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Bipolar Disorder and The Cycles of Insight

Bipolar Disorder and Insight

I got an email asking about Bipolar Disorder (AKA Manic-Depressive Disorder) and how it related to the traditional maps of the Progress of Insight. As one who advocates for truth in advertising and frank disclosure of what can happen when people get into insight practice, both good and bad, here is my response in slightly edited form. I hope that it provokes some thoughtful discussion of this complex topic.
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You are obviously not the first to notice the similarity between A&P events and Manic Episodes and The Dark Night (Dukkha Ñanas, Insight stages 5-10) and Depressive Episodes. The parallels are many and striking.

Here's a short list:

Age of Onset: most people who cross the A&P spontaneously do so in their teenage years to 20's. Most people who are Bipolar will have their first Manic Episode then as well.

Sequence: The Dark Night follows the A&P like thunder follows lightening. Same for Depression following Manic Episodes.

Timing: The A&P tends to last some number of days to maybe a week or two tops: so do manic episodes. The Dark Nights that follows A&P Events tend to last for months: so do the depressive episodes that follow manic episodes.

Sleep: People tend to sleep very little during the A&P and be more tired during the Dark Night. Same for the corresponding bipolar states.

Energy: People tend to have all kinds of energy to put into grand projects, schemes, relationships, sex and the like during the A&P and have much less for those same things, including work, school and relationships during the Dark Night. Same goes for their bipolar equivalents.

Mood: People tend to be high as kites during the A&P and dark and depressed during the Dark Night. Same applies to bipolar states.

Powers: People in the A&P may feel they have special powers, common ones being things like seeing through their eye lids, seeing bright lights, reading other people's minds, traveling out of body, seeing past lives, hearing and seeing entities, and many others. Ditto for Manic Episodes.

Here are the differences:

People in the A&P tend to generally function well, where as people with Manic Episodes, as classically defined, tend to need to be institutionalized or medicated to avoid really destroying their lives, spending all their money, ruining their relationships, getting into fights, being arrested, gambling away all their money, having sex with lots of people, thinking they are the King/Queen of the Universe, etc. In short, this is a difference between functional hypomania and true psychotic mania.

People in the Dark Night tend to be somewhat less functional in terms of relationships and the like. In contrast, people with classic Depressive swings tend to be much more dysfunctional, suicidal, and may have psychotic features, like voices telling them to kill themselves, or delusions that they are very sick and will die soon, or everyone is out to get them, etc.

However, while I make the line clear cut by way of rhetoric, in truth it is not so straightforward. Case in point: I remember getting a call some time ago from someone who may actually be somewhere in the middle paths. They were suicidal at the time and quite afraid. A few days later they left Re-Observation and got in Equanimity and suddenly were fine, but it just goes to show that it is not always easy straightening this out, mapping it in real-time, or compensating even when you know the maps very well and are a skilled insight practitioner.

Another friend was in the middle paths and was formally diagnosed (rightly or wrongly) as having Bipolar II Rapid Cycling and put on meds for it, which helped somewhat. When they attained to a higher path they were suddenly alright and didn't needs meds at all. Was their diagnosis simply the struggling of a Western therapist to put the cycles of insight into their only related box, or was this actually a correct diagnosis that was in fact cured by more insight? These terminological questions are not just semantics and have real implications for mental health and insight practice and handling both skillfully. I wish I had firm answers to them, but I don't.

Regarding your question on whether or not the traditional sources help: I know of no Buddhist writings that address this. Nowhere have I found anything that describes these things in a way that fits with a Western psychological perspective. The traditional maps were written for monks, who in theory were pretty high functioning people, in a culture that had nothing like our current concepts of mental illness.

More interesting parallels: those who keep crossing the A&P and getting into Dark Night territory and then fall back due to not getting stream entry and then crossing the A&P again and getting into the Dark Night, etc., tend to get more reactive with each pass, just as people with Bipolar do: as they get older and have more manic episodes, they get worse.

If you are only having these experiences on retreat, they are probably related to the cycles of insight. Good practice and clear investigation with awareness of the maps and a willingness to compensate and keep your mouth shut except when around people who can help you navigate the territory is generally recommended. On the other hand, those who have these things in daily life with the features that seem more ominous of more classic Bipolar disorder should seek help quickly, as Bipolar disorder can really screw up your life. I have had a few close friends over the years who were Bipolar and I have seen what happens when it is not managed well and it is not pretty.

