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Rejection Sensitivity Study Reinforces Biological Basis of Bipolar Depression Symptoms

rejection sensitivityRejection sensitivity is a psychological condition that causes a person to feel oversensitive to rejection or perceived rejection in relationships and social interactions. An individual with rejection sensitivity may perceive an unintentional snub or even being made to wait as deliberate rejection and feel severe, painful anxiety and perhaps even anger as a result. Appearance-based rejection sensitivity may contribute to eating disorders (see “Sensitivity to Rejection Can Be Dangerous” on PsychCentral).

What drew my attention recently to rejection sensitivity was an article in this month’s edition of the journal Bipolar Disorder based on a study entitled “Pain during depression and relationship to rejection sensitivity” (Ehnvall A, Mitchell PB, Hadzi-Pavlovic D, Malhi GS, Parker G.). These researchers looked into the relationship between severe, treatment-resistant bipolar depression, pain, and rejection sensitivity.

This study found that in people with severe bipolar depression, increased pain sensations – particularly headaches and chest pain – actually occurred much more often in depressed patients who were also experiencing high levels of rejection sensitivity as part of their depressive episode.

When someone is depressed, a common symptom is perceiving that other people don’t like them or are rejecting them. Based on this study, it seems that specific pathways in the brain relate to depression and to these distorted perceptions about other people. Furthermore, when these pathways are disrupted they overlap into pain circuits, triggering physical discomfort, also a common symptom of depression.

What I found most interesting was the premise of the article – that depression, pain, and rejection sensitivity involve similar brain circuits. While I was familiar with the idea of pain and depression sharing similar wiring, I wasn’t familiar with the notion that rejection sensitivity was part of that brain loop.

I looked into another article to help me understand this, a study entitled “Black sheep get the blues: A psychobiological model of social rejection and depression” (George M. Slavich, Aoife O’Donovan, Elissa S. Epel, Margaret E. Kemeny published in Neuroscience and Behavioral Reviews, August 2010). In this study, participants were subjected to conditions that simulated a socially stressful situation, and researchers measured chemicals in their bodies and scanned their brains in an fMRI. Results showed that in the midst of these stressful situations, the human body releases inflammatory chemicals, just like those released after a physical injury, and those chemicals light up parts of the brain related to emotional distress.

The big story for me in these two studies is that researchers continue to identify brain pathways and circuits in bipolar disorder and depression that are clearly disrupted at a neurochemical level, and that we are starting to be able to focus on pathways that are related to specific symptoms of depression.

Ultimately we can use this information to further understand the complex brain processes involved in how people actually experience and express depression and develop more specific and maybe more efficient treatments. In the meantime, it continues to reinforce the scientific understanding of mood disorders and help us educate and advocate with people who still don’t consider mental illness a real physical illness.

Photo by Julie Jordan Scott, available under a Creative Commons attribution license.

Rejection Sensitivity Study Reinforces Biological Basis of Bipolar Depression Symptoms

Candida Fink, MD

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APA Reference
Fink, C. (2011). Rejection Sensitivity Study Reinforces Biological Basis of Bipolar Depression Symptoms. Psych Central. Retrieved on May 27, 2020, from


Last updated: 17 Feb 2011
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