Wednesday, October 14, 2015

Bipolar in Focus - On Empathy and Bipolar Disorder

The bipolar brain and empathy is yet another long overdue topic I'm finally getting to (for reasons I'll divulge in a moment). 

To be clear, I am not saying that empathy is unique to bipolar brains. The capacity for empathy is an integral human capacity. All people are capable of feelings of empathy (with the exception, it'd appear, of certain psychopaths and sociopaths but that is a very deep and difficult subject I best leave to address some day in my neuroscience blog)

So while empathy is of course not unique to bipolar people, I'm going to begin my argument that bipolar brains struggle with empathy in ways that many or most people do not. But fear not, non-bipolar mentally suffering peeps, I will address how you struggle with empathy as well and there will be much for any highly empathetic person to take away from today's piece.   

Regular readers will by now know (I hope) that I study various fields of neuroscience and human behaviour. I have also put an enormous amount of effort into exploring and understanding the symptoms (in the clinical sense), the real life mental and physical experiences people live with, all and any aspect of bipolar, schizophrenia, depression and anxiety and the unique and challenging worlds we live in. I take what I learn (from my own mental experience phenomenon and that of others) and then seek to understand the neuroscience of what is involved. It's a lot of work, but it's a work I am both highly motivated and driven to do and a work that I find deeply, deeply gratifying. I then attempt to digest what I learn and turn it into essays that I hope will help readers to understand and better cope with their own struggles. 

I strike many chords because I am attempting to play many tunes. I get private messages and emails from people all over the world responding to one of my posts or another, many with questions wanting to know more or looking for better understanding of their personal struggles. As I write very openly about my own disorders, conditions and struggles, many people feel a connection with me that they'd not get from a professional mental health worker (be it a psychiatrist, therapist and so on within the system).

As such, yesterday I got a private message from a male suffering from bipolar who's been impacted by his condition to the point of having to go on a disability pension and about my age. In other words, someone quite a bit like me. He had some very specific things he was struggling with about which he wanted to know more about my own personal thoughts. 

With his permission, I'm going to share some of what he wrote to me (anonymously of course) because a) I think he expressed very well what many of us struggle with, b) he asked some very good questions and c) connecting with a fellow sufferer often helps me springboard into very useful posts most of us sufferers can I identify with and learn from. 

He wrote (in part):

I feel disturbed by a great many things regarding the state of the world.  If I had to label them, I'd call them 'unnecessary injustices'.  Everything from a greed-driven wealth disparity to power-driven class wars to the needless loss of life (e.g., 21,000 people die every day in a world where there already exists enough food to feed everyone -- wtf is up with that?).

Granting that my emotional volatility may be at least partly due to some bipolar dynamics, I believe that part of my volatility is simply a consequence of compassion.  Many of the issues that disturb me aren't even issues that affect me personally -- at least, not directly.

So my question to you is this:  is it possible that the desire to be 'happy' may, at least in part, be a denial of all the injustice and pain in the world?  I mean, how can a person find genuine inner peace when they're aware of such vast corruption in government, and such unnecessary loss of life due to a lack of resources that already exist, etc.?

I can't seem to do this.  Frankly, I'm not convinced that it's a "can't" issue (for me) as much as  "won't".  And though I wouldn't say that I'm consciously stubborn about such a position, what I find is that even when I'm successful at attaining some sense of peace and happiness, I can't for long hold onto it because there's no getting away from the overwhelming brokenness all around the world.

<private information withheld> ... that I again slipped into the same rut of not being able (or willing?) to escape the 'rut' of negativity all around me.

 I think many of you will be feeling a very big "Bingo!" and identifying very much with all of what the reader is experiencing and feeling. And let me just say that over the years of my own bipolar states, and growing worse all that time (up until recently when I began to better cope with it all within myself), that I struggled deeply and painfully with all of what the reader wrote above.

Now, if you'll allow me, let me try to begin to address what the reader articulated so well. 

