When trying is not enough: emotion regulation and the effort-success gap in bipolar disorder.

Bipolar disorder (BD) is presumed to involve difficulties in emotion regulation. Little is known, however, about the specific emotion regulation profile associated with this disorder. The present study examined the use of specific emotion regulation strategies among individuals with BD (n = 37) and healthy controls (n = 38). Participants' spontaneous use of reappraisal and suppression, as well as their associated effort and success at regulating their emotions, was measured in the context of three emotionally evocative films (neutral, happy, sad). Results indicated that the BD participants made greater use of spontaneous suppression and reappraisal across all films compared to the control group. BD participants also reported greater effort, but less success, when spontaneously regulating emotions. These findings suggest that bipolar disorder is associated with less success when regulating emotions despite a widespread engagement of regulatory efforts. Discussion focuses on the disjunction between troubled emotion functioning in bipolar disorder and sustained efforts to modify intense emotions.