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Empathy Changes for People with Bipolar Disorder

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December 19, 2022
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Wall of Empathy by David Goehring (CC by 2.0)

The Relationship between Bipolar Disorder and Empathy

Some people who live with the depression and mania of bipolar disorder report feeling extreme empathy. On the other hand, research has found that some individuals with bipolar disorder express less empathy than is generally considered common.

These contradictory findings point to the reality that while bipolar disorder does have basic characteristics of extreme highs and periods of depression, this mental health challenge differs from person-to-person as it is lived day-to-day.

Because relationships are a foundation of functioning in society, the effect of bipolar disorder on interpersonal interactions, including the expression of empathy, can have a profound effect on a person’s daily life.

Two Types of Empathy

Empathy is the ability to sense other people’s emotions and to imagine what they are feeling.

Researchers define two different forms of empathy. “Affective empathy” is how we react in response to another person’s emotions, such as feeling anxious because another person feels that way. “Cognitive empathy” is understanding another person’s emotions, as opposed to mirroring those feelings.

Scientists are beginning to uncover brain pathways related to empathy. Research has shown that some aspects of empathy may show up in brain cells, called mirror neurons, that fire when we see someone perform an action.

Empathy doesn’t mean we will immediately help someone in need, but it is the reason we often do respond to the troubles or needs of others.

Extreme Empathy

Bipolar II disorder is a diagnosis that means a person experiences episodes of depression, as well as phases of mania, but the mania isn’t as extreme as a person who is diagnosed with bipolar 1, when the mania is so extreme the person may have to be hospitalized.

Some individuals with bipolar II report experiencing intense empathy, which may be advantageous in relationships, but that empathy must be reasonable and balanced.

“In my personal experience living with bipolar II disorder, I live with extreme empathy, to the extent that it sometimes affects my mental health,” said Hannah Blum in an article on, a consumer website to support people with mental health concerns, as well as their family members and friends.

“I am an excellent listener who is genuinely trying to help,” said Blum. ”I want to undo the sadness that other people feel.”

Blum said she has learned to balance empathy with maintaining her own mental health.

“I have learned that some people are in bad situations for a reason and it is not my job to save them,” she said.

Decreased Empathy

Some studies have found that people with bipolar disorder find it difficult to recognize emotions in others through their facial expressions. In addition, individuals with bipolar disorder may have difficulty understanding the emotions others might have in a variety of situations.

Socialization with Bipolar Disorder

Empathy is an important part of socialization, so it’s a basic element of developing relationships with others.

As with any mental health issue, the most important first step is consulting with a professional to get an accurate diagnosis. Then an individual treatment plan can be developed to manage bipolar disorder with medication or psychotherapy, or a combination of those, and live a productive and fulfilling life.

How common is Bipolar Disorder?

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


Blum, Hannah, “Bipolar Disorder and Extreme Empathy", HealthyPlace, June 5, 2017

Goleman, Daniel, “When Can Empathy Move Us to Action?Greater Good Magazine, March 1, 2008

What is Empathy?Greater Good Magazine, 2019

Do People with Bipolar Disorder Lack Empathy?” Healthline, 2019

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