When I started this whole quest for better understanding every aspect of the major psychiatric and mood disorders at the beginning of 2013 (almost three years ago already!), I explored every avenue I could. Early on, I placed ads looking for bipolar and schizophrenic people who'd be willing to share their experiences with me. The best respondent was a man in his mid-forties who had struggled mightily his whole life with bipolar and ADHD named "John". He was very, very well informed and articulate and very open to sharing all he knew. I spent a very memorable (and enjoyable) long afternoon listening to him tell me his remarkable story and what he'd learned from the one psychiatrist who specialized in bipolar disorder and who'd finally and truly helped him. He shared with me some very, very useful insights. 

One thing that he told me particularly lit up some light bulbs within me in understanding my own struggles and is precisely the topic at hand for today's post. 

John's own research into bipolar disorder and what he'd learned from that one excellent psychiatrist is that bipolars tend to be unusually highly empathetic people. As well, we can often have very, very strong senses of justice and fairness and as such react acutely and intensely to any perceived (this is a very important distinction) injustice or unfairness. He also said bipolars will feel intensely driven or impelled to do something about it (which can account for some of our impulsive violent tendencies). 

This, as you can see, is very much in tune with what the reader who contacted me wrote above about his own mental anguish and struggles.

As I said, this meeting with "John" was early on in my own big research/study push and this gave me an enormous amount to think on and look into further. I especially wanted to know and understand better the neuronal basis for this and why we reacted so intensely to social injustice and unfairness and suffer so from it all. 

I'm only going to be able to scratch the surface of this topic today (every topic I raise and write about is like this!) but I'll start to outline what empathy is and why some of us suffer for it so deeply. 

Empathy, to put it very briefly, is "the experience of understanding another person's condition from their perspective". While we now know this ability is not unique to humans, the human mind has an capacity to experience empathetic feelings over a broader spectrum. And some of us suffer from it much more than most people. 

I am not going to get into the science of this today, but it is now known that empathy and pain regions and circuits in the brain are closely linked together. From an evolutionary development stance, this makes perfect sense. Small amounts of pain can create stronger memories (we'll examine this much deeper when we learn more about Post Traumatic Stress Disorder, its symptoms and what creates it in the brain) and thus better identifying with others' experiences and pain helps us learn better survival through others' experiences. That shot of pain we feel when we witness the pain of another helps sear that memory into us in order to help us avoid a similar fate. Experiencing the pain of others also impels us to help that other person and not stand idly by. 

So in our evolutionary past, empathy and empathetic pain was critical for humans (and our primate cousins, along with some other higher intelligence mammals and even some bird species) to learn stronger survival techniques and how to better work together to ward off threats. Empathetic abilities are common to all social mammals. 

But, as I've argued in my essay 
Evolution, Life and Why Our Brains Developed the Way They Are, human evolution took place over millions of years and for conditions that in no way, shape or form resemble today's living conditions. We spent most of our evolutionary development living in small groups or clans and our empathetic capacities thus developed not only for those closest to us, but for very small groups. It is part of my argument that the human brain has not kept pace with the incredibly fast pace of human social and cultural development of the past half century or so and that part of our modern suffering is due in part to our brains not being able to keep up with the pace of the enormous and fast paced human cultural and societal change that has taken place since the Industrial Revolution and especially in the last several decades of the post WW II years.

As well, like any human capacity, the capacity for empathy is not equal among us and there's a whole range and spectrum for how it's experienced, for whom and how strongly. I'm going to leave aside any judgement of those who experience empathy less than we do and I'd ask that you do the same. We gain nothing from judging others and I'd prefer to focus on understanding our own experiences and why we suffer. Suffice to say for now then that there is a class of people we'll call "highly empathetic people". Just as how any human mental capacity can be stronger in some than others - be it mathematics, artistic, athletic, language and so on - some of us are endowed with far greater capacity for empathy. 

