Is it safe to do insight practice with bipolar disorder? I take medication for it, but I wonder if things like A&P event and dark night can trigger mania/depression?

Anyone out there who's mentally ill from amityville and doing insight practice ok?

I have a myriad of mental illness, certain periods of the path can definitely heighten your mental illness, but if you practice in a balanced, stable way you will be just fine! in fact... if you are good enough your purity can even eventually cure your of things like bipolar of schizo, they are just knots to be untangled.. deep knots

Well, it depends.

How much psychosis have you experienced? Do you experience psychosis or do you just have milder mood changes or mood changes without psychosis? Would you say there is any potential, whatsoever, for a psychiatrist to diagnose you as schizoaffective?

If you experience significant psychosis, it's not really that safe, though I've recently found vitamin approaches that seem to work well for psychotic symptoms.

Either way, it's probably not going to be nearly as safe as someone who does not have mental health issues.

There are a few people here that have posted that they have bipolar disorder and have succeeded in meditation despite experiencing a few manias and depressions along the way. I have succeeded to a fair extent, but likely almost killed myself several times along the way as I was extremely stubborn and kept meditating despite the below posted kind of thing happening over and over.

Not to scare you or anything, but to give you an extreme of what can happen (so you are well informed), here is an old post of mine:


In this post I write that I was not on typical meds when this happened. Yes this is true, but I also tried intensively meditating on meds many times and eventually became just as psychotic if not more so even when taking the meds. In my experience, meditating 1-2 hours a day of insight practice is generally pretty safe. One time when I upped it to 5 hours a day (plus a weekend retreat) then psychosis manifested in about 5 weeks. If meditating on retreat (about 14 hours/day) then psychosis manifested in about 1.5 weeks. The below example post is a psychosis that manifested after meditating about 10 hours/day for about two weeks. The post states I was caught up in those symptoms for about two weeks, this is true, it was two weeks AFTER the symptoms manifested (meaning I meditated sanely for 2 weeks, then ran around insane for another 2 or 3). So what I mean here is that these time markers are where the symptoms of psychosis began to appear. I, personally, call this the point of no return. Meaning there is generally no way to go back without spending a significant amount of time in a hospital bed.

I've recently (a few months) been taking high doses of niacin and it has erased virtually all residual voices that arose and stuck after intensive meditation over a few years.

Click this link for my old post regarding an extreme of what can happen:


http://www.dharmaoverground.org/web/guest/discussion/-/message_boards/message/1032824

[Edited a bunch of times for clarity]

Do you know how to use sleep/wake patterns, mood tracking, and light and darkness exposure to prevent and terminate mood episodes? You ought to have thorough familiarity with the behavioral techniques for managing bipolar disorder before entering A&P and Dark Night territory. The meds can be great, but they aren't the only way.

"sleep/wake patterns, mood tracking, and light and darkness exposure"? I don't know about those, what are they?

Me too. Right now I'm being driven nuts by insomnia, so any help in this area would be greatly appreciated.

I have a long history of something that certainly quacked and waddled like mental illness (several varieties actually), but the less drugs I took and the more I meditated the more it started to look like a plain old-fashioned insight problem.

My working hypothesis is that things like A&P and Dark Night ARE mania & depression. Of course this is not sound science, or received dharma, but it makes intuitive experiential sense to me. (Also, ADD could be largely strong but undisciplined concentration in the wrong band of the jhanic spectrum, a not entirely unrelated point.)

Accordingly, I would say, the best thing to do is to keep practicing because it sucks to be stuck THERE. Is it safe? Well, one of my favorite practice tricks is to ask the opposite: Is it safe to remain stuck in the Dark Night or in a bi-polar trough or whatever the malaise actually "is"? Moreover, is it safe to turn oneself over to the conventional mental health system, and take the drugs currently popular? Having nowhere to turn can be a starting point for working with what is immediately present.

In my experience, medication is profoundly unhelpful, but getting off it is extremely difficult. I got off all meds coming up on two years ago. Notwithstanding one last go-round of skull-crushing depression, I was fine. I laugh now, but it wasn't funny at the time. I wasn't doing much sitting then, but I essentially observed it and put the entire phenomenon in the category of "probable withdrawal reaction over the course of the year following getting off meds" and watched it roll in, stay for a while, and then roll back out, just like every other sensory phenomenon on every scale, without exception. If you can spot that pattern, you will have a great leg up on insight practice.

