The United States is a culture deeply invested in the pursuit of happiness. But what if feeling excited or ambitious could lead to devastating consequences, such as going bankrupt, hospitalization, or harming yourself?
Bipolar disorder is a mental illness where people experience manic episodes, which for some are characterized by intense feelings of euphoria, pride, or excitement. In common parlance, people often use the terms “bipolar” or “manic” in a derogatory sense, to mean “crazy” (e.g., “She is totally bipolar”). But in reality, bipolar disorder is a serious psychiatric condition with specific symptoms surrounding waves of extreme positive emotion and waves of depression. You’d think that experiencing a lot of positive emotion would be a good thing, but it’s possible to have too much of a good thing. Feeling too good can have negative consequences.
June Gruber at the University of Colorado, Boulder, among others, has shown that people with bipolar disorder experience more positive emotions and for a longer duration than people who do not, even if they are not experiencing a manic episode (for a review of this literature, go here). Manic episodes may also be characterized for others by intense feelings of irritability and general emotional instability. Overall, however, while manic episodes may feel good for some people, they also lead to an increase in engaging in risky behavior (such as reckless driving) and impulsivity, among other symptoms, and can damage interpersonal relationships, cause severe financial stress, or lead to suicide. Further, many people with bipolar disorder also experience depression between manic episodes, where they may feel sad, not enjoy things that they used to enjoy, find it hard to do everyday tasks, and also have thoughts of suicide.
Balancing emotions in bipolar disorder can be tricky when both feeling good and feeling bad have severe consequences, and some people may decide that it’s simply too risky to put themselves into situations that can cause too much happiness. Research has shown that some people with bipolar disorder try to reduce, or dampen, the positive emotions in their lives more than people without bipolar disorder. For example, they may try to not make a big deal out of positive experiences or avoid positive situations (such as pursuing romantic relationships) altogether to help them prevent a future manic episode. Such strategies lead people to report a lower quality of life and may ultimately put themselves at risk for depression.
So how can people with bipolar disorder stay healthy but also still experience the positive emotions that make life so enriching? As part of a team of researchers led by Sheri Johnson and Ann Kring at the University of California, Berkeley and Judy Moskowitz at Northwestern University, we are currently testing a group treatment intervention to increase healthy positive emotions in people with bipolar disorder. Based on Dr. Moskowitz’s work on interventions designed to increase positive emotion in other populations, such as in people with schizophrenia and people recently diagnosed with HIV, we have developed a 10-week group treatment intervention study called the Learning Affective Understanding for a Rich Emotional Life (LAUREL) Group. The group uses basic emotion research and teaches skills related to increasing positive emotions that have not been shown to significantly increase the risk of a manic episode, such as low activation positive emotions (e.g., calm, relaxation, serenity) and emotions focused on others (e.g., gratitude). Some examples of the skills we teach include emotion regulation strategies (e.g., changing the way we think to change the way we feel), mindfulness meditation, and self-compassion. The study is currently ongoing and we have already received a lot of positive feedback from previous group members. We hope that skills such as these can help people with bipolar disorder — in addition to their current treatments — navigate the balancing act of their emotions so that they can both stay healthy and feel good in their daily life.
Special thanks to Sheri Johnson, Ph.D., for her feedback on an earlier version of this post.
Photo credit: https://flic.kr/p/8PW6dT