers also experience postpartum depression.
Researchers in England and Wales wondered whether there might be a similar trend when it comes to fathers living with bipolar disorder: Do fathers, like mothers, have an increased risk of perinatal mood episodes? How are they similar and how are they different?
To answer their questions, the research team asked fathers and mothers who were participating in a larger research study on bipolar disorder specific questions about their moods during the peripartum period. In all, they heard from almost 200 fathers (cisgender males of biological children who lived with the birthing parents and child) and nearly 600 mothers (cisgender females of biological children).
When they analyzed the data, here’s what the researchers learned:
- Peripartum mood episodes are common in fathers. In this study, more than 36 percent of fathers with bipolar disorder reported mood episodes during the peripartum period. This is about half the rate of mothers in the study, 73 percent of whom said they had a peripartum mood episode.
- The most typical time for mood episodes in dads is during pregnancy. About 42 percent of fathers said their mood episode started while their partner was pregnant, while about 25 percent said their episodes started between six weeks and six months, and around 21 percent said mood changes started within a week of the birth. This is a different pattern from the mothers with bipolar disorder who participated, where the first week of delivery was the most vulnerable time for mood episodes.
- Peripartum mood episodes look a bit different in dads than in moms. The type of peripartum mood episodes fathers experience is pretty evenly split between low (depressive episodes) and elevated (mania, mixed episodes, or psychosis) mood states. For mothers who experienced mood episodes peripartum, around 38 percent had depressive episodes, while about 60 percent had episodes of elevated mood. The researchers think the different balance could reflect the biological changes women undergo during pregnancy and postpartum.
Because this study is the first of its kind, more research — with a larger, more diverse group — is needed to understand how the perinatal period impacts mood in fathers who live with bipolar disorder.
Why It Matters
Having a perinatal mood episode can affect your ability to provide for the people who matter most to you during a critical time — and the impact can extend beyond your child’s early days. While research specific to perinatal bipolar disorder in fathers is lacking, related research suggests that poor perinatal mental health in fathers can hurt their children’s development for years to come. But knowing the risk can also help you reduce it by enacting a plan to prevent mood episodes.
What This Means for You
- Dads need help, too. With a growing baby and a partner preparing for and then recovering from birth, new fathers might feel like their needs should come last. But these results suggest that fathers living with bipolar have unique mental health concerns during this period that should also be prioritized. The family is strongest when all its members are at their best, dads included.
- If your partner is preparing for birth, add taking care of your mood to your getting-ready-for-baby checklist. Although it’s common to deal with mood episodes during your partner’s pregnancy and once your child is born, it’s not a guarantee, according to the results of this study. At times of increased risk, it’s smart to boost your support, too. Stay on top of your mental health by asking your doctors for help spotting any mood changes and ensuring you get the things you need for maximum mood stability. Caring for yourself is a strength.
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Pilot Study Tests App That Detects Mood Changes Using Speech
Key Takeaways
- A new app quietly records short voice clips to watch for mood shifts without extra effort.
- So far, it’s not as accurate as simply checking in with a mood survey.
- Using both voice analysis and surveys together gave the clearest picture of mood changes.
- It’s promising tech, but for now, you’ll still want to keep your regular mood tracker.
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When you live with bipolar disorder, mood tracking gives you insight into how you’re doing, and what steps you might need to take to support mood stability. Today, you’d need to use an app or a good-old-fashioned pen and paper for the job. For some, these systems work. But for others, they take too much effort.
Could there be another, easier way?
A new study published in the journal IEEE Transactions on Affective Computing explored how an algorithm that analyzes your speech could someday transform mood tracking for bipolar disorder.
What the Research Says
People with bipolar disorder often talk more and speak faster during manic episodes, which makes analyzing speech patterns a promising way to monitor mood changes and an active area of bipolar research.
Building on this knowledge, a research team based at the Heinz C. Prechter Bipolar Research Program at Michigan Medicine is developing a smartphone app that tracks your mood by analyzing your speech as you go about your regular day.
It works like this: Every 15 minutes, around the clock, the app records 30 seconds of audio. This all happens in the background, so your day isn’t interrupted. Wherever you are — with your kids, driving, at work, on a date — the app records your voice and analyzes it. (The app is trained to ignore anyone else you’re with.) Once the speech algorithm analyzes your voice, the recording is deleted.
The goal of the analysis? To measure your mood based on how your voice sounds. The analysis focuses on two aspects of mood: emotional valence (how positive or negative you sound) and emotional activation (how high or low energy you sound). A happy voice would score high in valence and activation, while a sad voice would score low on both.
