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. 

Photo credit: https://flic.kr/p/8PW6dT

Emoting online – more than just smileys

Lisa Williams

Social media: love it or hate it, it’s here to stay. Speaking of love and hate, a surge of recent research has tackled core questions regarding emotional processes as they play out on social media.

How do we e-communicate our emotional states? Emoticons, and their more graphical cousins emoji, are one popular route. Since the 1980’s, online communicators have been using combinations of punctuation marks to convey sarcasm or a joking tone (e.g., “bugger off!” and “bugger off :-)” certainly convey different meanings). Recently, social psychologist Dacher Keltner teamed up with folks at Pixar to develop a ‘sticker’ set of animated emoji called Finch. Finches were designed to reflect the great variety of emotional experience that simply can’t be captured with semicolons, parentheses, and dashes, including love, sympathy, awe, jealousy, and embarrassment.

Not only are Finch emoji quite popular, analysis of their use presented by Dacher Keltner at the February meeting of the Society of Personality and Social Psychology reveals fascinating trends around the world. Use of the ‘loving’ Finch is highly frequent in Russia and Mediterranean regions; use of the 93571524_43b1e4070f_o‘sympathetic’ Finch is highly frequent in Australia and the Americas. What can emotion communication tell us about a culture? Apparently, quite a bit.

Emotion communication in social media is of course not limited to emoticons and emoji. The words we use also convey how we felt about a past event, currently feel at the moment, or anticipate feeling in the future. Linguistic analysis of Facebook and Twitter posts reveals a great deal about users’ emotions. An intriguing interface at the World Wellbeing Project (www.wwbp.org) allows visitors to track word usage across age groups, including, but not limited to, words with emotional tone. Analyses are based on over 75,000 Facebook users. My own cursory analysis revealed that older users use ‘grateful’ more often and ‘angry’ less often than their younger counterparts. So, the informative nature of emotional e-communication isn’t just cultural – emotive language online varies according to age groups, genders, and personality traits.

It turns out that online emotive language is not just descriptive – it can serve as an indicator of a community’s level of wellbeing. Analysis of 148 million Twitter posts conducted by a team led by Johannes C. Eichstaedt revealed that communities whose residents tweet with angry language are communities high in risk for mortality from atherosclerotic heart disease. In fact, language on Twitter did a better job of predicting cardiac disease mortality than a set of 10 predictors including demographics (e.g., gender), socioeconomic variables (e.g., income), and health risk factors (e.g., smoking).

Complemented by findings that online emotions are ‘contagious,’ it becomes clear that emotional processes on social media are potent. Controversial Facebook experiment aside, the concept that emotions spread through social media networks has received robust empirical support. Analysis of 3.5 million Twitter-like posts from China (on Weibo) 5653817859_3567ac7c8f_orevealed that joy spreads quickly through the network, but is outpaced by anger. In another study conducted on millions of Facebook users, positive posts by one user increased positive posts by that user’s friends at a factor of 1.75 (and decreased negative posts at a factor of 1.80). The factor for one user’s negative posts increasing friends’ negative posts was 1.29 (and 1.26 for decreasing friends’ positive posts). Additional evidence for emotional contagion online comes from Jonah Berger and Katherine Milkman, who analyzed the viral nature of 7,000 New York Times online articles. Content that angered readers was more likely to be shared than those that saddened readers.

It’s not as dire as it may seem: in that latter study, NYT content that resulted in a sense of awe was also shared widely. Negativity is viral – but so two is positive content – especially that which ‘wows’ us.

This isn’t to say that we are passive users of social media, subject to the emotional whims of others. Indeed, we use social media as a forum for emotion regulation: research by Benjamin K. Johnson and Silvia Knobloch-Westerwick shows that, when in feeling a bit down, individuals seek out downward social comparisons to other social media users that might be worse off (apparently in an effort to feel better about ourselves).

