Improve Bipolar Disorder with Mindfulness-Based Cognitive Therapy
By John M. de Castro, Ph.D.
“Bipolar disorder can be complicated by stress, and having bipolar disorder is stressful in itself. Relaxation techniques such as meditation can reduce the stress you experience from bipolar disorder, which can help you keep your mood in check.” – Timothy Legg
Bipolar Disorder, also known as Manic Depressive Disorder, is a mood disorder characterized by alternating states of extreme depression, relative normalcy, and extreme euphoria (mania). The symptoms of depression and mania are so severe that the individual is debilitated and unable to conduct their normal daily lives. The depression is so severe that suicide occurs in about 1% of cases of Bipolar Disorder. There are great individual differences in Bipolar Disorder. The extreme mood swings can last for a few days to months and can occur only once or reoccur frequently.
Bipolar Disorder affects about 1% of the population throughout the world at any time. But about 3% to 10% of the population may experience it sometime during their lives. It is usually treated with drugs. But these medications are not always effective and can have difficult side effects. This disorder has been generally been found to be very difficult to treat with psychotherapy. Hence, there is a great need for alternative treatments.
Mindfulness practices and treatments have been shown to be effective for major mental disorders, including depression and anxiety disorders and to improve the regulation of emotions. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior.
It would seem appropriate to summarize what has been learned about the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) for the treatment of bipolar disorder. In today’s Research News article “Mindfulness-based cognitive therapy for bipolar disorder: A systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7448295/) Lovas and colleagues review and summarize the published research studies of the effectiveness of MBCT for the treatment of bipolar disorder. They identified 13 published research studies.
They report that the published research studies found that Mindfulness-Based Cognitive Therapy (MBCT) significantly reduced depressive symptoms of patients with bipolar disorder while not eliciting symptoms of mania. MBCT appears to also reduce anxiety and suicidality. It appears to reduce depressive symptoms and improve mood by decreasing rumination, repetitive negative thoughts. It also appeared to improve attentional control, broadening present moment awareness from a focus on negative thoughts. In addition, it appears to create reappraisal, such that the patients were able to reappraise their negative thoughts as just thoughts and not facts. The improvements in depressive symptoms were found to be related to the amount of home practice during MBCT training.
These are promising results suggesting that Mindfulness-Based Cognitive Therapy (MBCT) is a safe and effective treatment for the depressive symptoms of bipolar disorder. But the authors report that the published research studies were generally of low research quality and underpowered to discern statistically significant effects. So, better designed and larger studies need to be conducted before firm conclusions regarding benefits can be reached.
So, improve bipolar disorder with Mindfulness-Based Cognitive Therapy.
“mindfulness-based cognitive therapy (MBCT) may help individuals with bipolar disorder prevent depressive episodes and has lasting benefits to the brain and cognition.” – BP Magazine
CMCS – Center for Mindfulness and Contemplative Studies
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Lovas, D. A., & Schuman-Olivier, Z. (2018). Mindfulness-based cognitive therapy for bipolar disorder: A systematic review. Journal of affective disorders, 240, 247–261. https://doi.org/10.1016/j.jad.2018.06.017
Persisting high levels of relapse, morbidity and mortality in bipolar disorder (BD) in spite of first-line, evidence-based psychopharmacology has spurred development and research on adjunctive psychotherapies. Mindfulness-based cognitive therapy (MBCT) is an emerging psychotherapy that has shown benefit in related and comorbid conditions such as major depressive, anxiety, and substance disorders. Furthermore, neurocognitive studies of MBCT suggest that that may have effects on some of the theorized pathophysiological processes in BD.
We conducted a systematic literature review using PsychINFO and PubMed databases to identify studies reporting clinical and/or neurocognitive findings for MBCT for BD.
This search revealed 13 articles. There was a wide range in methodological quality and most studies were underpowered or did not present power calculations. However, MBCT did not appear to precipitate mania, and there is preliminary evidence to support a positive effect on anxiety, residual depression, mood regulation, and broad attentional and frontal-executive control.
As meta-analysis is not yet possible due to study heterogeneity and quality, the current review is a narrative synthesis, and therefore net effects cannot be estimated.
MBCT for BD holds promise, but more high-quality studies are needed in order to ascertain its clinical efficacy. Recommendations to address the limitations of the current research are made.