Improve Bipolar Disorder with Mindfulness
By John M. de Castro, Ph.D.
“Mindfulness-based cognitive therapy appears to have lasting benefits for people with bipolar disorder, a new study . . surveyed participants two years after the training and found that incorporating mindfulness practices and mindful breathing into daily life on a regular basis was associated with better prevention of depressive relapse.” – BPHope
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. It is thought to result from imbalances in the monoamine neurotransmitter systems in the nervous system and appears to be highly linked to the genes. 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. 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 for the treatment of depression and has been shown to be very effective. MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. So, MBCT may be a safe and effective treatment for Bipolar Disorder.
In today’s Research News article “Effectiveness of Mindfulness-based Cognitive Therapy in Patients with Bipolar Affective Disorder: A Case Series.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5769203/ ), Joshi and colleagues report on the treatment of 5 cases of bipolar disorder with 8-12 weeks of Mindfulness-Based Cognitive Therapy (MBCT) with the addition of emotion regulation training, meeting for minutes 60-90 once a week with additional home practice. Patients completed measurements before and after treatment for depression, anxiety, emotion regulation, quality of life, and acceptance.
They found that all 5 patients had clinically significant improvements in depression from 57% to 100%, clinically significant improvements in 4 of 5 patients in anxiety from 36% to 68%, and clinically significant improvements for 2 patients in acceptance from 40% to 54%. Patients also showed significant improvements in emotion regulation especially in acceptance of emotional response and access to emotion regulation strategies, and in quality of life. Hence, MBCT training appeared to produce clinically significant improvements in all 5 patients bipolar disorder symptoms.
This was a case study design without a control or comparison condition and as such is open to bias and confounding. Other controlled research, however, has demonstrated that mindfulness training, including MBCT training, causes significant improvements in bipolar disorder, and in depression, anxiety, emotion regulation, quality of life, and acceptance. So, it is likely that the improvements observed in these 5 cases of bipolar disorder are the results of MBCT producing symptom relief.
So, improve bipolar disorder with mindfulness.
“Mindfulness exercises and meditations are useful for people with bipolar disorder (manic depression) because mindfulness: decreases the relapse rate for depression, reduces stress and anxiety, which contribute significantly to the onset of both mania and depression and may worsen the course of the illness, and improves a person’s ability to manage thoughts and feelings and increases awareness of the way the person tends to internalize external stimuli.” – Shamash Alidina
CMCS – Center for Mindfulness and Contemplative Studies
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Suvarna Shirish Joshi, Mahendra Prakash Sharma, Shivarama Varambally. Effectiveness of Mindfulness-based Cognitive Therapy in Patients with Bipolar Affective Disorder: A Case Series. Int J Yoga. 2018 Jan-Apr; 11(1): 77–82. doi: 10.4103/ijoy.IJOY_44_16
The present investigation was undertaken to examine the effects of mindfulness-based cognitive therapy (MBCT) on interepisodic symptoms, emotional regulation, and quality of life in patients with bipolar affective disorder (BPAD) in remission. The sample for the study comprised a total of five patients with the diagnosis of BPAD in partial or complete remission. Each patient was screened to fit the inclusion and exclusion criteria and later assessed on the Beck Depressive Inventory I, Beck Anxiety Inventory, Difficulties in Emotion Regulation Scale, Acceptance and Action Questionnaire-II, and The World Health Organization Quality of Life Assessment-BREF. Following preassessments, patients underwent 8–10 weeks of MBCT. A single case design with pre- and post-intervention assessment was adopted to evaluate the changes. Improvement was observed in all five cases on the outcome variables. The details of the results are discussed in the context of the available literature. Implications, limitations, and ideas for future investigations are also discussed.