Bipolar Disorder and the Balancing Act of Emotions

Jasmine Mote

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 ActBalancing 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. 

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The Science of Saying Thanks

Lisa Williams A few months ago, gratitude challenges were all the rage. Social media feeds filled with outward expressions of gratitude, lists of appreciation, and photos of ‘the small things’. The arrival of the holiday season has brought the next generation of social media-driven gratitude outpourings (see Facebook’s Say Thanks Campaign). This time of year, even our face-to-face interactions have a distinctly grateful tone. For many of us, Thanksgiving Day meals have a round-the-table tradition of saying out loud one (or more) things for which we are grateful.

However you might feel about these trends and traditions, science corroborates the benefits of expressing gratitude. Longitudinal, cross-sectional, and experimental data from individuals, couples, and even near-strangers suggests that saying ‘thank you’ serves to foster and strengthen social relations.Please do not reproduce without explicit permission

First, let’s take a look at romantic relationships. Individuals who express gratitude to their partners naturally or who are asked to do so for the purpose of research experience a number of benefits: boosts in relationship satisfaction, more comfort in voicing concerns about the relationship, and increases in perceived strength of that relationship. Some studies have even found benefits of hearing thanks from a partner (but some haven’t). Benefits of expressing gratitude in romantic relationships, whether for the thanker or the thankee, appear to be supported by the oxytocin system, a system related to social bonding in mammals.

In recent research, Monica Bartlett and I tested whether saying thanks might foster nascent relationships – that is, amongst previously unacquainted individuals. The first challenge was to create a situation in the lab where we could manipulate the expression of gratitude in a way that mimicked real life. We devised a cover story about piloting a new mentoring program run by the university. As part of the pilot, participants gave advice as mentors on a writing sample from a high-school student mentee – thus engaging in an action that might prompt gratitude in the mentee.

A week later, participants returned to the lab and received a note purportedly written by the high school mentee. The note either simply acknowledged the advice or also included an expression of gratitude. We next gave participants the opportunity to write a note to their mentee, and hence the chance to further foster the relationship by leaving their contact details. As expected, participants who had received a note expressing gratitude from their mentee were 50% more likely to leave their contact information for the mentee. In other words, expressions of gratitude for simple acts of kindness amongst strangers can kick start the formation of new social relationships.

Yet the question remains: does saying thanks on Facebook or cursorily at the Thanksgiving table also impact relationships? I can’t yet answer that question with empirical evidence. Yet, our study suggests that an expression of gratitude serves as a signal – a signal that conveys interpersonal warmth. It remains to be tested whether that signal is only relevant between a thanker and a thankee, or if overhearing thanks or seeing someone else’s gratitude campaign postings might invoke an affiliative response in us.

To our loved ones, the key appears to be how responsive the expression of gratitude is to the person being thanked. That is, a thank you that conveys understanding, validation, and caring is bound to be effective. When asked to thank one another in a lab setting, romantic partners who believed that their better half’s expression of gratitude was attuned and authentic experienced more improvements in their relationship over the ensuing six months compared to partners receiving less responsive expressions of gratitude. It’s likely that these same processes unfold with expressed gratitude amongst non-romantic familial ties.

So whether you celebrate American Thanksgiving, Canadian Thanksgiving, Hanukkah, Christmas, Kwanzaa, St. Nicolas Day, New Year’s, and/or Festivus, it’s a good time of year to reflect on how and to whom you might express gratitude. Chances are, you and your relationships will benefit.

And thank you for reading.


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