Mindfulness Based Cognitive Therapy for Bipolar

Peter Forster Bipolar Treatment, Treatments of Depression

Mindfulness Based Cognitive Therapy for BipolarMindfulness Based Cognitive Therapy for Bipolar May Reduce Anxiety and Improved Cognitive Function

Researchers in the Departments of Biology and Psychiatry at University of Cape Town, in Western Cape, South Africa, recently reported results from a study in which 23 bipolar patients received neuropsychological tests and functional MRI scans before and after a Mindfulness Based Cognitive Therapy 8 week program.

The study showed increased activity in the medial prefrontal cortex that was strongly correlated with the improvements that were seen in cognitive flexibility and anxiety.

Overall the participants showed  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.

This is the summary of the results from the article –

“The main findings of this study were (1) at baseline,bipolar patients reported significantly increased levels of anxiety and emotion dysregulation compared with healthy controls,and scored lower in mindfulness and domains of executive functioning including working memory and inhibition….MBCT resulted in significant reductions in anxiety and emotion dysregulation and improvements in mindfulness and executive performance….Significant BOLD signal increases were observed in the medial PFC and posterior cingulate cortex in the BPT (bipolar treatment) group ,compared to the BPW (bipolar wait list) group,during the mindfulness task. These changes in BOLD signal resulted in an activation pattern more closely resembling those of healthy controls.”

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.

References

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