In this pilot study, the research team wanted to test the new speech algorithm against two other established mood tracking methods: self-report surveys and clinical interviews. With the help of 16 volunteers (15 with bipolar 1 or 2 disorder and 1 person without a mental health diagnosis), they tried out all three methods for about 16 months:
- Speech Algorithm The smartphone app ran continuously in the background, requiring no effort from the participants.
- Self-Report Surveys In this method, people had to take a brief break from their day to share how they were feeling. Most weeks, that looked like just one set of surveys rating their moods. But, for one week each month, they filled out several surveys each day.
- Clinical Phone Interviews The same week that people filled out extra surveys, they also spoke to a clinician who asked them about their bipolar symptoms.
The researchers could use the emotion scores from each source to see the participants’ typical mood state, how much it changed, how stable it was, and whether there were any sudden shifts.
But what they really wanted to know was how closely the mood tracking based on the speech algorithm and self-report surveys matched the clinical interviews. Here are highlights of what the research team found:
- Both the speech algorithm and the self-report surveys tracked the clinician’s impression. To some degree, each mood tracking method aligned with what the expert observed.
- But the self-report surveys and speech algorithms didn’t match each other. This suggests the two capture different aspects of emotion.
- Self-report surveys were more accurate than the speech algorithm. If you wanted to pick just one method for tracking bipolar depression and mania symptoms right now, you’d want to go with the self-report surveys that are already in common use.
- Using the speech algorithm and self-report surveys together matched the clinician’s impression best. If you wanted the most precise mood tracking method of all, you’d combine the speech algorithm and surveys.
The researchers say they plan to continue this research so that someday the speech algorithm better matches how someone would rate their own emotions without them having to fill out a survey.
Why It Matters
Effectively managing bipolar disorder means staying on top of mood changes. Traditional mood tracking helps, but it’s time-consuming, and spotting patterns can be tricky. Apps that analyze your voice offer a new approach and the results of this pilot trial are encouraging. With further research, apps like this one could potentially lead to more reliable and effortless mood monitoring, which could, in turn, improve your care.
What This Means for You
- Apps that analyze your speech may capture emotional information that self-report surveys miss. It makes sense that how you’d describe your own emotions might differ from what an outside observer (or algorithm) could detect in your voice. The results suggest that combining both approaches — using self-report surveys and speech analysis — could make mood monitoring more accurate.
- But speech algorithms can’t yet replace existing mood tracking tools. The speech algorithm in this study was able to estimate emotions, which is an exciting development in the quest to improve mood monitoring for people living with bipolar disorder. But it’s not yet able to replicate the accuracy of self-report surveys or clinical interviews, the results suggest. The upshot? While this line of research is one to follow, it’s too soon to toss out your current daily mood tracker.
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Psychiatric Advance Directives Not Used Enough, Study Finds
Key Takeaways
- A Psychiatric Advance Directive (PAD) records your treatment wishes so they’re followed if a crisis makes self-advocacy hard.
- A Texas hospital study found zero PADs among 13,000-plus patients with mental health diagnoses.
- Free guides and forms make it simple to create and update your own PAD.
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With Psychiatric Advance Directives (PADs), you document your preferences for your care during a future mental health crisis. You make PADs when you’re feeling well and thinking clearly, so that at times when you’re not able to advocate for yourself, your wishes can still be honored. They’re a good idea for anyone who has a serious psychiatric illness like bipolar disorder.
But how often are they actually used?
A new study published in Psychiatric Research and Clinical Practice revealed a startling answer for one large Texas hospital, suggesting that far too few people use this powerful legal document.
What the Research Says
Before diving into this study, some background: PADs are legal documents that become part of your medical record. If you have a mental health emergency and a PAD on file, your healthcare team will use your PAD to help them decide how to treat you.
Many countries and about half of U.S. states have special laws permitting PADs. But medical advance directives are allowed in all U.S. states. So even if you live somewhere without special PAD-related laws, you can still make one as part of your medical advance directive, per the American Psychiatric Association (APA).
PADs are special because they are mental health-focused. They formally document how you would like to be cared for in a psychiatric crisis. According to the APA, your PAD might include:
- Who you trust to make treatment decisions on your behalf
- Who should be told if you are in crisis
- Where you want to receive treatment
- Which mental health providers you want to help make decisions about your treatment
- What treatments you want — and which you don’t
When you have a PAD, you’re more likely to have a positive treatment experience during a vulnerable time. PADs can help you work together with your care team, avoid unwanted interventions, and feel better about your care, according to the National Alliance on Mental Illness (NAMI). Because of these and other advantages, NAMI encourages PADs for people living with mental health conditions.
How frequently are PADs used? A research team in Dallas set out to answer the question for one large county hospital.
The research team combed over the electronic medical records of everyone who had been admitted to the hospital for any reason in one year — 41,000-plus people. About 33 percent of these individuals (13,653 people) had a mental health diagnosis in their chart. More than 3 percent (455 people) were diagnosed with bipolar disorder or schizophrenia.
