I marched happily down the hiking trail of the nature preserve, which had become one of my favorite places to be in the past several months. If I wasn’t running on the connected greenway trails to burn off some of my seemingly inexhaustible energy, I was hoofing it along the hiking trail in rapturous appreciation of nature’s majesty.
Lately, it seemed like everything was just … more. Colors were more vibrant, like the difference between standard and high definition television. Sounds and music had a new clarity. My selection of clothes was guided by which items were least likely to feel rough and scratchy and I’d become extremely sensitive to cold.
I looked across the preserve’s butterfly meadow and its warm-season grass habitat and marveled at the kaleidoscope of colors—from burnished golds and buttery yellows to tones of deep rich honeys and chocolates.
When I was a teenager, I discovered Anne Rice’s Interview with the Vampire and its florid and sensuous account of Louis, who had become a vampire at the hands of the powerful and mercurial Lestat. Rice seems to be a fan of the word “preternatural,” and that is exactly how her vampires experience the world around them. Upon his birth as a vampire, Louis recounts, “It was as if I had only just been able to see colors and shapes for the first time. I was so enthralled with the buttons on Lestat’s black coat that I looked at nothing else for a long time.”
I couldn’t help but snap pictures on my phone. The photos didn’t do it justice of course, but you could still get a sense of the rainbow of colors and the delicate play of the light across the tall blades of grass.
I look at those photos now and they’re a bunch of pictures of a brown field.
An Underreported Aspect of Bipolar Disorder
In a 2017 study in The American Journal of Psychiatry, Dr. Gordon Parker and colleagues estimate that 82 percent of people with bipolar disorder experience changes in one or more of their five primary senses during a hypomanic/manic episode. Sensory changes during a bipolar depressive episode are also very common, occurring in an estimated 65 percent of bipolar individuals.
The researchers noted that, given how common this phenomenon is, it’s odd that more hasn’t been reported on it in the bipolar research literature. They went on to theorize:
As patients rarely volunteer comments on such perceptions, is it that they are concerned that reporting them might be judged as evidencing psychosis (and does that indeed occur?), or do they simply view them as correlates of their mood state?
As someone with bipolar, I can say “yes” to the former. I remember sitting in medical screening rooms answering intake questions and thinking that I should be careful how much I shared about what I was thinking and feeling for fear of being labeled psychotic or even schizophrenic.
The investigators detailed how, among those bipolar individuals who experienced a sensory change during hypomanic/manic states, the overwhelming majority reported heightened senses.
Colors were brighter and more vibrant, and sight was sharpened. Hearing seemed to have greater amplification, better clarity, or a better ability to hear subthreshold sounds distinctly. For smell, they used terms like “more intense,” “clearer,” “stronger,” and “sharper.” Taste was described as stronger or heightened. Touch tended to involve increased sensitivity or hypersensitivity, including some who reported not being able to wear “itchy” clothes.
Getting Bitten by the Radioactive Spider
During my worst manic episode, I experienced an enhancement of all five senses, though the most prominent for me were changes in vision, hearing, and touch.
I became fixated on movies and television shows that depicted characters who I thought were the best examples of showing what I was experiencing and leaned heavily on superhero movies.
Like my photo essay on beige, I snapped pictures on my phone of scenes on the television that resonated with me. One in particular was from the movie Man of Steel, in which a young Clark Kent is shown to be overwhelmed by the enormous sensory input created by his superpowers. It’s like he had no sensory filters for the bombardment of sights and sounds he was trying to process. He had to learn to focus his attention by filtering out extraneous sensory noise.
That spoke to me. Although I don’t recall consciously feeling overwhelmed by sensory input, on some level I connected with this portrayal of trying to learn how to deal with amazing enhancements of your senses.
The Neuroscience of Increased Sensory Sensitivity in Bipolar Mania
Because sensory sensitivity in bipolar disorder has not been studied extensively, not much is written on the specific underlying brain mechanisms involved.
However, my money is on enhanced dopaminergic transmission in higher-order sensory processing areas of the prefrontal cortex. Findings from pharmacological and imaging studies over the past several decades support the hypothesis that mania results from a state of hyperdopaminergia and a hyperactive reward processing network.
Intriguingly, many Parkinson’s Disease (PD) patients report sensory deficits. Even researchers tend to think about PD mostly in terms of the motor symptoms caused by a loss of dopaminergic input to the striatum. But dopaminergic cells in the ventral tegmental area and the substantia nigra pars compacta also send projections to the prefrontal cortex and are impacted in PD.
If mania is associated with excessive dopamine, then it seems likely to me that the same pathways that impair sensory processing in PD due to depleted dopaminergic transmission work overtime when flooded with dopamine. The result is a sensory boost.
A Taste of Power
I can sympathize with bipolar patients who are non-compliant with medications because they don’t want to lose the edge they feel that their mania gives them, or just because they enjoy the natural high they get from it. Sometimes I wish I could recapture the heightened senses of my worst manic episode. Art is one of my hobbies and I remember thinking at the time that anything I painted had a depth of color I hadn’t been able to achieve before.
I look at those paintings now and they don’t sparkle like they did then.
Facebook/LinkedIn image: transurfer/Shutterstock
Ashok, A.H., Marques, T.R., Jauhar, S., Nour, M.M., et al. (2017) The Dopamine Hypothesis of Bipolar Affective Disorder: The State of the Art and Implications for Treatment, Molecular Psychiatry, 22(5):666–679, DOI: 10.1038/mp.2017.16.
Mingxin, Z., Li, M., Ye, D., Jiang, W., et al. (2016) Sensory Symptoms in Parkinson’s Disease: Clinical Features, Pathophysiology, and Treatment, Journal of Neuroscience Research, 94(8): 685-692, DOI: 10.1001/jnr.23729.
Nakajima, M., Schmitt, L.I., & Halassa, M.M. (2019) Prefrontal Cortex Regulates Sensory Filtering Through a Basal Ganglia-to-Thalamus Pathway, Neuron, 103:445–458, DOI: 10.1016/j.neuron.2019.05.026.
Parker, G., Paterson, A., Romano, M., & Graham, R. (2017) Altered Sensory Phenomena Experienced in Bipolar Disorder, American Journal of Psychiatry, 174(12):1116-1150, DOI: 10.1176/appi.ajp.2017.16121379.