When people ask me about bipolar treatments or bipolar therapy here, I tell them about the research on the therapy or treatment and I tell them this, “different bipolar treatments and bipolar therapies work for different people so try it and see if it helps.”
And I consider this good advice. It’s absolutely true. Different bipolar treatments and bipolar therapies do work for different people – but that doesn’t mean that I, personally, believe in them.
And, to be clear, it’s not so much that I don’t believe in them entirely, it’s more that I don’t believe in them for me.
Enter mindfulness-cognitive therapy or mindfulness meditation.
Does Mindfulness-Based Cognitive Therapy Work?
Now mindfulness is a therapy that’s sort of like meditation and is a part of dialectical behavior therapy (DBT). DBT is, of course, all the rage right now and so is mindfulness right along with it.
Meditation has been shown to actually change the way the brain functions and the structure of the brain and there is evidence of mindfulness/meditation having a positive impact on a person’s mental health, particularly anxiety.
- Here mindfulness-based cognitive therapy was shown to improve cognitive functioning in bipolar disorder
- Here mindfulness-based cognitive therapy changed brain function in bipolar disorder
- Here mindfulness-based cognitive therapy improved residual mood symptoms like depression and attention-difficulty in bipolar disorder
- And so on and so forth
So the evidence would suggest that mindfulness does have a positive impact on bipolar disorder.
Do I Believe in Meditation/Mindfulness-Based Cognitive Therapy?
Well, not really. I think sitting on a pillow in a yoga sanctuary trying desperately not to think for hours at a time and “live in the now” sounds ridiculous, boring and completely unhelpful.
But my doctor recommended a mindfulness course and I decided to take it anyway.
Why would I do that?
It’s simple. Because I don’t know what I don’t know. And it could be helpful. Just like any other bipolar treatment, I won’t know if I don’t try. And I’m the kind of person who looks at the science, and the science is there.
Dedicated to Eight Weeks of Mindfulness Meditation
So now I’m dedicated to one class a week and one formal mindfulness practice per day for eight weeks. And I will do this exactly as prescribed as without trying it with all due effort I’m not really giving it a chance to work. It would be like abandoning a medication after only three days – it’s not useful.
And I’m trying to keep an open mind. While I have major doubts that mindfulness can teach me anything I don’t already know I might be wrong about that and it’s important that I investigate that possibility. Because if I sit here and write about how there are always treatment options and about how people must work at those options then the least I can do is walk that talk.
(FYI, it turns out that mindfulness isn’t so much about sitting in a yoga sanctuary and not thinking. But more on that in a later post.)
My wife and I did 8 weeks and I struggled with it becuase it was so hard to have a quiet mind. dozens of thoughts racing but my wife found it extraordinary calming and does it every day. So, if any of you may not htink that it will work for you, remember the divorce rate of people with bipolar disease and all the broken families and relationships on turning sour. Take the course with them and if they really get into it , it just may save your relationship and or your marriage. My wife now copes with my daily mood swings and all the crap that comes along with it far better and that has taken stress and some guilt off of me. Heck, so many people I know dont even take a “course”. Go to you tube or pick up a book. Pretty simple to do. What is ther to lose? Some time? What is there to gain? In some cases , miracles. It has been a lkife changer for my wife and now my son is doing it and the changes in him are incredible. What the difference between mindfulness and journaling.. Isnt journaling being mindful of what happening in the now?
I feel it has helped me.
Can you recommend a medication that causes less weight, other than Lamictal, which does not work for me? Thanks.
Of course, mindfulness is actually an ancient Buddhist method of achieving peace and ultimately helping oneself and others. Many of my friends have become Buddhists and find this very helpful; none of them has bipoloar disease. I agree that medicine is a must. I was misdiagnosed for 11 years. Finally, I managed to break away from that psychiatrist and find a new doctor who immediately understood my symptoms and began experimenting with different medications. I have some very good ones at this time and am able to see the world fairly close to the way I did before my illness became out of control. I realize that this state likely will not last forever; on the other hand, who knows. So, mindfulness. In the ’60’s, we said “Be here now” (Ram Das). That is how I view mindfulness. When I am in a good moment. I concentrate as hard as I can; I feel the lift in emoltions; I tell myself to remember it; finally, I put all of my power and strength into hoping it will come again. My thoughts scatter much of the time as well. This may sound uterly simplistic, but I try hard to think of something good that the day has brought. I try to get outside of myself. I don’t think we should assume that minfullness means the same thing to all. Why not look at it as something that may merely accentuate the medications and just might work at some level.
About finding the right medication: I have been on a couple dozen and after 12 years of nothing working was told by multiple psychiatrists there is nothing left to try. What few meds I have not been on are in the same classes and work the same way as every one I’ve tried.
I wouldn’t give up and went to another psychiatrist who told me the same thing. She thinks I’m not be bipolar but have an extremely overreactive nervous system. She suggested I try EMDR (Eye Movement Desensitization and Reprocessing, usually used with trauma). I spoke to several therapists who confirmed EMDR is basically for one traumatic incident (which could be one that was ongoing for years like sexual abuse). I was told I have too many different pieces to work on beyond a trauma.