In theory, anyone with a mental health diagnosis could benefit from recording their wishes for care in case they faced a mental health emergency in the future. But that’s especially true for serious psychiatric illnesses like bipolar disorder and schizophrenia, since episodes where you’re not able to advocate for yourself are more common.
So how many PADs did the research team find?
Not a single one.
You could download a customizable PAD right on the hospital’s website, so why weren’t more people using this valuable document?
The researchers concluded that the hospital needs to make PADs a regular part of care when people visit for mental health conditions. To make this happen, the hospital would have to make some behind-the-scenes changes to its systems. It would also need to do more to reach out to people with mental health diagnoses — especially individuals living with bipolar disorder and schizophrenia — to share how having a PAD can help you get better care during a crisis.
Why It Matters
While this study looked at just one large hospital, its findings fit into a bigger pattern of PAD underuse and are a wake-up call that more needs to be done to help connect PADs with the people who can most benefit from them. PADs let you have a say in your mental health care even when your symptoms make it difficult for you to self-advocate, like during a psychiatric hospitalization.
What This Means for You
- Learn about PADs. The go-to authority on PADs is the nonprofit National Resource Center on Psychiatric Advance Directives (NRC-PAD). Its website offers tons of resources to help you understand how PADs work in your state and how you can create your own. You’ll even find easy-to-follow videos to guide you on your path. If a downloadable guide is more your speed, check out the one from the Substance Abuse and Mental Health Services Administration (SAMHSA).
- Consider making a PAD to get back control during a crisis. You can find a downloadable PAD from the Depression and Bipolar Support Alliance. This form is a starting point — you’ll need to work with a professional (like a lawyer, paralegal, or advocate) to make your document legally official.
- Keep your PAD up to date as your needs change. Living with bipolar disorder is an ongoing journey, and your treatment preferences may shift over time. Once you have a PAD, regularly review and update it to make sure it still reflects your current wishes about medications, who should be involved in your care, and other preferences. Think of it as a living document that grows with you.
Editorial Sources and Fact-Checking
- Islam MS et al. Wearable Organic-Electrochemical-Transistor-Based Lithium Sensor for Precision Mental Health. Device. July 18, 2025.
- Steger C et al. Trends and Determinants of Prescription of Lithium and Antidepressants for Bipolar Disorder in a Large Health Care System Between 2017 and 2022. Journal of Affective Disorders. July 15, 2025.
- Lin S et al. Non-Invasive Touch-Based Lithium Monitoring Using an Organohydrogel-Based Sensing Interface. Advanced Materials Technologies. April 22, 2023.
- Qi C et al. Effect of Mood Stabilizers on Cognition in Bipolar Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Affective Disorders. December 15, 2025.
- Chokhawala K et al. Lithium. StatPearls. January 15, 2024.
- Paterson A et al. Lithium and Cognition in Those With Bipolar Disorder. International Clinical Psychopharmacology. March 2017.
- Provost EM et al. Emotion Recognition in the Real World: Passively Collecting and Estimating Emotions From Natural Speech Data of Individuals With Bipolar Disorder. IEEE Transactions on Affective Computing. January–March 2025.
- Huang KY et al. Detecting Unipolar and Bipolar Depressive Disorders From Elicited Speech Responses Using Latent Affective Structure Model. IEEE Transactions on Affective Computing. July–September 2020.
- Ulbricht CM et al. Prevalence of Bipolar Disorder in Perinatal Women: A Systematic Review and Meta-Analysis. The Journal of Clinical Psychiatry. July 13, 2022.
- Brooks R et al. Perinatal Mood Episodes in Fathers With Bipolar Disorder. Journal of Affective Disorders. December 1, 2025.
- Rao W et al. Prevalence of Prenatal and Postpartum Depression in Fathers: A Comprehensive Meta-analysis of Observational Surveys. Journal of Affective Disorders. February 15, 2020.
- Le Bas G et al. Paternal Perinatal Depression, Anxiety, and Stress and Child Development: A Systematic Review and Meta-Analysis. JAMA Pediatrics. June 16, 2025.
- Mathesh V et al. Psychiatric Advance Directives: An Analysis of Current Usage at a Large County Hospital. Psychiatric Research and Clinical Practice. July 7, 2025.
- Psychiatric Advance Directives. American Psychiatric Association.
- Psychiatric Advance Directives (PAD). National Alliance on Mental Illness. December 3, 2020.
- Videos. National Resource Center on Psychiatric Advance Directives.
- A Practical Guide to Psychiatric Advance Directives. Substance Abuse and Mental Health Services Administration.
- Advance Directive for Mental Health Treatment. Depression and Bipolar Support Alliance. October 2019.