Bipolar disorder affects about 1% of the population1, so that means about 3.2 million people in the United States, and 74 million worldwide. People with a bipolar diagnosis often struggle with major depression, mania and hypomania, and difficulty keeping their life on track. My doctoral research focuses on how people with bipolar disorder use mindfulness skills to stabilize their moods, thoughts, and behaviors. Jon Kabat-Zinn has defined mindfulness as “paying attention in a particular way: on purpose, nonjudgmentally, in the present moment”2. Mindfulness is a practice, a state, and a trait: mindfulness practice can help produce a mindful state, as well as strengthen one’s overall capacity to be mindful. This article focuses on some of the benefits that mindfulness can have for clients with a bipolar diagnosis.
Coming Into the Present Moment and Decreasing Rumination
Mindfulness practices help people notice what’s going on right now, rather than ruminating on the past or the future3. While thinking about the future and learning from the past can be important, excessive or habitual thinking about past and future can contribute to mood episodes. Mindfulness practice helps clients come into the present moment, and this helps cuts through the rumination that feeds manic and depressive cycles.
Emotional Regulation
Mindfulness can help clients observe emotional states with awareness, rather that be caught up in them. Adopting a witnessing stance towards emotions can reduce rumination, because when clients notice an emotion but don’t add to it with thoughts, they refrain from adding fuel to the fire. Once clients have a grasp on coming back to the present moment (for example, by noticing the breath or doing a body scan), they can use mindfulness to bring awareness to their emotions themselves. In this way they can discover the actual experience of their emotions, rather than their ideas about their emotions; this can bring increased self-compassion and greater insight into emotional patterns.
Prodrome Detection
Many psychoeducational approaches to treating bipolar disorder focus on helping clients notice the early signs of a mood episode4. These warning signs are called “prodromes.” By helping clients pay closer attention to their thoughts, emotions, and behavior patterns without getting swept up in them and losing awareness, mindfulness training can help clients identify the beginnings of a mood episode and take appropriate action to head the episode off at the pass.
Increased Mental Clarity and Self-Acceptance
Mindfulness practitioners commonly report a feeling of increased mental clarity and greater self-acceptance. For clients who need greater clarity to shape their recovery plans and follow through on health commitments, mindfulness can help them cultivate mental spaciousness, clarity, and calm. Self-acceptance and acceptance of experience doesn’t mean giving up on change, but it does mean acknowledging how things are without judgment or aggression5. Mindfulness can help clients with a bipolar diagnosis overcome internalized stigma, denial, and self-aggression, and thus promote recovery.
Studying Reaction Patterns and Shaping Recovery
Mindfulness practice includes examining how thoughts, perceptions, emotions, and behaviors interact and interweave to create experience. Extending mindfulness practice into daily life helps clients understand their experience in microscopic detail, and this can help dismantle patterns of suffering by providing new options for change6. This same mindful awareness can extend to the choices clients make in their lifestyle, activities, and internal ways of organizing experience. By noticing what helps them to feel healthy, stable, and good each step of the way, clients can take the feedback from their own experience in order to build a vehicle for recovery that works for them. Mindfulness promotes self-awareness and gives clients tools to interrupt automatic behaviors and create new patterns in their lives.
Promoting Neural Integration
Mindfulness practice promotes neural integration, neuroplasticity, and attunement to self and others7. By enhancing neocortical integration with the limbic system, mindfulness can help clients achieve greater capacity to modulate emotions. Properly applied, mindfulness can also help clients regulate their autonomic nervous system and exit the fight-flight-freeze responses of trauma states 8. Whether clients with a bipolar diagnosis have a trauma history or not, mindfulness can help soothe the nervous system and teach new skills for self-regulation.
Summary
Mindfulness, then, is a practice, state, and capacity that has powerful potential benefits for people with a bipolar diagnosis. Theory and research increasingly show benefits to mindfulness practice that can be translated to treating bipolar disorder. Because it helps clients work with their experience both in and out of sessions, mindfulness may be a powerful tool for change and recovery.
This article was originally published in The Counselor, Spring 2016, Vol. 45, No. 2, pp. 14–15 and has been lightly edited for publication here.
References
- Jauhar, S., & Cavanagh, J. (2013). Classification and epidemiology of bipolar disorder. In M. Power (Ed.), The Wiley-Blackwell handbook of mood disorders (2nd ed., pp. 289–309). Chichester, England: Wiley-Blackwell. doi:10.1002/9781118316153.ch11 ↩
- Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. New York, NY: Hyperion. ↩
- Deckersbach, T., Hölzel, B., Eisner, L., Lazar, S. W., & Nierenberg, A. A. (2014). Mindfulness-based cognitive therapy for bipolar disorder. New York, NY: Guilford Press. ↩
- Swartz, H. A., & Swanson, J. (2014). Psychotherapy for bipolar disorder in adults: A review of the evidence. Focus, 12(3), 251. doi:10.1176/appi.focus.12.3.251 ↩
- Brach, T. (2003). Radical acceptance: Embracing your life with the heart of a Buddha. New York, NY: Bantam Books. ↩
- Linehan, M. (2015). DBT skills training manual (2nd ed.). New York, NY: Guilford Press. ↩
- Siegel, D. J. (2010). Mindsight: The new science of personal transformation. New York, NY: Bantam Books. ↩
- Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. New York, NY: W. W. Norton. ↩