I used to suffer from insomnia. Now sometimes I don't sleep, but I don't suffer much. When I really need to sleep, I take melatonin. Otherwise, sometimes my patterns are fine and I enjoy that, other times it gets out of whack and I roll with it -- this is the upshot of a formal strategy I developed at great length with a doctor, by the way. Obviously, exercise and diet and good sleep hygiene help.

I wouldn't say I was "from Amityville" but my journey has brought me from that direction and I am definitely doing ok. I wish you great luck, and all the strong determination you can bring to bear.

I can speak to mood tracking.

This is a ploy developed by the drug industry to pathologize just about anybody's affective cycle. The idea is that you keep a notebook or journal, and document how you feel at various times. There will be fluctuations. When contrasted with your prior idea that a hypothetical "normal" person should feel more or less the same most of the time, you will appear sick. Then they sell you drugs. Almost nobody to whom this is recommended has (or is offered) any meaningful baseline for comparison, and individual variations are not entertained. It is a brilliant sales technique, convincing actual and potential customers to convince themselves that they need drugs.

Anybody with even a nodding acquaintance with the idea of anicca should be able to see right through this, but sadly the drug industry has a much larger marketing budget than proponents of the dharma.

That's an interesting thought but somehow I think they're different. Mania involves a speeding up of thoughts, delusional ideas and impulsivity. Does A&P involve those?

A&P is easier to identify by where it fits into the pattern than by how it presents, although there tends to be a high focus, quasi-maniacal tone to it. Whenever I have been sitting a lot and I get a torrent of "great" ideas, I check where I might be in the progress of insight. I would suggest reading lots and lots of descriptions of people's experiences and guesses, and forming an impression of what kinds of things you are looking for. There has been a fair bit of discussion on this, and if you do a few searches you will turn up any number of old threads on the topic. There is certainly the question of mania vs hypo-mania also; I have never been fully manic. They may not be the same thing, but they sure smell similar -- maybe someday similar brain structures or underlying mechanisms will be identified. In the meantime, and I chose these words carefully, my working hypothesis is that they are the same. What I find useful in this, is that to whatever extent they are, the part that is a result of some insight cycle is amenable to being dealt with by skillful and/or diligent practice. And the more I sit and the longer I take no drugs, the less I seem sick and the more I accept myself as a guy who just has a certain rhythm that I am learning to work with -- lately the "downs" aren't particularly depressive, and the "ups" aren't particularly manic, but there is still a cycle. How about this: I prefer seeing it this way.

Yes, it does. By the way, this is also my working hypothesis.

My working hypothesis also includes the idea that everyone goes through these kind of cycles all the time, they just don't get as extreme and long lasting as in the case of mania and depression. For instance, in children it is very clear that they get grumpy if they are awake a few hours after getting really excited; an adult's behavior is more inhibited, but we get similar effects to those.

Also, after having understood the thinking pattern of euphoria to some extent, I can detect it in many normal people very frequently. People believe and express positive, grand things without any basis for it other than their feeling pleasure/thrill in that belief; this can happen in massive scale culture wide (e.g. "all you need is love").

In my very extensive experience, they are likely the same, but that does not mean people "diagnosed" with bipolar disorder are exactly the same as yogis not "diagnosed" with bipolar disorder as the cycles during intensive meditation will likely be far more intense/painful/pronounced. Though, in my experience, day to day cycling without intensive practice does not seem to have this effect.

Therefore, (because people are throwing this idea around) this should not be mistaken to mean that meditation is just as safe for people "diagnosed" with bipolar disorder as it is for all other people, as it is not. It is more dangerous.

Do you know if medication interferes with insight practice?

Maybe this: http://psycheducation.org/depression/darkrx.htm

Yes, medication can alter the practice a little, but the effect of medications on the practice is far less than the actual manifestation of the underlying "illness" itself. A temporary side effect from antipsychotics, called akathisia (intense restlessness + sense of terror and doom), is pure hell and will be exaggerated if a high dose of antipsychotics are taken during an acute psychosis from intensive meditation. One example, at one point in an emergency room, I was injected with a high dose of some antipsychotic and the resulting akathisia lead to me running down the hallway completely naked trying to slam my head into the wall screaming "KILL ME." Not fun.