It's more than that, however. Not only are some of us more strongly endowed with the capacity for empathy, we also more acutely develop and feel emotional pain of all kinds. We suffer the hurt of life much deeper and longer than most; we experience heartbreak more intensely, we suffer rejection more deeply and painfully, we miss people we love and care about more intensely, we suffer loss more intensely; the list is long. Combine these highly developed emotional  pain circuits with a higher than average ability to empathize with others' hardships, pain and suffering and we thus feel their pain more intensely. 

Take these high capacities for empathy and emotional pain and then look at how the news of the world and its suffering is piped into our lives 24/7 through media of all kinds, and you have a recipe for acute and chronic emotional suffering on a massive scale. It is seemingly inescapable. In my 
series on the stress response system when we look deeper into emotional pain of all kinds and how this keeps our stress response system locked on, we will see that this has very serious mental and physical health consequences.

For it's more than even just experiencing the pain of others. Looking back at the evolutionary basis for empathetic pain, this pain triggers our stress response system to do something about it. In our past, this would have been restricted to those immediately around us. Our ancestors would see a family or clan or tribe member suffering in some way, and their stress response system would activate just as it was themselves experiencing the threat and a course of action would be clear (help fend off some sort of attack, for example). This is a critical part of how and why empathy developed - to not only trigger our own "fight or flight" stress responses to save ourselves, but to save or help others as well. It's designed to make us take action for the sake of the greater good (which actually aides our own chances of survival). 

As humans developed higher organized and sophisticated social structures and in much larger and diverse numbers, this capacity for empathy and action also became more sophisticated and began to respond to non-physical threats and include threats to our well being and that of others from what we now term as "social injustices" or "class injustices" and all the unfairness involved. We therefore might be driven to fight against it (hence class wars or even civil wars on the scale of the Russian Revolution) or to flee it (which accounts for no small part of the history of human migration).

And herein lies a great deal of the trouble with our modern selves. For the vast, vast majority of pain and suffering and death and social injustice we now bear witness to, we have no capacity at all to either fight it of flee it. Yet we cannot block it out. Or as the reader wrote, "there's no getting away from the overwhelming brokenness all around the world". 

Now, as we evolved the capacity for empathy and experiencing empathetic pain, we also evolved the capacity to block it out when it becomes overwhelming for in the strictest terms of how life works it is not an evolutionary benefit to emotionally break down from overwhelm and not be able to continue on. 

And this is what I was looking at in my piece 
Broken Ego Defenses - how some of us lack the essential capacity to block out what can damage us emotionally and not only will we get pummeled by the pain of our own suffering, we'll get pummeled by the pain of so much of the world around us. I spent a great deal of time studying the whys of suicide and at one point spent several days reading suicide notes (compiled by a suicide prevention organization, they numbered in the hundreds and went back to the middle of the 18th century) and this suffering "the pain of the world's injustices" was a very common theme. To put that briefly and bluntly, this overwhelming emotional pain can kill us.

Back to bipolar and empathetic suffering. Why is it that bipolars tend to suffer more? A number of reasons. 

One, bipolar people are generally far above average in emotional intensity and not only that, across the entire emotional spectrum. We tend to experience all emotions at the extreme edges of intensity. This is one of the key factors in creating a bipolar mind that can go from the highest highs to the lowest lows. 

As well, bipolar people also tend to be very driven, very compelled to take action, and not just any action, but great action. We tend to be very driven to find solutions and act in big ways. If we happen to be high on the human empathy spectrum, this will set us up for a lot of pain and suffering if we are unable to do anything or if our actions don't get results. 

Now this does not mean that you have to be bipolar to live with this kind of empathetic suffering. Through this blog and in my own explorations of human experience, I come across a lot of people suffering to some degree from depression and/or anxiety. And in talking with them and probing their mental experiences, virtually every one would rate very high on the "empath scale". 

Is there anything we can do about it? 

I believe there is. In fact, I doubt very much I'd be alive if I did not learn how to deal with my own suffering in this regard and develop stronger "ego defenses" to better protect me from this kind of empathetic pain. 