But one of the therapists led me to somatic experience; therapists and other health practitioners train extensively at medical schools in this. It to retrain the sympathetic and parasympathetic nervous systems. It’s a combination of two techniques: 1. You focus on bodily and emotional feelings. Then when you move to the next feeling, pay attention to what you were thinking or feeling (emotionally or bodily) just before you shifted. 2. The other piece of it is body; therapist touches body parts associated with specific organs and goes into different levels of depth within your body (fascia, bone, etc) I have so far had 7 sessions and I do not feel hugely different yet, though it’s very relaxing while she’s doing it. And I THINK I’m agitated slightly less often. I will say I sleep like a rock the days I have body work and I typically have horrible, chronic insomnia. So we’ll see ….
So if you are surprised and find out mindfulness training works, let us know why/how!
What you were saying about forcing yourself to meditate being ridiculous: you’re right, but it’s supposed to be about the opposite of forcing yourself, or even “trying” to make it work. You’re supposed to just let your thoughts come and go. If you wander, you wander. But, I like you Natasha wonder if it works at all for some of us. I think some of us need to have more help quieting our minds before we can meditate. Some of the guided imagery recordings help me; I let my mind come and go just like the therapist on the tape gives us permission to do. And I ultimately end up dosing off, having heard only so much of the recording (at least if I do it when I go to bed). But it does calm me if I can start out not racing wildly.
Here’s more on relaxation techniques – being in the moment and other strategies:
http://www.1uponcancer.com/2012/06/15/be-happy-damn-it/
Meditation/relaxation:
http://www.1uponcancer.com/2011/08/06/3890/
Guided imagery:
http://www.1uponcancer.com/2012/08/09/relaxation-techniques-to-break-away/
I am wondering whether I can ever go medicine free…I have managed to wean off all my medications. I have done meditation, it seemed to help..even if my mind would not shut off either, Natasha! Thank you so much for this blog, by the way! I concentrate on my breathing. I am currently in Equine Therapy. The reason I am off my medications are because I felt as though I had this large concrete wall blocking me to do anything. I was very lethargic. Now I have problems sleeping. But I think meditation can help..and yoga is also recommended. I mention equine therapy because even through the time I was feeling as I mentioned, I could get out of bed Saturdays and know I would be able to be in the barn, able to focus moving that curry comb and brush, and sometimes I would be able to be ride. I believe in therapy, but is there a way to be medicine free? I hate this..I am so frustrated because I do not want to be on medicine for the rest of my life! This is what I was on…900 mg of Lithium, 800 mg of Seroquel, 10 mg of Diazepam..I would take this all at night. It was when the doctor would increase the dose of Lithium, I became more sedentary. It is scary to me…I have no idea how to approach things with medicine because I am afraid I am going to have to take medication. It has also put a great strain on my marriage. I am glad I have a supportive husband…but I feel really guilty about things.
Hi Whitney,
Look, I’m just going to be honest with you, bipolar is _not_ normally manageable without medication. What I hear most often is that people get off their medications and then all sorts of terrible things happen to them, causing them oodles of pain before they start medications again.
Nevertheless, the odd person here and there can manage without medication. They are the exception, however, and not the rule.
Whether you take medication or not is up to you, but I suggest you make peace with taking medication forever, because likely, that’s what you’re going to need. I need it. Many people need it. It doesn’t make us deficient or less than anyone else. It just means that our brains need help. That’s OK.
That being said, the experience you have had with medication, isn’t the only one. If you’re not happy with your medications, I _always_ recommend people work with their doctor to find a better mix. Abandoning medication is not the answer – finding better medication is. It may turn out that the medications you were on had too many side effects for you. It may be that those just weren’t the optimal ones. That’s OK. There are many options out there.
No matter what you decide, do what is right for you and don’t feel guilty. We all make the best choices we can with the information that we have at the time. There is nothing to feel guilty about.
(One other thing, I consider sleep to be, possibly, the most important factor in mental wellness. If you’re not sleeping, get some help, at least temporarily, until you can find another solution.)
Good luck.
– Natasha Tracy
Thanks, Natasha.
I have begun to accept my fate. I am probably going to need medication. I believe that I have been Bipolar Disorder One all this time. I think about the times in my life, and the events that seem to fit under this category. I would go weeks without much sleep feeling as though nothing could stop me in this world…as a child/teenager, as well as my early twenties. I started smoking marijuana at twenty-two, and tried cocaine. I can admit to myself that if I had a line in front of my face I would snort it. It was those times I was reckless and just drawing and drawing. My hands always had pastels and charcoal on my fingers. I have been into dance and theatre as well…those were the times I felt grandiose as well.
I also know in those times after days or weeks without sleep, I would crash and completely withdrawal from society. Everything suffered in my life. Bipolar Disorder runs on both sides of my family…I love my husband. He has been extremely supportive. I believe that being married has grounded me as far as staying a way from drugs and the wrong influences…my dog has been having seizures for the past couple days(he’s fine now!), and it seems to have started after not being able to sleep. So I can say it is Friday morning, at 2:31 I am writing this. I really do want to function as a person. I love animals and now am pursuing my dream of becoming a veterinarian because I actually feel a better connection to animals than I can to people. I take mental health seriously, as well as those suffering from it. I hate people who make accusations…a few months back someone told me “GET OVER YOURSELF!” That really upset me, because I want to get up and do things…however as I stated before, I have begun to accept things in my life, my fate. It is not always going to be rosy, but I will figure things along the way. I have accepted I will have to take things one day at a time. And it is hard, but that is how it is.