So, yes, the A&P is very much the same thing as mania, though there are some very important differences if it is approached from a "practice" perspective as the vast majority of manic-depressive people are not mediators and thus the A&P will manifest as mania rather than as A&P (or a manic A&P) because there is generally no attempt at mindfulness or regular or intensive sitting. When approached from a practice perspective, it changes the nature of the experience in a way that can actually intensify it, though clarifying it greatly.

As far as the depression part being the same as the Dark Night, this is also true (though there are some differences) because, in my experience, depression is CAUSED by the dark night as it is not exactly the dark night itself. Again, since most bipolar people are not meditators, they will generally not make a great attempt to keep mindfulness up when it begins to lag in this territory. Thus most bipolar people will get stuck in a chronic depression at this point because their mind is locked into some personal obsession or other which blots out the present. Thinking back to before I knew anything about dharma/meditation (and would have massive depressions) I remember noticing that the sub-cycles of dissolution, fear, misery, disgust, desire for deliverance, reobservation would become apparent when doing a drug of some sort during these depressions - (marijuana or alcohol). When the drug wore off, I would be still depressed, but the cycles of fear, misery, disgust, etc. would not be there (or at least were no longer obvious). I have not been depressed in the clinical way I used to be since starting practice, and it is likely due to maintaining some degree of mindfulness when mindfulness starts falling apart in this territory. However, unfortunately, there are some significant dangers to doing so....

During intensive practice the dark night can be just as dangerous as the A&P. That example I gave in my post about sitting on the toilet all night waiting for my body to rot through the floor? (You guessed it, dark night). During dark nights my body would feel so completely and utterly rotted and dead. Psychosis can appear in this arena, just as well, and it can be just as scary and dangerous. Bizarre and delusional ideas/voices/beliefs that would take a very long time to explain and would make little sense if I tried.

Holy shit dude... dark night... psychosis... fuck.

I'm wondering if insight is worth it lol... maybe I should stick to concentration... :/

Though if what you say is true, wouldn't that mean nearly everyone with bipolar ends up stuck in the dark night? Since the only way out of the dark night is practice...

No, no, no; you always have options. Don't forget insanity and death!



Along the way, don't forget to balance these things: First, aggregate the experience of a large number of people who seem to have been through something similar to your situation and compare and contrast it with your own experience. Second, remember that not everything that has happened to everyone will happen to you. What is most likely to happen to you is something resembling something around the middle of the sample. Third, if things get really hairy there is an incredible wealth of experience here and if you reach out for help you are extremely likely to get all the support you need to get through it. If posting doesn't attract enough help try to message, then phone, and maybe eventually meet one or more people who seem experienced and sane, and we will all help each other out. You really do have options.

I would say that in all likelihood, yes, people diagnosed with this condition are stuck going back and forth between A&P and dark night (in the first insight cycle) over and over and over...

If you are afraid to practice, there are a few clinical indicators that may indicate you could have reactions such as mine.

Have you been "diagnosed" as Bipolar I or bipolar II? Bipolar II is a much milder variant of bipolar disorder (characterized by a sub-threshold mania called hypomania mixed with periods of depression) and my guess is these people would fare well if told to meditate and get stream entry. It is reported these people are depressed 32 times as often as they are hypomanic, and this would fit right in with a standard timetable of being stuck in the dark night.

If you have been diagnosed with bipolar I or schizoaffective disorder, then you are stuck between a rock and a hard place (EDIT: though it's definitely possible to make progress - see the instructions written here - http://www.dharmaoverground.org/web/guest/discussion/-/message_boards/message/3373753) as the cycles have become so intense as to be almost too dangerous to practice (EDIT: If practice means going on a retreat or meditating for long stretches. Retreats are optional and not necessary to progress) as practice will tend to intensify what is already there. This happens to be the category of my experience (as 'I' have been "diagnosed" as both by different doctors at different periods of time - even before I knew what meditation/buddhism was), so if you are not in it, then don't expect as extreme of results.

