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Recovery

Mindfulness - The Ultimate Mood Stabilizer

 

What is arguably the most effective recovery tool requires a highly disciplined mind.

by John McManamy

 

Mindfulness in mental health recovery. Mindfulness is essentially the mind watching the mind. The Buddha came up with mindfulness 2,600 years ago, but all modern talk therapy is derivative of the practice (though only dialectical behavioral therapy explicitly acknowledges its indebtedness).

These days, mindfulness is the new recovery buzzword. There is even something called “mindfulness-based cognitive therapy” (which is something of a redundancy).

In 2005, Melbourne researcher Sarah Russell PhD published a study that surveyed 100 “successful” bipolar patients, asking what they did to stay well. Seventy-six percent of the participants were in paid employment, 38 percent were parents.

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What Dr Russell discovered boiled down to mindfulness, though she didn’t use that term. Rather, she talked about “moving swiftly to intercept a mood swing.” This had to do with how patients “were responding to their mental, emotional, social, and physical environment.”

Dr Russell observed that these patients were adept at identifying their mood triggers. These needed to be picked up much earlier, they reported, than what their doctors recommended. Once depression or hypomania picked up a full head of steam, it was already way too late. Instead, these patients were microscopically attuned to such things as subtle changes in sleep, mood, thoughts, and energy levels.

By quickly responding, successful patients could nip an episode in the bud. Sometimes it was as simple as getting a good night’s sleep or stopping to smell the roses.

At around the same time, Monica Basco PhD of the University of Texas, Dallas came out with “The Bipolar Workbook: Tools for Controlling Your Moodswings.” "See It Coming," said the heading of the first section.

Dr Basco is a leading proponent of cognitive behavioral therapy. In her book, she gives the example of a person with a great idea who stays up all night following up on it. The problem is not the great idea, Dr Basco notes. The problem was staying up all night. Now, thanks to a lack of sleep, there is all hell to pay.

Dr Basco points out that emotions change our thinking, which affects behavior. We need to learn to take stock, spot patterns, and recognize triggers.

In other words, we need to be exceptionally mindful about how we conduct our lives, even if we are on meds.

Meanwhile, I was engaging in a series of conversations with John Gartner PhD of Johns Hopkins, author of “The Hypomanic Edge.” Hypomania can be a very scary proposition for many, but for a lot of us, Dr Gartner pointed out, it can also be a very positive personality trait. I long held the belief that psychiatrists tended to err on the side of overmedicating us. Now a clinician was validating my suspicion.

What I needed from my meds was that they slow me down just enough so I remained in control, not so I felt my wings were being clipped. Hopefully, all the recovery techniques I had learned over the years would pick up the slack. In essence - low dose meds, high dose recovery techniques.

Enter mindfulness.

“Mind precedes its objects,” reads the first line of the Dhammapada, the best-known of the Buddhist scriptures. “They are mind-governed and mind-made. To speak or act with a defiled mind is to draw pain after oneself, like a wheel behind the feet of the animal drawing it.”

Further down, we read: “A disciplined mind leads to happiness.”

Jon Kabat-Zinn PhD of the University of Massachusetts is a molecular biologist and meditation teacher. In his book (with three co-authors), “The Mindful Way Through Depression,” Dr Kabat-Zinn urges cultivating awareness by not taking our thoughts so literally and by “disengaging the autopilot.”

Mindfulness, say the authors, “is the awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to things as they are,” rather than as we want them to be.

If I felt myself becoming unduly agitated, I would typically take a “time-out” from my routine. If I felt myself starting to feel sorry for myself or getting depressed, I would make it a point to get out of the house. On and on it went, all the little coping tricks. Things we do all the time.

Half the trick of mindfulness is being able to spot your mood episodes as they begin - or even before they begin - while you are still in control of your brain, while you still have choices. Most of the time, the solution is fairly simple - a time-out, a break, some quiet moments, a good night’s sleep.

The other half of mindfulness is detachment. Detachment is a key part of Buddhist teaching. When the mind watches the mind, the skillful person does so with practiced disinterest, as if observing the grass growing or the paint drying. Mind you, detachment is way easier said than done, especially when you sense your brain is in the process of rapid disintegration.

Mindfulness begins with the painful reminder that life is not safe. We are vulnerable. Nothing is fixed. Our situation is constantly changing around us. Psychologically speaking, we are always walking at midnight in a bad neighborhood. We need to be awake. We need to be vigilant.

But we have a paradox at play, here. As we grow more adept at mindfulness techniques, our lives become more safe, our existence less fearful. Hypomania no longer has to automatically mean a prelude to mania. And a bad hair day is not necessarily the end of the world.

Bipolar has been called “a dangerous gift,” one that many of us would gladly return to the customer service counter of life. The practice of mindfulness opens up the possibility of realizing our potential, but it also necessitates working within our limitations and leading highly disciplined lives. It means calling it a night when the party is just getting started. It means chilling out in the middle of a productive hot streak. It means maintaining our composure when we feel our situation or our lives falling apart.

We all employ mindfulness to some degree, but cultivating the practice is going to take time. Mindfulness is no quick fix. It is advisable to stay on your current meds doses until you have your high dose mindfulness and other recovery practices well in place. Even then, knowing when to bump your meds doses back up should be part of your mindfulness game plan.

Be mindful. Live well ...

See also: Mindfulness - Living in the Present

Feb 10, 2008, reviewed Jan 4, 2011

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