Today's post is by Simon Barker (University of Tartu) on his recent paper, "Epistemic health, epistemic self-trust, and bipolar disorder: a case study" (Synthese 2025).
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| Simon Barker |
Four years ago, I was diagnosed with bipolar disorder (and later, ADHD). My mind soon after returned to the point when my PhD studies were violently derailed by what I now see as a mix of depression and mania. Then, it took an extended break and inordinate support from my partner, supervisors, and other staff in the Sheffield philosophy department to get me over the line. Now, from my post-diagnosis vantage, I saw that those struggles fit a pattern. My bipolar disorder (and ADHD) and intellectual life have always fluctuated together – as if the same thing. My depressions comes with intellectual disinterest, crashing confidence, and an inability to think; my manias with an urgent flame of intellectual grandiosity yet thoughts racing too fast to make sense of.
This entangled mental health and epistemic agency – our capacity to know and understand the world, ourselves, and others, to ask questions, have intellectual interests, and pursue them – is hardly unique to me or bipolar disorder. They are interdependent by nature. Both are also at the very centre of who we are and what lives we lead. And because of that, their relationship – our epistemic health, as I think of it – is deeply important.
In my paper “Epistemic Health, Epistemic Self-Trust, and Bipolar Disorder”, I offer a first attempt at a philosophical sketch of what I have in my mind by epistemic health and, hopefully, illustrate why that concept might be a useful one to have. To do so, I present a case study of the associations between bipolar disorder and – what I struggled with during my PhD – maladjustments of epistemic self-trust.
Self-trust is a key aspect of our epistemic agency because any effort “I” make to know or understand something requires me to exercise my own intellectual and cognitive abilities, and, likewise, its success depends on how and how well I do that. Thus, if I am to know or understand anything at all, I must first “trust” myself.
In the paper, I follow the view that this really is a form of trust – a positive attitude toward oneself akin to those we have when we trust other people. When I have this attitude, I feel that my efforts and interests are worthwhile and that I am competent to pursue them. This feeling, in turn, provides me the motivation and direction needed to do that.
It is this combination of feeling, motivation, and direction that puts the self-trusting in a position to acquire knowledge and understanding. It also marks self-trust as an affective attitude – which is precisely why it always stands in relation to one’s mental health. This is significant because self-trust, like trust in general, can become harmfully maladjusted:
I can fall into self-distrust – de-motivated and feeling intellectually worthless and utterly incompetent. I can develop excess self-trust – all restless energy and intellectual arrogance, dogmatic in the rightness of my every thought. With either, I become vulnerable to significant epistemic harms that range from losing knowledge to excluding myself from social practices like discourse and disagreement that are vital not only as epistemic resources but to who we are as persons more generally.
Given the necessity of self-trust and the harms of self-distrust and excess self-trust, its interconnectedness with mental health is also central to our epistemic health. The reason I chose to look at bipolar disorder, then, is because depression and mania can also involve swings in motivation and energy and feelings about self-worth and competence – as well as cognitive impairments. Thus, it is easy to imagine how it could be associated with maladjusted self-trust in both directions.
In the paper, I explore this idea in two parts.
First, to see if there is any generalisable evidence of a vulnerability to maladjusted self-trust, I survey research on bipolar disorder and its association with metacognitive impairments. Second, to make sense of what it is like to experience that vulnerability first-hand – a perspective I think is essential to understanding any aspect of mental health – I discuss three extracts from Kay Jamison’s bipolar memoir An Unquiet Mind.
Leaving the details to the paper, my conclusion is that there is evidence of an association between bipolar disorder and self-trust – though it is more heterogeneous than I had initially supposed. Moreover, when it turns harmful, the impairments to epistemic agency are neither incidental to nor caused by the disorder. Rather, the maladjusted self-trust becomes a constitutive feature of the disorder at that time, and vice-versa. And for the person who experiences that, they are one and the same thing – a state and a part of epistemic health.