Bipolar Disorder: Reward Sensitivity AND Mood Disorder

Reframing of bipolar disorder from a mood disorder to a reward processing disorder (Sheri L. Johnson, PhD a distinguished professor at the University of California Berkeley; Nusslock, Mittal, and Alloy, 2025)

Misidentifying mood disorders with brain biochemistry leads to artificial dichotomy. Mood has biochemical correlates (everything happens in the brain, after all), but they are not synonymous.

Moreover: a hypersensitive reward system and a mood disorder are not mutually exclusive. One might lead to the other or the latter could be the subjective experience of the former (two languages to describe the same thing: neurocerebral events and how they are experienced).

Moreover, a hypersensitive reward system is typical of multiple mental health issues and illnesses. There must be confounding factors at play.

The literature also confuses high ambition (even compulsion) with mania in bipolar disorder. It is a bit of a culture-bound thing: the regulation of moods is a goal in the West (“the pursuit of happiness”). People with bipolar disorder believe that everyone is like them!

Goal pursuit is linked to dysregulation, overconfidence, and risk-taking as well as a sense of remorse and loss. It is reminiscent of infatuation, all resources are mobilized.

In bipolar disorder the problem is not the reward system but the circuit breakers: self-reinforcement is self-contained (in other words: addiction to a euphoric high).

We are pathologizing diversity and excellence: creativity, charisma, success, and reward sensitivity run in bipolar families at higher rates than general population Simon Kyaga, MD, PhD, MBA in Sweden).

Find and Buy MOST of my BOOKS and eBOOKS in my Amazon Store: