I wrote that Mindfulness Doesn’t Help My Bipolar Disorder. And I think mindfulness, at least how I was taught it, just doesn’t significantly, positive affect a serious, neurological illness. I find it works best in people who experience stress and anxiety. And many do agree with me on this.
That said, John McManamy does not. Here are his thoughts on mindfulness in bipolar disorder.
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Mindfulness is essentially the mind watching the mind. The practice has been around forever. It is a staple of Buddhist practice, and is also the basis of modern talking therapies such as cognitive behavioral therapy (CBT), even if its proponents fail to give it credit.
In all likelihood, if you have had success in managing your bipolar, you are employing mindfulness techniques, though you may be unaware of it.
Mindfulness in Action in Bipolar Disorder
In 2005, Melbourne researcher Sarah Russell published a study that surveyed 100 “successful” bipolar patients, asking what they did to stay well. What she discovered boiled down to mindfulness, though she didn’t use that term. Rather, she talked about “moving swiftly to intercept a mood swing.” This had to do with how patients “were responding to their mental, emotional, social, and physical environment.”
Dr Russell observed that these patients were adept at identifying their mood triggers. They were microscopically attuned to such things as subtle changes in sleep, mood, thoughts, and energy levels.
By quickly responding, successful patients could often nip an episode in the bud. Sometimes it was as simple as getting a good night’s sleep or stopping to smell the roses. Other times, it was about making medication adjustments.
Monica Basco’s cognitive therapy approach to managing bipolar, The Bipolar Workbook: Tools for Controlling Your Moodswings, similarly takes a mindfulness approach, again without explicit acknowledgement. “See It Coming,” reads the heading of the first section.
We need to learn to take stock, she advises, spot patterns, and recognize triggers. In other words, we need to be exceptionally mindful about what is going on in our lives.
Enter mindfulness. In his book, The Mindful Way Through Depression, Jon Kabat-Zinn urges cultivating awareness by not taking our thoughts so literally and by “disengaging the autopilot.”
Mindfulness, he says, “is the awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to things as they are,” rather than as we want them to be.
Once again, it’s all about spotting trouble way in advance – stress, energy levels, destructive thoughts and emotions – before our vulnerable brains run away from us.
How People with Bipolar Can Use Mindfulness
A good deal of the time, the intervention is fairly simple – a time-out, a break, some quiet moments, a good night’s sleep. In cognitive therapy, this is where we work on changing “it’s the end of the world” to “let’s see if we can find a solution.”
As with any bipolar treatment or management technique, there are no guarantees, but cultivating a keen awareness of what is going on in our brains at any given moment is a surely a much better strategy than passively being taken by surprise.
The second edition to Goodwin and Jamison’s Manic-Depressive Illness characterizes bipolar as an illness that takes on a life of its own. Indeed, that is our apparent fate, to be at the mercy of the relentless cycles that define our illness.
Or we can choose to be active players in managing our illness. This is generally easier said than done, especially when we sense our brain in the process of rapid disintegration.
One day, my illness may swoop in out of nowhere and show me once and for all who is boss. The daily challenge of living with my illness forces me to be aware of that terrible truth every day of my life.
I need to be vigilant. I am dealing with an illness that takes no prisoners. For me, mindfulness is not an option. It is an absolute necessity.
Author Information
John McManamy is the author of Living Well with Depression and Bipolar Disorder. He is currently working on a six-book Bipolar Expert Series. The first book in that series, Not Just Up and Down, is now available.
Banner image by Flickr user Darragh O Connor.
When I heard the term ‘mindfulness’ for the first time, I did what I often do, researched it. I probably became manic with excitement. I thought it sounded like great stuff. I was not feeling well that day and I was desperate to try something new.
But like many new methods that I have read about, I soon became overwhelmed. The old ‘who am I kidding’ voice said ‘you really think you can even feel well long enough to absorb all of this information?’
Frankly, it all seemed a bit overwhelming, too wordy for my simple sick brain.
And yet I could not deny the value of the theory behind it: focusing one’s awareness on the present moment.
When I did try it I found it quite calming. For a moment I stopped focusing on the many other anxious thoughts I was having and instead concentrated on just one simple thing and it helped.
Choosing to focus, not bad advice.
And when I think of the opposite of mindfulness which is mindlessness, well, that is just not an option.
Giving up is not an option either. I like to think that I manage bipolar, not that bipolar manages me!
I have struggled with bipolar disorder for 14 years. I have found that mindfulness is more helpful, at least for me, than any other form of therapy for anxiety, stress, obsessive thinking, etc. It doesn’t directly help my mood. If I feel less anxious and can let go of certain thoughts or reach a place where these thoughts no longer appear it does help my mood indirectly. The more aware I am of myself, of my thoughts, of this disease and how it affects me, the more I can do to help myself and that’s where mindfulness is very helpful.
I guess I use mindfullness-if I’m understanding what it is. What I have done for a long, long time is to sort of step outside my body and watch what I’m doing/feeling/saying in a clinical or scientific way. I have severe bipolar disorder and I’m disabled, but if I can catch that a thought or particular set of thoughts or actions that point to a mood change, I can slam my body with enough medication and stay in for a few days to either stall, slow down, or get rid of a mood swing. Only works with hypomania/mania/depression, not rapid cycling or mixed mania. I those cases, I will crash very quickly-there is no way for me to do the whole “step outside myself” thing, I simply can’t think straight enough. Depression is too subtle for me to catch until it’s pretty bad, too, and I can do nothing about that anyway, I can’t use antidepressants. Plus the stepping outside myself thing is only one tool that I use…it’s not enough in itself to control bipolar disorder. I have a whole toolbox of things that I use.
An observation: many people with bipolar also suffer from anxiety and stress. Natasha, you may be right that mindfulness is more effective for stress and anxiety–but surely anything that helps with those two things will also, at least indirectly, have some effect on bipolar symptoms, just because they are so inextricably intertwined.
I did a course on mindfulness meditation at one stage, based around Kabat-Zinn’s book. The problem I had, as I always have had with trying to learn meditation, is that I felt motivated to practice while I was depressed, but as soon as I felt good my motivation disappeared.
Having said that, the general practice of the mind watching the mind has been very helpful to me. I haven’t had any mood swings for a number of years now, but when I did I found it helpful to talk to myself about what was happening, to say something like : “You’ve been through this stage before. Your mind is racing, but it won’t last” or “You’ve felt depressed like this before. Just go through the motions.”
I recently read David A. Kessler’s book Capture : Unraveling the Mystery of Mental Suffering. It helped to give me a clearer idea of how mental illness works. The emotions which ideas evoke in us are what focuses our mind on them. When we are depressed our mind is captured by negative thoughts about ourselves because the pain they cause us makes them more interesting than any other thoughts. And the same can apply to anxious thoughts or grandiose thoughts or whatever. Kessler comes to the conclusion that the cultivation of mindfulness is one of the best ways to deal with this problem. It helps us to look at what our mind is doing without getting caught up in the strong emotions the thoughts might otherwise engender. (He points out that medication works in a similar way, because it dulls the responsiveness of those parts of the brain which experience those painful or exciting emotions and thus, without the emotional hook, our mind can break free from the capture at least for a while.)
Yeah, very well said!
I found a book long ago, when the doc (M.D.) thought that I was only dealing with clinical depression. Anyway, the book is called “Feeling Good, The New Mood Therapy” by Dr. David Burns. It helped me tremendously, not just with depression, but the mania, too. (Even though nobody new it existed) I realize now that it is a Cognitive method of mindfulness. Even though I still went “off the deep end” from time to time, I did begin to recognize patterns of my own behavior. I was able to adjust, or tweek my attitude, when triggered. Although it is not as helpful to avoid cycling, it has helped me to understand better what is happening in the moment. I had some positive gain from the Dialectic method, as well.
I have BP 2, so what works for me may not work for BP 1. I also have been through myriad of pharma coctails. Each might work for a few months, then needs to be changed again. Something else I did in college out of curiosity, was to read some Kahlil Gibran. He may not know it, but he is a cognitive therapist. Of sorts. Actually, he is a philosopher. But he did help me to adjust my personal mindset.
I am 59 years old, and wasn’t correctly diagnosed until I was 50. I worked hard to understand what had been happening to me, my whole life finally made sense! I guess the very act of learning was a Mindfull technique.
For years, I felt guilty for being less ill than so many others with this illnes. I felt that I had no right to go on disability because it had finally gotten “in front of me, instead of beside or behind me”. But, I still try to be mindful. My meds still have to be adjusted. I just try. It’s far better for me than not trying.