For further reading on empathy - and a bit of a look into the "dark side of empathy" - and some insight how to reduce empathetic suffering, please see the follow up piece 
Taming the Polar Bears in Focus - Taming Empathy

For now though, I hope I have given you an at least somewhat better understanding of what you're feeling and why. I hope also to let you feel that you are not alone and that there is actually nothing inherently "wrong" with you. You are simply human, perhaps more so than others. I want you to feel that you are an important and vital part of the world.

Mostly, however, I want to open a door in your mind to the belief that you needn't suffer so. To answer the writer's question above, yes; "to be 'happy' may, at least in part, be a denial of all the injustice and pain in the world". But by that, I do not mean you turn your back coldly to the suffering in the world. We just have to get you to learn better how to a) block out what you cannot solve and b) better channel your highly empathetic mind to better use. I hope to nudge you towards the belief that is possible to be a caring, compassionate and empathetic human being and not suffer so much for being so.

I want you to feel hope that there is a better way to be that great and wonderful You. 


  1. Thank you, from the bottom of my heart for this piece. Tears streaming down my face. It is very difficult to live like this. I may not be bi-polar but I am overly emphatic. And I understand what your reader wrote 100%.
    I hope you will follow up soon with an article on how to overcome this. It is very hard not to become hopeless and utterly depressed.

    1. You are most welcome, Nina. Thank you for reading.

      A follow up post is in the works and will be published soon.

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  2. Thank you Brad. I have been criticized for being too emotional and have suffered from the weight of the world problems, injustice.. I realize I have been this way since childhood. When I am in the "up" side of my disorder, I put things into action to help others. It helps takes the focus off myself and I feel better. When I am depressed, I basically do as little as possible and I have a hard time caring about myself or anything, anyone else, for that matter. So from my experience, I feel more empathtic when I am in a more positive frame of mind.

    1. Thank you too for reading and responding, Trudy. Your experiences when you're "up" or "down" reflect what many (and probably most) bipolar people experience.

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  5. My son who is now 34 just got outta the hospital today. He was diagnosed 10 yrs ago as Bipolar. I said from the get go he thinks to much he doesn't forget anything and when he is on his meds he is the type of person who will give you the shirt off his back. Right after he was diagnosed he was severely depressed he drove himself to the hospital but told me later he didn't stay because he thought the people that were waiting in the ERIC needed the help more than he did.

    1. Thank you for sharing. Yes, the almost always over-active thought circuits are common in us.

      I wish him all the best. I hope you can gain value from other posts in this blog.

  6. Thank you so much for this post!! When I was a little girl I was diagnosed with depression which I was put on Valium. The older I go I was diagnosed with Anxiety disorder, then Bi-Polar Disorder, at one point even told I was Manic Depressive. All I knew was that when people hurt I hurt. when animals hurt I hurt. When plants are hurting I hurt, even bugs. Yep I am even a bug savior, talking to them, making sure they are OK and out of harms way. I have to be honest and say this ....well this just wears me out. I want to take everyones pain away, but when I can't I beat myself up. As a matter of fact I am doing the same thing as we speak. Here, taking care of my Sis. My heart and soul wants to help everyone, but my body cannot keep up. My peace only comes when I am alone. No person setting next to me, just me and my solitude. This is the only thing that turns the blender in my head off.

    1. Yes, I quite understand.

      It is, however, something we must learn to understand more about ourselves and learn to "tame" and control better. Otherwise, as you've noticed, it will almost literally eat us alive. Please stay tuned for further posts on empathy.

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  8. Hi, I loved your post and I believe it is true, we are born with brains that work differently (highly empathetic since 3 y/o) mixed with external stimuli or triggers is like the perfect recipe for any mental illness (in my case BPII).
    Keep up the good work and remember that we all are unicorns, the difference is that some will die never knowing it xoxo.

  9. Hi, I loved your post and I believe it is true, we are born with brains that work differently (highly empathetic since 3 y/o) mixed with external stimuli or triggers is like the perfect recipe for any mental illness (in my case BPII).
    Keep up the good work and remember that we all are unicorns, the difference is that some will die never knowing it xoxo.

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