How to maximize the practice of mindfulness for bipolar disorder wellness
Reprinted from "Mindfulness" issue of Visions Journal, 2016, 12 (2), p. 18
I was first introduced to the concept and practice of mindfulness when I was in high school, not as part of the school curriculum but as a supplement to my treatment for bipolar disorder and anxiety. Throughout high school, I experienced rapid mood cycling and constant racing thoughts, which made it difficult to concentrate and be fully present in school and other areas of my life. My school counsellors and my psychologists suggested mindfulness in the hope that it would help to prevent unmanageable mood states.
At the beginning of counselling sessions, the counsellor would lead me in creating a soothing mental image that enabled me to relax and open my mind to learning mindfulness techniques. I enjoyed these brief, quiet vacations from the loud and unforgiving experiences I was enduring.
The Bipolar Youth Action Project
Wellness and mindfulness strategies for people with bipolar disorder
The Bipolar Youth Action Project was a research collaboration between youth co-researchers with bipolar disorder, the Collaborative Research Team to study psychosocial issues in Bipolar Disorder (CREST.BD) and the Bipolar Disorder Association of British Columbia. As a peer researcher with the project (which was funded by the Victoria Foundation), I helped to uncover wellness strategies among young people with bipolar disorder and gain insight into their daily self-care. Together, we shed light on numerous strategies and supports, including the mindfulness practices youth were engaging in for general and in-the-moment mood regulation. Among the many variations of mindfulness practice, meditation and nature appreciation were said to be helpful, as were yoga and other grounding exercises. Participants also commented on the use of CBT techniques in identifying and easing irrational thoughts.
Many participants recognized the capacity of mindfulness strategies to shift their state of mind toward a more positive outlook and to increase their awareness of their inner thought processes. In turn, this allowed them to better recognize depressive and manic mood states and to develop effective in-the-moment coping strategies.
After two years of collaboration, the Bipolar Youth Action Project developed a knowledge database of wellness strategies for youth living with bipolar disorder. The strategies included a wide range of biopsychosocial aspects, from mindfulness practices to diet and exercise and social supports. This knowledge can be used to better inform young people and their service providers about mental health treatment options.
You can find the Bipolar Youth Action Project’s video on mindfulness strategies at www.crestbd.ca
However, after years of practising various mindfulness strategies, such as body scans, mindful breathing and gratitude exercises, I began to feel as if the process was contrived and not very helpful. I felt pressure to look as if mindfulness practice was working, even when I felt it wasn’t. For example, often I was too depressed or too manic to commit to therapy but found myself acting like the mindfulness strategies were helping me in order to please my therapist. I frequently felt put on the spot, too intimidated to admit that the practice wasn’t working for me. It didn’t help that during my counselling sessions the therapist would often maintain direct eye contact, which made me feel emotionally vulnerable, awkward and nervous.
I was never able to successfully replicate and practise the exercises at home on my own. This increased my anxiety and made the experience even more intolerable. By the end of high school, I had come to see mindfulness practice as a tedious, somewhat patronizing process—one that I didn’t have much choice about. In hindsight, I see that the problem was the manner in which mindfulness was introduced to me, not the practice of mindfulness itself.
It wasn’t until I took responsibility for my own wellness strategies in university that I realized I could make mindfulness practice something that could work for me. As mindfulness is often a self-directed method of therapy, I couldn’t rely on someone else to increase my understanding. I was the only person who could take control of my learning.
For many people, mindfulness can seem like an overwhelming process. But as a process, mindfulness practice takes dedication, time and effort. The benefits of mindfulness practice aren’t immediate, and mindfulness practice can be difficult to maintain, especially when negative symptoms like racing thoughts, restlessness and suicidal ideation are relentless and actively affect your cognitive and emotional state.
For me, one of the most challenging aspects of practising mindfulness for bipolar disorder is the focus on being totally aware of one’s mental state. I had begun learning mindfulness techniques pre-emptively, in order to help alleviate the intensity of my bipolar episodes, but at times I was still experiencing challenging mental states. If I was in the middle of one of these episodes, or experiencing any number of negative, bipolar symptoms (such as irritability or agitation), the last thing I wanted to do was be more aware of the mental state I was trying to ignore. At first, the concept of practising mindfulness in this context was absolutely frightening.
