Bipolar depression presents treatment challenges. Even with
pharmacological stabilizationof bipolar symptoms,upto60%
of individuals experience recurrence of bipolar depression
within 2 years (Miklowitz, 2008). Adverse effects of lithium,
anticonvulsants, and antipsychotics contribute to illness
burden, comorbidity, and treatment nonadherence (Malhi,
Adams, & Berk, 2009). Treatment of bipolar depression with
antidepressants has not been substantiated by randomized