If you happen to be in the latter category, then your experiences will likely be closer to the extremes I have described and as such this danger should be considered when planning your sitting lengths as the dangers are directly proportional to the dose (period of time) of sitting meditation. Sit just enough so that you are making progress through the nanas, however slow that progress may have to be to avoid a psychotic and/or manic response. Don't even think about going on any retreats if you have bipolar I w/ psychotic features or schizoaffective disorder. If you have bipolar I without psychotic features, then you may (note: possibly - though you're taking a huge risk of later having psychotic features...) be able to safely complete a retreat. My guess is that someone with bipolar II could easily complete a retreat. In this case it is actually do as I say, not as I have done, as I have gone on an official retreat and many on my own time and learned my lesson the very hard way.

Yes. Like hallucinogens. If you're unhappy before you start, all the drug does is intensify the experience.

If *set and setting* are the determining factors in the drug experience, it makes perfect sense that you would make your mindset and surrounds as good as possible before attempting meditation.

So people with depression should not take hallucinogens or meditate, but instead take great care to improve their happiness and surrounds. Improving one's happiness and surrounds is achieved by making money and enhancing the ego.

Am I the only one on this forum who understands this?

*http://en.wikipedia.org/wiki/Set_and_setting

"Of course, the drug dose does not produce the transcendent experience. It merely acts as a chemical key — it opens the mind, frees the nervous system of its ordinary patterns and structures. The nature of the experience depends almost entirely on set and setting. Set denotes the preparation of the individual, including his personality structure and his mood at the time. Setting is physical — the weather, the room's atmosphere; social — feelings of persons present towards one another; and cultural — prevailing views as to what is real". ~ Timothy Leary

A healthy ego is a good base to cultivate. Making money though, i would not say is a given to be able to do that. It may ease the tendency to 'worry', but I'd say it is different for each person. Let's say you are the only one pushing this notion, CCC.

A healthy ego is a good base to cultivate. Making money though, i would not say is a given to be able to do that. It may ease the tendency to 'worry', but I'd say it is different for each person. Let's say you are the only one pushing this notion, CCC.

To give this a Dharmic spin, here are the highest blessings according to the Buddha. Perhaps they should be considered as part and parcel of developing a healthy 'ego' before embarking upon dismantling it.

This is most definitely a good thing to do, but for people with bipolar disorder this is never going to stop their cycling. You could spend years building yourself up only to have it all torn down by the next mania/depression that hits. Some time needs to be spent trying to make your way through the nanas in a way that is as safe as possible given the circumstances. Unfortunately, you need to learn your own limits, and the only way to learn them is to test the boundaries to some extent.

Edit: I cannot comment too much about practice for manic-depressives with significant suicidal tendencies, as my experience has never been in that group, despite the severity of my symptoms. If this aspect is present it should be eliminated before starting any insight meditation practice whatsoever (though I'm not sure how one would go about doing that without practice as practice would help immensely with seeing suicidal ideation for what it is). Metta or yoga might help, maybe some simple breathing practices.

I could improve on 3 of those points thanks Nic.

Cloud, I haven't experienced bipolar, but I have been able to watch my moods move around quite rapidly from minute to minute. Sometimes I can link the mood change back to thoughts running unchecked in my subconscious. So just a question: when your mood changes to depression, is it possible to dig around and find a dominant thought pattern that triggers this? Also, does depression always follow a manic phase, or can you swing between normal and depressed phases? Thanks.

Okay, first, I think my definition of depression is a little more severe than most people use when they throw the term around. When I think of depression I think of full on clinical depression which I have not experienced, that i know of, since starting meditation in early 2008. If there is a manic phase, there will always be a depression phase that follows it (just as the dark night always follows the A&P).

Clinical mania and clinical depression are not triggered by thoughts, but rather stress and/or A&P/dark night phases which tend to kick in whenever the dharma decides it's time to go forth and drag you on (I'm sure many people have particular times of year, seasons, or individual patterns of their own in this respect). Resistance to giving into, practicing during, and accepting the A&P and Dark Night (or ignorance of) will lead to mania and depression, respectively. The intensity of these phases is determined by your individual makeup and history.

I guess milder depressions could be triggered by thoughts, or getting caught up in weird obsessions or thought patterns for a long enough period of time could do it. But clinical depression (in bipolar disorder) happens of its own accord, most likely due to mindfulness falling apart and the person not practicing upon entering dark night territory (not that I believe everyone should practice in this instance either, as I have stated).

