How can Mindfulness help individuals with bipolar illness?

"Dr Tamara Russell"

We know that those with bipolar illness face some particular challenges, and the first one is often acceptance of the illness. Acceptance of thoughts and feelings, as well as the illness itself can be an important step for someone with bipolar.

We also know that the recurrence of illness is high (up to 60% in 2 years), adherence to medication is low, and even individuals who are optimally medicated are likely to have a recurrence of illness in 50% of cases. The presentation of the illness also varies widely which means that a “one size fits all” psychological treatment may not be suitable.

Mindfulness training can help individuals with bipolar in a number of ways including:

• Greater sensitivity to changes in mood (e.g. noticing mood increasing or decreasing)
• Greater sensitivity to changes in mental state (e.g. noticing racing thoughts)
• Acceptance of illness and the uncertainty it brings
• Better able to recognize stress and act effectively to combat it’s deleterious effects
• Improved communication with family and loved ones around illness issues

How effective is Mindfulness training help those with Bipolar

There is a small but growing research literature on the effectiveness of mindfulness training to help those with bipolar.  An early pilot study by Williams and colleagues (Williams et al 2008) revealed that an 8-week, group MBCT training program alleviated anxiety symptoms in individuals with bipolar. This finding was in a sample of individuals who were currently in remission but had a history of suicidal thoughts.

A larger study by Miklowitz et al (2009), also recruiting participants who were between episodes, demonstrated that both depressive and mania symptoms can be reduced by this training.  Chadwick’s study was qualitative in nature (Chadwick et al 2009) and asked those who had taken part in a mindfulness program to share their experiences of what was helpful.

Several themes emerged, including:

• clearer awareness of mood state/change;
• acceptance,
• mindfulness practice in different mood states,
• reducing/stabilizing negative affect,
• relating different to negative thoughts,
• reducing impact of mood state and focusing on what is present.

Finding a qualified Mindfulness Teacher specialising in Bipolar

Although the majority of studies have explored group based mindfulness training it is also possible to learn these meditation techniques in one-to-one therapy with a qualified teacher.  It is recommended that those with mental illness seek out a therapist who has been trained in mindfulness as this professional with have the appropriate knowledge about the illness as well as the mindfulness training.

We know from research with healthy populations that the key determinants of “successful” mindfulness training relate to the experience of the teacher and the amount of personal practice the individual can complete.  Therefore, it is essential to find a therapist who has their own personal practice and appropriate supervision to ensure you are getting the best chance to benefit from mindfulness training.

You will also need to make a commitment to yourself about how much you are willing to put into your self-development over the course of the training.  You might also think about whether now is the time to do this work.  Another thing we have learnt from studies is that it is often those who are suffering the most who benefit from the training. This is most likely due to their increased motivation to do (or try) something different and their motivation to practice at home.

Adaptations to the training for those with bipolar illness include a more detailed focus on bodily and mental sensations and experiences related to mania and hypomania, as well as thoughts and feelings associated with periods of depression.

Key facts about mindfulness training:

• Find an experienced practitioner/therapist
• Be prepared to do the homework
• Be prepared to meet you mind (and all its monkeys)
• Be prepared to turn towards mental and emotional experiences you might previously have avoided

Clinical Partners offers Mindfulness practise for Bipolar sufferers

At Clinical Partners we have a Clinical Psychologist, Dr Tamara Russell who specialises in Mindfulness-based approaches to help clients work through a variety of mental health issues including Bipolar Disorder.