Thankfully, through online resources and personal trial and error, I discovered several different mindfulness strategies that work well for me, given my distinct needs and limitations (in addition to BPD, I struggle with anxiety, learning disabilities and various family issues that affect how consistent, motivated and mentally present I can be at any given time). I realized that focusing on something external was the best way for me to obtain the benefits of mindfulness without becoming overwhelmed by my own thoughts.
I find being alone in nature to be incredibly enjoyable, whether I am doing something active or simply sitting on a beach listening to the sound of waves on the shore. It is much easier to practise mindfulness techniques within this sort of environment. I focus on external things—the beauty of a particular area, even the details of a single tree or flower—instead of on internal cues. In this type of mindfulness practice, the goal is to focus on the details of something external very intently, like the curves of a flower petal or the sound of crashing waves, without allowing my thoughts to wander.
In the beginning, I struggled to stay calm and maintain my focus. Reminding myself that mindfulness is a difficult, ongoing process has made it much easier. I allowed myself to learn the process organically, without judging myself or my abilities. I made my mindfulness practice the time I set aside in my life to engage in self-care and become more in tune with the beauty of the outside world.
My advice for someone pursuing mindfulness practice as part of a wellness routine is to choose a mindfulness strategy that is simple, convenient and personally meaningful: find something that speaks to you. This will make it easier to maintain the practice. It will make your experience more enjoyable over the long term, and the techniques will be easier to master.
For instance, you could begin your mindfulness practice by exploring the mindfulness meditation videos on YouTube, which are very watchable. I often access the guided meditations or nature sound videos before an exam or to help me fall asleep. Another mindfulness strategy is to focus your awareness on very basic daily processes such as breathing and eating. This is a great way to become acquainted with the practice of mindfulness: it’s free, convenient and always accessible.
The most important thing to remember is that there’s no perfect, right way to be mindful. If we get caught up in the idea of practising mindfulness perfectly, this inhibits our ability to focus on the present moment. The true beauty of mindfulness is that it creates a space in your mind that is free of judgement and criticism. With practice, this space can become a defence against negative or harmful thoughts and challenging mood states.
For more information on CREST.BD, visit www.crestbd.ca.
The Bipolar Disorder Society of British Columbia website is http://bipolarsociety.ca/.
For more information on wellness and bipolar disorder, visit the Bipolar Wellness Centre website, at www.bdwellness.com.
Another great resource is the Bipolar Babes Project at www.bipolarbabes.com.
In 2017, CREST.BD will be launching an international study of new psychological interventions for bipolar disorder, including mindfulness and psychoeducation. You can find out more about this study at www.crestbd.ca/research/research-areas/psychosocial-interventions.
It is also important to remember that there are several limitations to practising mindfulness. First, despite the current hype around mindfulness, it is not a cure-all therapy. Although there are many positive benefits of mindfulness as a stand-alone practice, it is often supplemented with medication and other therapies (such as cognitive-behavioural therapy, or CBT). Second, approaching mindfulness with expectations that are too high may result in disappointment and a resulting reluctance to continue, especially when one doesn’t see immediate benefits. In some cases, this kind of experience can even perpetuate anxious thoughts and feelings of inadequacy (along the lines of “I must be doing this wrong” or “I’m not good enough”).
It is not necessary to have all the information about mindfulness before you start, but it’s important to consider the pros and cons of incorporating mindfulness practices into your life. You may need to determine whether coming to terms with negative thoughts and emotions through increased awareness is a safe and beneficial process for you. Mindfulness may not work for everyone. However, by exploring different mindfulness options and trying new mindfulness practices, you can mould mindfulness to your lifestyle. Self-directed therapies like mindfulness can help you build control over your own wellness strategies and help alleviate the negative symptoms that create barriers to your well-being.
About the author
Jeanne-Michelle is 24 years old and pursuing a BA in psychology from the University of Victoria. She is a co-researcher with the Bipolar Youth Action Project and a passionate advocate for mental health initiatives and living with mental illness. She has a strong interest in supporting vulnerable populations through volunteerism and community involvement