I am only about 30 days into my mindfulness journey but I am already seeing the positive effects of being aware. The big things that hit me in this article were the “good nights sleep” and “taking time to smell the roses” because that is exactly what has been happening. I don’t expect mindfulness will be the magic bullet, but anything that can give me a degree of control instead of the illness has to be a good thing.
Another free 21 day meditation on mindfulness backed by Deepak Chopra and Oprah Winfrey as just begun on July 11. I find all meditation and prayer comforting to my mood swings if I can calm down enough to get into it. I have not had good luck with psych pharma and medication side effects often prevent me from getting into it. Today’s message says: “How to Be Renewed Every Day, CENTERING THOUGHT I embrace the newness of this day. “I can hardly wait for tomorrow, it means a new life for me each and every day.” – Stanley Kunitz
Today’s meditation teaches us that when we rely upon familiar repetition to guide us through life – instead of stepping into the ever-new possibilities of the present moment – we remain in a stale, stuck pattern of living. When we learn to fully embrace the limitless potential in the now, we are continuously renewed and liberated from the stuckness of powerlessness and blame. Living in a state of renewal then becomes easy and natural.”
While in the meditation, I experience that peace and respite. However, the stale stuck pattern of my bipolar past seems to want me to be accountable to those behaviors. That old life doesn’t just disappear.
I was introduced, when first officially diagnosed, to the world of being Bipolar via HealthCentral’s Bipolar website. I was introduced to John and yes, to Natasha because it was a link on that site that brought me to Natasha’s original Bipolar Burble (prior to the move to the US, the subsequent toss back, etc.).
Like Natasha claims.. cause anyone can be anyone on the internet… John worked a full career, to come up with Bipolar diagnosis (he was misdiagnosed) to be on scores of meds and find he could no longer work his full career. So, he went home and at some point later, became an Author. He does the lecture and seminar circuit and at one time, was very big within his NAMI circles. So, he is “one of us”.
Am I pro John? No more than I am pro Natasha but I am not going to discount his blog of “mindfulness”.
It is not for those with Stress and Anxiety only and we, who have Bipolar, suffer mercilessly with stress and anxiety. It is really a common component and if you stop and really think about it (part of the mindfulness, by the way), we’d all realize that we all respond and react to stress and anxiety in our daily lives.
“Mindfulness” is becoming less of a novelty and more of the “norm” for those with mood disorders (even some psychiatrists are on board with recommending groups and studies). Like the pharma psych meds; what it was once created for is now utilized in so many different areas because in many, it helps.
Does it replace psych pharma? Absolutely not, but, it does assist or as one above noted; adjuncts to the treatments and therapies.
As i understand it – it teaches you to focus on your thoughts and feelings and physical responses, choose to validate them or put them aside and observe. This hesitation by focusing on thoughts, feelings and physical responses.. creates time to really stop and decipher whether what is going on is accurate or a perception created by our illness = which as we often know, is twisted when we are symptomatic.
It also teaches to break down the anxiety and feeling of overwhelm… to take stock in what actually seems to trigger and stress us.. and to recognize our part of how we behaviorally respond. It helps us to acknowledge and accept, to learn what are triggers and stressors, and how we can positively avoid or go through them.
This, of course, focuses on WE stopping to become mindful of how we are not only feeling in response to but also how we behaviorally respond to… that which creates impulse to do or act or feel. To non-judgmentally observe and then decide whether we act or we sit back and put it aside.
Like catching the head of it and trying to steer it around or stop it, rather than be whipped around by it’s tail.
It is just another form of therapy treatment to add to the many, including pharma meds, to help us in our daily lives to function more and dysfunction less.
Like everything else… not everyone gets it and not everyone has success with it.
Our illness, if properly and accurately diagnosed (cause Bipolar is very much mis-diagnosed in so many, much as other MIs).. is a highly complex and individualized illness that affects and effects each person individually. It is not the same in each person but each person shares common traits and it does not manifest the same in each person. Thus, eh, the complexity of it.
Your BP I is not my BP I, etc.
CBT has helped me transform my life in a big way. To me, not having cognitive awareness of your moods, thoughts, and actions means being a slave to bipolar. After my diagnosis, I used CBT to get me through before I finally settled in on some effective medications. Just the CBT alone had a huge impact. I think it is really great that CBT has similar aspects with Buddhist wisdom. It validates it all the more.
