Meditation and Bipolar

"Knuckles - Meditation" by carriepika

Ok so lately I have been attending meditation classes (at Rigpa). I think I have been doing this for about 5 weeks. So far I feel it has been really beneficial. First there is the meditation itself, which is interesting, and then there is the fact that I guess it is nice to be able to be actually engaged in the aspiration to improve myself and be a better person. I think one of the benefits of therapy is that you are actively working on self-improvement, so it is the same with doing a meditation course (or perhaps similar kinds of courses such as yoga).

The thing is, although I have let the instructors know I am prone to anxiety and negative emotions, I haven’t told them I have a bipolar 1 diagnosis and that I am on antipsychotic medication (350mg of Seroquel a day). I remember years ago I had a friend who suffered from clinical depression who signed up to do a meditation retreat and the centre knocked him back, saying that people with a history of mental illness shouldn’t attend such retreats. I guess I am worried that if I tell the Rigpa instructors I have a history of mental illness they may freak out in some way that will make me feel stigmatised. Then of course there is the concern that maybe meditation is a risky thing? To answer this question I have been doing a fair bit of reading up about this topic and the conclusions I have reached thus far suggest that people with a history of mental illness, in particular people with a history of clinical depression, anxiety, schizoaffective disorder or bipolar:

• are likely to benefit from learning and practicing meditation, and cultivating mindfulness, for it can help to “tame the mind” (have more self control and be calmer) and to understand the mind by enhancing perception of the underlying processes that kick off complex emotions;
• should learn mediation from an experienced teacher (rather than just from books or videos) and (eventually!) inform their instructor/s of their psychiatric history;

Anger, Self Control and Acting Opposite

"Anger of the Rainbow" by c-d-i

Yesterday I became angry - really angry. I hadn't taken my medication that morning and I didn't have any on me (I was out - my meds were at home). I knew I needed to take them, I knew not having taken them was making me feel so much angrier than I needed to feel (although I would have been angry anyway). I also knew that I was super angry, so angry that I was liable to do something impulsive and foolish. I could almost hear my (ex) therapist's comments about the need sometimes to just "sit on one's hands" because "when emotion goes up problem solving abilities go down". I actually knew what the smart thing was to do (in this instance, do nothing and find a solution later, when I was much calmer), but I was so angry, so self righteously and so uncontrollably angry that I did something that escalated the situation and made me suffer all the more.

Shame vs Compassion

Shame by InertiaK (inertiak.deviantart.com)

I have been listening to Radical Self-acceptance by Tara Brach lately after having read her book Radical Acceptance years ago and being really impressed by it. On this audiobook Brach often talks about the debilitating effects of shame on mental well being. I had an opportunity to experience this for myself last weekend when I attended a large social gathering (kind of like a christening celebration) arranged by a very good friend of mine. There were a few things operating to make the whole thing a pretty awkward and unpleasant experience for me. When the whole thing was over I was glad to get out of there and as my partner drove us home I started to feel really, really awful.

What I was feeling more than anything else was shame, I felt ashamed that I had experienced social anxiety, I felt ashamed that I couldn’t have just taken the whole thing in my stride. I felt ashamed that once again this f—ked up side of me was coming out. I felt ashamed of being a mentally ill person. At pretty much any other time these emotions could have overwhelmed me, but on this occasion, because I had being listening to Brach’s commentary on the toxicity of shame, I decided to acknowledge the shame I was feeling – on top of the anxiety which had caused it – and I also thought about what I would have done if I was with a friend who was experiencing the anxiety, the shame and the real emotional pain I was experiencing just then. I realised then that I would not do what I habitually do to myself in these situations – mentally abuse myself for being f—ked up and drown myself in self-loathing and shame. No, if I had a friend who felt this way I would feel enormous compassion for her and I would want to let her know that these feelings are temporary and that it is ok to feel like this and I would treat this friend with kindness – this is what I would do if it were a friend, so shouldn’t I aspire treat myself as Tara Brach says like my “own best friend”? Or to put it another way, “do unto myself as I would do unto others”. I would never say or feel the vile things for someone else that I so habitually think about myself when I am unwell, so maybe I can be a little kinder to myself, maybe I can feel the compassion for myself that I would be willing to feel for others in my situation.

Cultivating Contentment - Revisiting Buddhism

Green Tara (image sourced from kadamsharawa.org)

Lately I have been thinking about bringing myself back to the teachings of the Buddha, as I have never been happier than in those years when I sought constantly to commit not an unwholesome action, to cultivate a wealth of virtue, to tame my mind, for this was the teachings of the Buddhas (Dhammapada, verse 183). I did not drink or take drugs, I was uncompromisingly truthful, I tried to meditate (though I found that a struggle), I recited mantras (and found they helped to calm my mind), I prayed to Green Tara to make me more wise and compassionate, I did not live extravagantly but I lived well (on the downside my home was infested with cockroaches, as I abided by the five precepts and thus refused to kill them), for I was mostly content.

Reducing Medication

Normal dose: 400mg of Seroquel a day.

"Seroquel" by Frozen Wing (deviantart.com)

Aim: 350mg of Seroquel a day (and after 6 months of being on 350mg go down to 300mg a day - no plans to go lower than 300mg as I have been told this is the minimum maintenance dose I should take).

Why: mostly to lose weight. As an adult I have tended to weigh, when not taking medication (eg, SSRIs, SNRIs, lithium and/or antipsychotics) around 60kgs. I currently weigh around 70kgs.

Method: I rotated 350mg one day and 400mg the next for a few days and am now trying to just go straight down to 350mg a day, feel the pain, deal with it and make progress faster.

Why this method: I have tried rotating 350mg one day and 400mg the next over longer periods but it always ends up being painful anyway and then I lose my nerve and go straight back to 400mg a day. I figure I need to just balls up and feel the pain and get it over and done with in a quick hit.

Women and Mental Illness in the c.1950s - Ads

It's hard being a woman, and in the 1950s pharmaceutical companies knew this only too well, which is why, I guess, so many of the advertisements from around this time seem to zoom in on female depression and anxiety. While there are apparently a whole bunch of natural remedies to help treat depression and anxiety (therapy, various herbs, cutting out caffeine, nice warm baths, walks on the beach at sunset, etc) there are also a shitload of pharmaceutical options - in the 1950s it was no different, though the drugs were different, and often far more dangerous, and the ads were ... awesome (and awful). Here are some of my favourites:

(1956) Butisol (butabarbital) is a barbiturate which has been used to treat insomnia and anxiety 

Seroquel

Seroquel (quetiapine) is an atypical antipsychotic developed in the 1990s by AstraZeneca, a British-Swedish multinational pharmaceutical company. AstraZeneca's patent expired c. 2012 and there are now a number of generic versions of the drug, however AstraZeneca still has exclusive rights to market sustained released quetiapine (until c. 2017). Seroquel has been used to treat schizophrenia since 1997 and bipolar since c. 2004. Since c. 2009 it has, in its extended release form and generally at a much lower dose than for schizophrenia and bipolar, been used to treat recurrent major depressive disorder and generalised anxiety disorder.