Mindfulness Based Cognitive Therapy for Bipolar

Mindfulness for BipolarMindfulness Based Cognitive Therapy for bipolar may reduce anxiety and bolster emotional stability

As with many psychiatric disorders, bipolar disorder isn’t impossible to treat but it has its own unique and unremitting way of seriously wearing down a patient’s resolve. Mindfulness based cognitive therapy (MBCT) for bipolar joins a handful of therapies that can help.

A kind of yo-yoing of moods and mental states occurs with bipolar disorder, as states of mania and depression alternately lead to elevated mood or high affect and irritability, followed by precipitous crashing into depressive states that include sadness, futility and worthlessness, respectively.

But now, a study suggests that a combined approach of mindfulness meditation with cognitive therapy might seriously lessen day-to-day symptoms of mood instability and anxiety and provide people who have bipolar disorder with hope for long term improvements in functioning.

This good news comes from researchers in the Departments of Biology and Psychiatry at University of Cape Town, in Western Cape, South Africa, who report the results from a study in which 23 bipolar patients received neuropsychological tests and functional MRI scans (this is a type of brain imaging technique that tracks activity in the brain, by tracing cerebral blood flow to those areas) to document the results of the treatment in more detail than is typical in such studies.

Participants received fMRI scans before and after the study. Afterwards, the participants with bipolar disorder showed increased activity in brain regions linked with cognitive flexibility.

The participants also had improved working memory, spatial memory, and verbal fluency, in addition to greater ability to regulate emotions and anxiety, as compared to bipolar patients who hadn’t participated.

How did these results come about?

During the 8-week-long study, participants underwent a Mindfulness Based Cognitive Therapy (MBCT) intervention. Mindfulness Based Cognitive Therapy is an approach to the treatment of depression developed by by Zindel V. Segal, J. Mark G. Williams, and John D. Teasdale. It is based in mindfulness and, in particular, the work of Jon Kabat-Zinn who began to explore mindfulness therapy as an approach to the treatment of people with chronic pain. MBCT adds a component of cognitive therapy to just mindfulness practice. The goal is to recognize a particular pattern of thinking that is common in depression – “driven doing” – which involves urgent mental activity designed to understand negative thoughts about oneself….

For example, you end up stuck in traffic on the way to your therapist and you start thinking, “I can’t believe I am going to be late again, I am such a loser… how did this happen?”…

This leads to an urgent need to understand the problem and implement a solution…

But there is not actually anything that can be done right at that moment.

So your brain whirrs around in a spiral of activity and self-criticism.

MBCT is designed to teach you to recognize that pattern of futile activity and teach you an alternative pattern of thought. It differs from pure mindfulness practice in that it actively tries to change how you are thinking, rather than just recognizing and accepting all thoughts… but the goal of both are probably the same.

If you are interested in more information about this approach to treatment we encourage you to explore the workbook by Segal, Williams and Teasdale called The Mindful Way Workbook.

– Eric Baron


The effects of mindfulness-based cognitive therapy in patients with bipolar disorder: A controlled functional MRI investigation. Victoria L Ives-Deliperi. Fleur Howells. Dan J. Stein. Ernesta M. Meintjes. Neil Horn. Journal of Affective Disorders 150 (2013) 1152–1157

The Mindful Way Workbook: An 8-Week Program to Free Yourself from Depression and Emotional Distress by John D. Teasdale, J. Mark G. Williams, Zindel V. Segal PhD. The Guilford Press. 2014.

For more information

Mindfulness for Bipolar

Bob Talks about Mindfulness Meditation

Mindfulness and Bipolar