Is Bipolar Disorder Linked to Empathy Challenges?

How mania and depression affect emotional and cognitive empathy

— People with bipolar disorder often struggle with empathy, the ability to tune into others’ feelings, due to brain changes and mood swings. But experts say that empathy isn’t gone — it’s sometimes just overshadowed by the condition’s symptoms, and strategies can help rebuild it.

Bipolar disorder causes dramatic shifts in mood and energy. Manic episodes bring high energy and agitation. Depressive periods plunge people into deep lows that mimic major depression. Types include bipolar I, with full mania; bipolar II, with milder hypomania; and cyclothymia, a less severe version.

This condition doesn’t just affect mood. It can alter thinking, including empathy. Empathy comes in two main forms: cognitive, where you understand someone’s mental state, and emotional, where you feel their pain as your own.

Brain scans reveal clues. A 2017 study found lower activity in brain regions tied to empathy for others’ pain among those with bipolar. In 2021, researchers noted weaker connections in areas handling cognitive empathy. Even during stable times, a 2022 study showed empathy levels stayed low.

Yet it’s not all one-sided. During mania, emotional empathy can spike, per a small 2017 study. That means people might feel others’ emotions intensely, but struggle to act on it.

Symptoms play a big role too. Mania can make someone hyper-focused on their own racing thoughts, sidelining concern for others. “They become overly self-absorbed,” said Ryan Sheridan, a psychiatric nurse practitioner in Washington, D.C. Depression brings hopelessness, making it tough to respond empathetically.

Not everyone agrees on the impact. Research is spotty and sometimes clashes. One 2021 study saw no empathy shortfalls in bipolar patients. Differences might stem from how studies measure empathy — feeling it versus showing it in behavior.

During mania, executive function, the brain’s control center for decisions, falters. Someone might recognize a friend’s hurt but fail to respond kindly, appearing selfish instead.

No pill targets empathy directly. But stabilizing moods helps. Medications like mood stabilizers can manage episodes, though some users feel emotionally numb. Treatment often mixes drugs with therapy, life skills training, and support groups.

Building empathy takes effort. Experts suggest journaling feelings to name them. Mindfulness keeps you present with emotions. Observing people in daily life hones recognition skills. Therapy discussions unpack how feelings affect relationships.

Develop awareness of your emotions and others, says Candace Kotkin-De Carvalho, a social worker in Morris Plains, New Jersey. Learning about bipolar itself fosters understanding of its behavioral ripple effects.

Timing matters. Practice during calm periods, not crises. This builds habits for tougher times.

The disorder’s empathy toll varies widely. For some, it’s a major hurdle in relationships. Others manage well. Effects differ greatly among individuals, Sheridan said.

Overall, bipolar can dim empathy, but it’s not permanent. With symptom control and targeted practice, people can reconnect emotionally.

This builds on a growing body of research highlighting bipolar’s cognitive side. As mental health awareness rises, such insights could reduce stigma and improve support.

The article draws from a review published on Medical News Today, summarizing studies from 2017 to 2022.

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