General News — 14 January 2015
Facing difficulties: why people with bipolar disorder don’t always see how you feel

Anxiety

 

People with bipolar disorder often experience amplified emotions, and consequently struggle in their inter-personal relations. They can also appear self-absorbed, resistant to reason and don’t seem to care how people around them feel. New Melbourne-based research, however, has found sufferers have reduced ability to recognise emotions in other people’s faces.

The inability appears to be more pronounced in recognising negative emotions, such as anger or fear – a discovery that has potentially serious consequences for interpersonal relationships.

In a recent paper, Melbourne researcher Tamsyn Van Rheenen, of the Monash Alfred Psychiatry Research Centre, notes: “Perception of emotion from facial information is vital for effective social and relational functioning; misinterpretation of emotional expressions can lead to uncomfortable social situations and reduce appropriate social communication.”

The idea of there being a deficit in bipolar sufferers recognising emotions has been around for a while, and supported by a growing body of research, but inconsistencies in the way experiments have been carried out and uncertainties over whether mood was playing a part in the problem meant the extent of the deficit was poorly understood.

In a complex series of experiments employing 50 bipolar patients and 52 people with no family history of mental illness as a control group, , Dr van Rheenen demonstrated that mood does not play a part and that the impairment is significant, rather than a subtle one.

The test subjects were asked to complete three computer tasks where they reviewed a series of black and white photographs of unadorned faces. Using morphing technology,  Dr van Rheenen manipulated the level of emotional intensity of facial expressions in the photographs so that each portrait was presented with low, medium and high levels of expression.

She says: “There are some past studies that have failed to show group differences in facial emotion recognition and discrimination in bipolar disorder. We wanted to know whether this was because patients with bipolar disorder are actually okay, depending on mood state, at recognising very obvious expressions, but worse at recognising more subtle expressions, which are the ones we encounter in everyday life more frequently.”

In the end, she says, “we found that there was a significant impairment across the board in the ability of the bipolar group to discriminate emotions at all intensities which shows that the deficit is not subtle”.

In the next stage of her research, Dr van Rheenen will employ brain scan technology to see what happens at the neural level when these impairments come into play.  Once the areas of the brain responsible for these impairments are identified, researchers can begin developing pharmacological treatments. So far drug treatment for bipolar works to stabilise the patient’s mood, rather than address the cognitive problems that lead to social dysfunction.

This article originally appeared in Sydney Morning Herald, 11 January 2015.

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