Cloud, thanks heaps for your advice.

Unfortunately I do have Bipolar I, and when I go manic I also go psychotic. I'm talking, running around naked fighting invisible demons psychotic.

Mania starts off with a good mood, seems innocent enough, but gradually my thoughts speed up, I sleep less and less, my ideas get stranger and stranger and then I cross a threshold where I become fully psychotic and there's no turning back - only strong drugs can bring me down.

When I come down I feel normal for a brief period - then depression hits and doesn't go away until the next mania comes.

Infact, I'm in a depression right now. The only way I've ever gotten out of depression before was via mania.

I'm now on anti-psychotics which stop the mania but do nothing for the depression.

In other words I'm going to be stuck in depression for the rest of my life unless I find a solution.

I was hoping meditation could be a way to transcend this illness...

I think I'm still going to do insight practice despite the warnings, but I won't do any drastic shit like 5 hour sits or retreats.

lol Yeah, I've been there.

I was able to stabilize myself fairly well with concentration practices (and most of the time actually just simple breathing practices at access concentration) before I started doing insight practices. Though I had to keep sitting down and formally meditating for an hour or more every time weird symptoms started (this kind of got tiring btw). I became stable for the first time since the "illness" began doing this (before this my history was about like you describe - getting depressed, manic, with pretty much no periods of "normalcy" - in and out of mental hospitals over and over). This is recommended to most people, anyways, before starting insight practices. Otherwise it's considered "dry" insight. Concentration practice (without having ever consciously done insight practice) most likely will not cause mania no matter how long you sit (as I would often sit for 3 hours or more during this time period, continuously).

I actually became so stable doing this that I had kind of forgotten about the whole bipolar I/schizoaffective stuff (as I hadn't had an episode in a couple years of doing this- as I would use concentration practice to stall the whole thing out) and was very ambitious about getting insight at this point.

Hi Jake,

You might want to have a look at http://www.dhammasukha.org/
They claim less harsh side effects from their insight practices and good results with depression and the like. I leave the truth of their claims up to the reader to decide.

Meditation instructions here:
http://www.youtube.com/watch?v=BncD2pinvTo&list=PLA82ACF2749E73118&index=9&feature=plpp_video

Perhaps there is something there for you, perhaps not.

Good luck.

Most mood-altering thoughts aren't available for conscious inspection. Given this, How do you know absolutely for sure that your mania and depression are not triggered by thoughts?

I once had a shell of a theory about bipolar disorder. A child experiences erratic parenting styles, lots of love one moment, then fits of rage and neglect the next. As a result, the child swings between feelings of love and feelings of despair. The memories get re-triggered by small happenings or karma during the day. A rapid cycle BPD had one loving parent and one insane parent, hence the rapid shifting of mood. A slow cycle BPD had parents who would alter their moods at a slower pace and in tandem.

I just don't buy that dharma is doing this to anyone.

The most user-friendly style of meditation I have used is the "awareness watching awareness" method, as described by Rose. Watching the breath, and most other methods will send me into deep depression.

They are not triggered by thoughts because they occur during certain seasons and months of the year. The cycle is very regular and rhythmic throughout the twelve months of the year. The cycles alter thoughts significantly more than thoughts alter the cycles. When you are in the dark night and you're having disturbing thoughts are you having a dark night because you're thinking disturbing thoughts or because you are in the dark night? It's obviously because you're in the dark night as "you" are not controlling or doing any of it anyways. After stream-entry the cycles have become indistinguishable from the A&P and dark night phases.

[Edit: That being said, perhaps thought patterns are occurring cyclically causing cyclic changes into A&P and dark night stages (for if you were to remove all thoughts, period, then there is likely to be no more cycling - as in AF/pce type thing). Either way, it doesn't really matter which is causing which as there is an interdependent network going on between the two.]

It has nothing to do with my parents as I could not ask for better ones. In this instance you may actually be getting bipolar disorder confused with borderline personality disorder which I recommend you read about here: Borderline Personality Disorder

BTW, the acronym BPD is usually reserved for borderline personality disorder and not bipolar disorder (try typing BPD in google).

You don't have to buy it, but why are you making theories about something that is not in your experience?