Mindfulness for Bipolar Disorder: How Mindfulness and Neuroscience Can Help You Manage Your Bipolar Symptoms by Dr. William R. Marchand lays out specific areas for mindfulness practices that be useful in managing bipolar disorder symptoms (and most if the book is also applicable to other mood disorders). I believe mindfulness can be a really helpful thing to incorporate into one’s life, so I had originally intended to write this as a summary of the book’s suggestions rather than as a review of the book. However, along with the good stuff I found a fair bit in the book that bugged me as well, so I didn’t think I should leave that out.
A note on language: The author talks about things like “your everyday bipolar life”, “your bipolar self”, and “being bipolar”. If people who have bipolar disorder want to talk about “being bipolar” because that’s how they conceptualize their self and their illness, that’s totally fine, but when people who don’t have a mental illness start talking about “being” bipolar/depressive/schizophrenic/anxious/personality disordered, it grates on me. It bugs me because it sounds like they’re telling us that we are our illnesses, even though it’s not up to them to define us, our identities, and where our illnesses fit in.
Ok, time to delve into the practices the book suggests.
Daily meditation practice:
This meditation is focused on breathing, and bringing the focus back to the breath any time the mind wanders. This noticing and refocusing is an important part of the practice. The breath serves as an anchor for all of the other meditations described in the book.
Targeting bipolar depression:
This chapter looks at recognizing and moving out of autopilot thinking patterns, which often serve the purpose of trying to avoid emotional discomfort. Instead, the aim is to accept the reality of the moment, unobscured by our own beliefs. By mindfully accepting depressive symptoms rather than fighting them, they are more likely to fade away on their own.
The mindful minute meditation is suggested as a regular practice three times a day plus more often as needed. It involves taking an inventory of the body, autopilot scripts that are playing, and mood, and then finding acknowledgement, acceptance, and presence.
Calming bipolar anxiety
The book talks about confronting one’s fears of impermanence. “Being present with impermanence is the toll-free expressway to freedom from suffering. This path leads to the solution to the bipolar puzzle and the solution to the puzzle of all our lives.” In my own experience, when I’m depressed, I’m not experiencing fear about impermanence. Quite the opposite, actually; ideas of permanence get me bogged down in hopelessness. Maybe there’s a freight train blocking my toll-free expressway.
Avoidance is described as a cause of suffering, and the suggested meditation practice involves sitting with an anxiety-provoking idea. This sounds similar to imaginal exposure work. The steps in the meditation are:
- Focus on breath as an anchor for around 5 minutes.
- Bring into awareness a moderately anxiety-provoking situation.
- Observe what happens, including thoughts and bodily sensations. Notice when shifts to autopilot occur and then refocus.
- Watch anxiety begin to fade. However, don’t hold onto a preference for it to go away.
Observing your thinking pattern
This chapter focuses on autopilot, an idea that’s similar to negative automatic thoughts in cognitive behavioural therapy. Autopilot learns from our past experiences, and one of its jobs is to protect us from getting hurt. While this can be useful at times, it can prevent us from taking risks and lead to us getting stuck. It’s useful to recognize how much we’re driven by autopilot, and see autopilots as just thoughts that are neither good nor bad. Rather than suppressing them, we should try to be fully present.
The steps of the recommended meditation are:
- Focus on the breath.
- Expand awareness to physical sensations and then sensory input.
- Watch your thoughts like clouds in the sky.
- Relax in mindful awareness.
Working with mania and desire
While desire is a major source of motivation, it can also underlie discontent and dissatisfaction. Autopilot scripts are often aimed at wanting to be different, and satisfaction doesn’t last long after desires are fulfilled. Mindfulness allows desire to be seen as empty of substance; satisfying it doesn’t lead to true happiness.
The recommended meditation involves the same first 2 steps as in the previous chapter. Then you bring a desire-provoking situation to mind, imagine an open space in your awareness where it can be present, and notice what arises in you.
Managing irritability and anger
In this chapter, thoughts and emotions related to desire and aversion are identified as causing the most problems in bipolar disorder. It’s important to learn to be present with these emotions rather than try to suppress them, and recognize that thoughts and emotions don’t define who we are as people.
Mindfulness is presented as a way to find freedom from fearing your symptoms; it is this fear that tends to trigger autopilot. The author goes so far as to suggest welcoming your symptoms, since they’re present anyway, and this will make it more likely that they will move along. I’m uncomfortable with this choice of words, as I see a considerable difference between accepting what is and actively welcoming it to come and join the party.
Rethinking your bipolar self
Mindfulness gives distance from thoughts about self, which can fluctuate and often become more frequent with depression and mania; instead, these thoughts are allowed to just run in the background. Mindfulness can allow you to be less attached to your own viewpoint, moving from an egocentric to a wider perspective.
The author explains that, “The answer to suffering is to move into mindful awareness, where you can be fully present with reality without needing to fix or change it.” I think this is overly simplistic, and based on some of the other books I’ve read recently (A Fearless Heart and The Book of Joy), compassion is a major piece that’s missing here.
Furthermore, mindfulness “means experiencing at a deep level that, in each moment, the universe and everything in it – including you – is perfect as it is.” From where I stand this is a load of crap. It’s quite a large leap from acceptance to perfection. If you consider the Buddhist idea that compassion is a wish for others and the self to be free from suffering, to see everything as perfect in the moment appears to deny the suffering of others and thus is an uncompassionate stance.
Being bipolar and happy
In this chapter, Dr. Marchand writes that ,“Mindfulness can teach you to view your illness as a gift.” While it seems that what he’s trying to say is that there are things we gain from our illness experience, in my mind calling it a gift makes light of the very real pain and suffering people with mental illness and their loved ones experience. Acceptance of the illness can be a powerful thing, and can allow us to see that there are things we gain from our illness, but that is very different from framing it as a gift.
Happiness is presented as something that “is always available to you right here and now… From the viewpoint of mindful awareness you can be happy and joyful in this very moment… That is the gift of mindfulness.” I’ve ranted before about the idea that happiness is a choice. I’m not saying that mindfulness can’t make it easier to find happiness, but I strongly disagree with the assertion that happiness is always available to everyone at any given moment if you only think in the right way. According to Dr. Marchand, this is as simple as doing a meditation that begins with the breath, then expands the awareness, and “now allow happiness and joy to arise”. The ad slogan “thanks, Captain Obvious” jumps to mind. How remarkably unhelpful.
So in the end, for me the irksome in this book tended to drown out the good, but I still believe in the benefits of mindfulness, and I’m going to continue to work on incorporating it into my life.
You can find my other book reviews in my blog index.