A really good answer about medication. I, too, think we do need it, likely forever. Before I found the medications that work best for me right now, I had to find a new psychiatrist. Because I was so ill, it was extremely and almost impossible to break away from the doctor who had been unable to help me. It finally happened when I was hospitalized, as I was many times. The “doctor” came into my room and started literally screaming at me that he didn’t know what to do and that I should tell him. The staff was shocked. When I found Dr.R.’ he shook his head, and said to me, “Bill just didn’t know what to do.” That was one of the best moments of my life. He started experimenting with meds., and I began getting my life back. It took a lot of trial and error, but I have been on 4-5 of them now for about 6 years, and they are good. I spent 11 years with a man who, for all of those years, truly ruined my life and the life of my family. A different doctor, I believe, can change one’s world.
I think that even though you don’t believe in it, the fact that you’re giving Mindfulness a go is fantastic. Finding therapies & techniques to manage my bipolar symptoms has always been trial & error and I’m happy I keep an open mind and try lots of different things.
Personally I found Mindfulness extremely effective- but only whilst I was practicing everyday during the length of the course. I haven’t been able to maintain the practice- probably as I don’t prioritise it high enough. It is definitely a discipline. If I’m being honest, going back to a daily mindfulness practice would be very good for me.
Thanks for talking about mindfulness. The course I went on specifically aimed at Bipolar patients was the best therapy I have had with the NHS and even if I don’t practice everyday, the concepts I learned have had an overall positive effect on my mental health. Hope you find it useful, but as you say, different therapies work for some but not others.
Mindfulness I am 46 yrs old I don’t know how to really link anything together. Too much exercise will pretty quickly exhaust me that includes Pilates and Yoga classes. Oh to throw it all away, breathe, clear my mind, drop my shoulders, stand straight and believe that I have complete control over the wiring in my brain. I have gone through too many bad experiences, non were good because it just doesn’t work that way, for my brain to believe/forget/rewire through “mindfulness” . I do Yoga at home to calm, relax and remember to breath, I don’t believe that I’m of the generation when it really is mind over matter.
I have struggled with medication for a long time – and I’m currently attempting to manage myself. I’ve been attending mindfulness courses & meditation classes and I’ve found them to be incredibly helpful, I can use the techniques on a day to day basis to calm my ‘triggers’ sometimes I find it very very difficult to quieten my mind and I have been taught that it is ok if your mind wanders, simply notice it and try to bring it back again or focus on the sensation of the air going past your nostrils when you breathe.
If taught properly I think this is an incredible tool – it really has made a massive difference to my life.
Despite trying many, many times I’ve never been able to meditate. My brain just doesn’t “get quiet,” EVER.
Hi Rox1smf,
I _agree_ completely. But here’s the secret they told me in class – you don’t have to “stop thinking.” I’ll be writing about that soon.
But seriously, as soon as I heard that I suddenly felt free to succeed.
More later.
– Natasha Tracy
I’m very anxious to hear whether or not mindfulness works for you. I’ve been seriously contemplating investing the time and money in an 8 week MBSR class but after spending $1500 to learn TM only to be told that the reason it wasn’t doing anything for me was that I “am on so much medication” I am hesitant. The mindfulness people of course say their program is completely different and would work wonders for all my bipolar-related symptoms.
Thank you, Natasha for being a guinea pig of sorts…
I think that cognitive therapies can really benefit us during periods of normal thinking. Perhaps even lessen the duration of manic and depressive episodes. This has been my experience anyway. But when we are either manic or plunging into a depressive abyss, and our brain chemistry is misfiring, I don’t think that cognitive therapy has much benefit. Just speaking from my own experience, that’s all.
Meditation, now that is a hard one; especially when you are manic. Depression is the best time for that, my brain just shuts off. I fall into a deep sleep.
In days of old meditation was called prayer. Since we have all but eliminated the God we trust… we must depend on each other for comfort and guidance. The result is a life complicated with machines we don’t understand and a government whose members are without confidence.
Charles,
I disagree completely. Meditation is not prayer, in the traditional sense. Meditation has nothing to do with god or religion and everything to do with self. If prayer helps you then go for it, but it’s not the sort of thing I would do.
And I believe that removing, “In God We Trust” is a good thing. It allows people to express their individual beliefs and not have the beliefs of others thrust on them.
– Natasha Tracy
Actually, there are different usage of mindfulness. For example, when I interact with a patient (I am a nurse), I do it mindfully which gives me the laser focus ability to be 100% present with my patient despite the fact I have 50 others things I needed to finish before the shift end. It can enhance enjoyment, for example eating. Instead of inhaling the food as many nurses do, if one do it mindfully, it is actually more healthy and also increases the enjoyment of the food that one is eating.