I advise people with bipolar to spoil themselves emotionally and physically – talking therapy, fresh air and sunlight, a reasonable amount of food treats, prayer, healthy living, etc; my bipolar doesn’t bother me at all any more (I am 50-ish now and seem to have ‘outgrown’ it, with help from God, although I have recently had a lot of other problems, but that’s life); ‘spoil yourself rotten’ in lots of good healthy ways to cope and to enjoy life. the mental health system is useless – be your own best friend and be kind and good to yourself, and don’t forget prayer.
Some of what is called “Zen Meditation” is not what was traditionally taught until recently. “Mindfulness” as I understand it is allowing one’s thoughts to go where they will, and follow them; Zazen is not like that. Traditional Zazen is better described as “controlled focus”, where you maintain concentration on your breathing or an assigned koan practice. You don’t manipulate your breath, but you stay focused on it; there is no wandering of thoughts in this practice. In the case of being Bipolar, I find it helpful, but a lot more difficult to do than before my symptoms worsened in the past 20 years, when I had given up the practice.
If you try to do it, it can be frustrating; do so under the direction of a teacher who has been practicing Zazen, and not some watered-down or Westernized version of it.
I think the freewheeling of thoughts in “mindfulness” is counterproductive for people who are Bipolar, as it can serve to amplify one’s thoughts, and not allow them to quiet.
I agree that mindfulness doesn’t affect my basic bipolar 1 illness. At best, it is an adjunct tool. I practice mindfulness type techniques. I don’t like to use that idiot buzzword because the fact that cognitive tools are often considered viable “treatments” for bipolar itself disgusts me! Yes, vigilance and aware watchfulness are imperative. These types of techniques do help me with situational stress and anxiety that can lead to hypomania or depressive crashes.
However, they do not make me FEEL GOOD. They do not affect where my cycle is or prevent acute episodes that just smash into me without warning. I think many mental health writers and professionals (especially those that don’t have bipolar) often forget that: #1. Bipolar IS a serious neurological brain disorder. #2. There are degrees of severity, so one size doesn’t fit all.
It REALLY burns me up when these kinds of cognitive tools are seen as addressing the basic SMI itself. Then when they aren’t effective, the attitude of practitioners tends to be, “Tch, tch. You didn’t read the handouts. (Usually slick, trite little brochures with pretty, smiling young people who had their heads in their hands on the 1st page). You didn’t practice what we demonstrated (often briefly in groups led by nervous interns).” Meanwhile, if mindfulness is being used in lieu of effective treatment, the person with bipolar is suffering terribly from the illness, plus the stigma of ‘failing’ at managing it, and they could frigging die!
I’ve had mindfulness, meditation, sleep hygiene, better eating habits, stress-coping skills, etc. lectured at me ad-infinitum by well-meaning friends, therapists, media, and negligent psychiatrists. I don’t speak for all people with every flavor of Bipolar Disorder. Those techniques may indeed work for everyone else. None of them have ever worked for me. If indeed they had, I would not, at 43, need either the medical community nor medication.
This. This is the thing. I live with this every single second of my life. Do I wish I could exchange my brain for a new one? Of course I do. But I don’t get that option. The last thing I need from anyone who isn’t, as the Marines like to say “in the s**t”, is what is an essential skill for coping with what is in my brain. Share with me by all means what’s worked in your experience, but DO NOT lecture me about what will be essential for coping with MY brain.
This is why many people become so frustrated with the medical/holistic/therapeutic/well-meaning community and just give up. We would all like to invite you into our brains for five minutes and see just how long you could actually hang. Work with us. Listen to us. Try to empathize with what we are telling you about what works and what doesn’t. Don’t lecture us about what “gold-standard” treatments are. Don’t look confused and tell us something should be working when we tell you it isn’t.
And honestly, after all these years, I’m more likely to take advice from a fellow soldier in this war, than I am from someone trying to make money off of it.
Yes! Well said!
Well said; that’s why I posted what I did. So much of what was once useful training of the mind has become b*stardized into some catchword for others to make money off of. Because everyone who is Bipolar responds to things differently, and at different times, it’s obvious there is no magic pill. For myself, I am better focused in the morning, and then after noon or so, it’s “anything goes.”