Most of us have our ups and downs. They’re part of life. People with bipolar disorder — also known as manic depression — experience highs and lows that are extreme enough to interfere with their personal relationships, work, and daily activities.

The cause of bipolar disorder is unknown. Experts believe that genetics and a neurotransmitter imbalance offer strong clues.

Manic episodes are the “ups” or “highs” of bipolar disorder. Depressive episodes can be described as the “lows.”

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

Some research also suggests that people with bipolar disorder may feel less empathy than people without the condition. Keep reading to learn more.

Did you know?

According to the World Health Organization (WHO), around 45 million people globally have bipolar disorder.

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

Affective empathy is the ability to feel or share 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 emotions and perspective.

In a 2012 study, people with psychiatric disorders like schizophrenia and depression and people without psychiatric disorders reported on their experiences with empathy. The participants with bipolar disorder reported experiencing less empathy and concern for others than the participants without psychiatric disorders.

The participants were then tested on their empathy after a series of tasks, like reading about real-life situations and imagining how they’d feel if they were in those situations. During the test, the participants with bipolar disorder experienced more empathy than indicated by their self-reporting.

In a 2017 study, 53 study participants looked at neutral images and images of people in physical pain (for instance, with one of their hands caught in a door). The study participants were then asked to assess how much pain the people in the images were in and which sides of their bodies were affected. Researchers used electroencephalograms (EEGs) to track their brain activity.

According to the EEG results, there was less neural evidence of empathy and emotional arousal in participants with bipolar disorder. Participants with bipolar disorder were slower to react than participants without bipolar disorder.

When asked to assess themselves, participants with bipolar disorder were also more likely to report that they did not feel as much concern for others.

The researchers also found that the more severe mania a person was experiencing, the less likely they were to feel empathy.

On the other hand, a 2020 literature review found that people experiencing manic episodes of bipolar disorder showed greater affective empathy than people experiencing depressive episodes and people without bipolar disorder.

The 2020 literature review also found that both manic episodes and depressive episodes of bipolar disorder were associated with reduced cognitive empathy.

In the 2012 study mentioned earlier, participants were also asked to look at pictures depicting neutral situations and situations where people were expressing basic emotions. Each picture included two people, one of whom was wearing a mask. The study participants were then shown three facial expressions and told to choose the most appropriate expression for the person wearing the mask.

The researchers concluded that the participants with bipolar disorder had difficulty recognizing emotional cues in others.

In a different 2012 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.

In the 2017 study mentioned earlier, people with bipolar disorder were less capable of taking on other people’s perspectives, based on their scores on a widely used empathy test.

Bipolar disorder can have a variety of other effects on your mental or physical health.

Common symptoms of mania include:

Common symptoms of depressive episodes include:

More research is needed on the effect of bipolar disorder on empathy.

Most studies looking at the effect 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.

In addition, research from 2019 suggests that antidepressants, not depression itself, may be responsible for reduced empathy, at least in people with major depressive disorder.

If you have bipolar disorder or someone you care about has it, seek help from a mental health professional. They can help address any concerns about reduced empathy or other effects.


What can I do to become more empathetic?

A Healthline reader


  • Set a goal to become more curious about other people, particularly those who are different than you in some way(s). Within this curiosity, be mindful of your active listening skills and even your nonverbal communication such as body language and facial expressions.
  • Seek out situations and conversations in which you may be interacting with those who have different viewpoints than you possess. During these conversations, truly listen, rather than listening while focusing on developing a reaction or rebuttal.
  • Exploring volunteer opportunities and expanding your world by learning about different cultures and the experiences of others may lead you to imagine yourself in someone else’s position in life.
  • Lastly, read as much as you can! Getting lost in a book allows the imagination to ripen.
Kendra Kubala, PsyDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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