Most of us have our ups and downs. It’s part of life. But people with bipolar disorder experience highs and lows that are extreme enough to interfere with personal relationships, work, and daily activities.

Bipolar disorder, also called manic depression, is a mental disorder. The cause is unknown. Scientists believe that genetics and an imbalance of neurotransmitters that carry signals between brain cells offer strong clues. Almost 6 million American adults have bipolar disorder, according to the Brain & Behavior Research Foundation.

There are different types of bipolar disorder and nuanced variations of each type. Each type has two components in common: mania or hypomania, and depression.


Manic episodes are the “ups” or “highs” of bipolar depression. Some people may enjoy the euphoria that can occur with mania. Mania, though, may lead to risky behaviors. These may include draining your savings account, drinking too much, or telling off your boss.

Common symptoms of mania include:


Depressive episodes can be described as the “lows” of bipolar disorder.

Common symptoms of depressive episodes include:

Each person experiences bipolar disorder differently. For many people, depression is the dominant symptom. A person may also experience highs without depression, though this is less common. Others may have a combination of depressive and manic symptoms.

Empathy is the ability to understand and share another person’s feelings. It’s a heartfelt combination of “walking in another person’s shoes” and “feeling their pain.” Psychologists often refer to two types of empathy: affective and cognitive.

Affective empathy is the ability to feel or share in another person’s emotions. It’s sometimes called emotional empathy or primitive empathy.

Cognitive empathy is the ability to recognize and understand another person’s perspective and emotions.

In a 2008 study that looked at MRI images of peoples’ brains, affective empathy was seen to affect the brain in different ways from cognitive empathy. Affective empathy activated the emotional processing areas of the brain. Cognitive empathy activated the area of the brain associated with executive function, or thought, reasoning, and decision-making.

Most studies looking at the effects of bipolar disorder on empathy have relied on a small number of participants. That makes it difficult to come to any definitive conclusions. Research results are sometimes conflicting as well. However, existing research does provide some insight into the disorder.

There’s some evidence that people with bipolar disorder may have difficulty experiencing affective empathy. Cognitive empathy seems to be less affected by bipolar disorder than affective empathy. More research is needed on the effect of mood symptoms on empathy.

Journal of Psychiatric Research study

In one study, people with bipolar disorder had difficulty recognizing and responding to facial expressions associated with specific emotions. They also had difficulty understanding the emotions they might feel in given situations. These are both examples of affective empathy.

Schizophrenia Research study

In another study, a group of participants self-reported their experiences with empathy. Participants with bipolar disorder reported experiencing less empathy and concern. The participants were then tested on their empathy through a series of empathy-related tasks. In the test, participants experienced more empathy than indicated by their self-reporting. People with bipolar disorder did have difficulty recognizing emotional cues in others. This is an example of affective empathy.

Journal of Neuropsychiatry and Clinical Neurosciences study

Research published in the Journal of Neuropsychiatry and Clinical Neurosciences found people with bipolar disorder experience high personal distress in response to tense interpersonal situations. This is associated with affective empathy. The study also determined that people with bipolar disorder have deficits in cognitive empathy.

People with bipolar disorder may, in some ways, be less empathetic than people who don’t have the disorder. More research is needed to support this.

The symptoms of bipolar disorder can be greatly reduced with treatment. If you or someone you care about has bipolar disorder, seek help from a mental health provider. They can help you find the best treatment for your specific symptoms.