The emotional tenor of online communication reveals a great deal about who we are as people, as cultures, and as humankind. Not only do we influence others, we are also influenced by the emotions we share via social media. Social scientists are just beginning to understand the emotion processes that play out in social media – we are at the exciting forefront of the era of ‘big data’.

Photo credits: https://flic.kr/p/9gzy9 and https://flic.kr/p/9BBi5g

Fruits, vegetables, and emotions

Tamlin Conner

Should people reach for a carrot rather than a candy bar to help protect against depression? Does a diet rich in fruits and vegetables actually make you happier? These are questions I ponder when not writing guest blogs for my friends.

The answer to these questions seems to be a growing yes.

There is compelling evidence that a healthier diet protects against depression. Multiple studies published in the last decade – mainly in nutrition journals – have found reduced risk for depression among people with a higher intake of fruits and vegetables. This link holds when controlling for socioeconomic status, education, physical activity, smoking, unhealthy food consumption, and pretty much any other variable you can think of that might explain this pattern. And, the evidence suggests that poor dietary intake precedes the onset of depression and not the other way around.

My research adds another flavor to this unfolding story. For the last six years, I have been tracking people’s daily intake of fruit and vegetables to see how consumption is related to changes in daily emotion. In each of these studies, I have found a striking and strong association between daily fruit and vegetable consumption and a variety of positive emotions like happiness. In my first study, I asked 281 young adults ages 18 – 25 to report their mood each day for three weeks, and to report the number of servings eaten that day of fruits and vegetables (canned, frozen or fresh, but not fried and not juices), and several types of unhealthy foods like cookies, potato chips, and desserts. I found that on days when people ate more fruits and vegetables, they reported feeling much happier. Unhealthy foods like chips and desserts had little to no association with mood. Also, by tracking people on a daily basis across those three weeks, I was able to address which came first – eating fruit and vegetables or feeling happy. I found that eating more fruit and vegetables predicted improvements in happiness the next day – but happiness did not predict eating more fruits and vegetables the next day – suggesting that diet preceded changes in happiness and not the other way around.

Recently, I published another study that replicated and extended this finding by showing that fruit and vegetable consumption predicted other positive emotional states even more strongly than happiness—states like how engaged and inspired people felt that day, how interested and curious they were in their environment, and, how creative they felt. In fact, these patterns were almost twice as strong as the patterns found with happiness. What is going on here? There may be a connection between fruit and vegetables and the motivation or drive to engage in daily life – known in scientific parlance as approach motivation.

There are biologically plausible pathways for why fruit and vegetables could promote engagement and drive. Fruit and vegetables contain a range of vitamins and minerals including vitamin C, folate, vitamin B-6, iron, and selenium. Vitamin C might be a key pathway here. It is an important co-factor in the production of dopamine, which is critical to motivational drive. A recent study found increased vitamin C levels in the blood following kiwifruit consumption with corresponding improvements in emotional vitality. B-vitamins and complex carbohydrates in fruit and vegetables also promote the synthesis of dopamine and serotonin.

The absence of approach motivation – called motivational anhedonia – is one of the key features of depression. This raises the possibility that a sustained lowered intake of fruit and vegetables could contribute to motivational anhedonia, which could raise the risk for depression. However, in my research studies of young adults, lower fruit and vegetable consumption related to lower approach motivation but not to higher depression.

What are the next steps? Intervention research. Before getting too excited about these findings, intervention studies are needed to test for causal effects of fruit and vegetables on approach motivational states. This requires getting people to eat more fruits and veggies, testing the consequences for psychological outcomes, and measuring the potential biochemical pathways that could account for such changes.

So, at this stage, I cannot say that eating carrots will make you more creative or that fruit will help you flourish, but the evidentiary base for this is growing. My best advice is to hedge your bet and eat at least five servings per day (two fruit and three or more veggies).  You can do this by including fruit and vegetables at each meal, and the servings will add up across the day.  Bottom line? Opt for carrots rather than candy.