Where one might be tempted to argue that people with Bipolar Disorder are merely the far extreme of what can happen in the cycles of insight, I don't have sufficient evidence to support that and would need further confirmation, such as sufficient numbers of clearly Bipolar people gaining sufficient paths and suddenly being cured to make definitive conclusions. At this time, so far as I know, there is simply not enough data. However, as you point out, there certainly are so many parallels that it is hard to simply write them off as being unrelated phenomena.

It is not accidental that I sometimes refer to those who have crossed the A&P at least once as having "Insight Disease".

I think that discussing the dark side of practice is important, and here is a page dedicated to one of these dark sides. Please feel free to lend your thoughts, experiences and wisdom.

RE: Bipolar Disorder and The Cycles of Insight
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20/03/09 8:02 en respuesta a Daniel M. Ingram.
Daniel, do you mind briefly addressing some of the physiological theory behind bipolar disorder?

It's a strange request but it might bring some light to things.

RE: Bipolar Disorder and The Cycles of Insight
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20/03/09 8:07 en respuesta a Daniel M. Ingram.
The primary criteria for Bipolar I in the DSM-IV is that the person has had at least one manic episode (the depressive episode isn't required, but it is more common than not). Bipolar II is a bit different, in that there needs to be at least one 'hypomanic' episode and one depressive episode. The difference between mania and hypomania is fairly clear as far as definitions go, though the real world application is much less precise. This analogy might help; A person in a 'hypomanic' phase might think they are very important and have an unusually high self-esteem, while someone in a true 'manic' episode may think they're Jesus Christ. Or, someone in a hypomanic episode may waste all of their money on clothing and food to the point of going broke, whereas someone in a truly manic episode may go out and buy six Ferraris on credit.

As far as I know, it doesn't matter a whole lot to a clinician what brings on the manic or hypomanic episode. If you've had an episode, you can receive the diagnosis. This gets tricky in regards to insight territory. Is the energy that causes manic episodes in Bipolar individuals the same as the energy that causes insight practitioners to cycle? It makes me wonder if there are any Bipolar individuals who experience Bipolar cycles simultaneously with insight cycles, and if they could really tell the difference between the two. In both cases, the cycling aspect seems to take on a life of its own.

RE: Bipolar Disorder and The Cycles of Insight
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20/03/09 9:54 en respuesta a Daniel M. Ingram.
Author: chrisb483

Bipolar can help with enlightenment, as can any event that breaks your association with reality, but it needs much greater effort to come out of it cleanly.

I was diagnosed with Bipolar Disorder in the late 90's, mostly depressive and sometimes hypomanic. I found that I have a problem with glutamate (not gluten). Those who know me say that the change is real. It has been a few years since I had wither a depressive or a manic episode and I was hospitalized twice and my cycles were always in the span of 6 months to a year.

I am happy to say science is finally catching up with my discovery:
http://scholar.google.com/scholar?q=glutamate+bipolar+disorder&num=20&hl=en&lr=&newwindow=1&client=safari&scoring=r&as_ylo=2004

Here is part of my story:
http://www.finkshrink.com/blog/bipolar-stories-and-insights/christian-bonanno

My family is riddled with the genetics of the disorder, in fact, my nephew just killed himself at 13 years old after suffering from lazy doctors and an early onset of the disease. I was just luckier than him or my other brother that I had some luck of insight and wisdom.

To me insight is all just a manipulation of chemicals in the brain, some can do it with drugs, some with meditations, and some have it thrust upon them with genetics. And just as anyone can get caught becoming addicted to drugs and meditation, one can get addicted to being bipolar. In effect, it is just forced insight, but without the correct context around it, bipolar disorder can seem to be a curse.

Daniel, it seems "oddly" coincidental that you posted this. :^)

RE: Bipolar Disorder and The Cycles of Insight
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20/03/09 10:10 en respuesta a Daniel M. Ingram.
chrisb483:

Thank you for sharing your personal experience. I'm sorry to hear about your nephew.

RE: Bipolar Disorder and The Cycles of Insight
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20/03/09 21:30 en respuesta a Daniel M. Ingram.
I don't know what to say. Ask me anything about this and I can produce limitless commentary. To steal a line from Bladerunner, "I have seen things... you people wouldn't believe."

My CV:

Relentlessly cycling from birth, I hit an A&P with massive force at 13. At 15, undertaking anapana-sati samathavipassana triggered undeniably clear and profoundly penetrating anatta/annicca fruition, at least 2nd if not 3rd path. I had no knowledge at that time that any of these terms even existed. By 16 I was forcibly hospitalized for the first time. I have been subjected to most every diagnosis, almost every form of treatment and damned near every drug. No lasting effects from any of that and no end of fallout from nanas and cycling. All told I have been forcibly confined for well over a year of my life. An enigma, untreatable, impenetrable, indefatigable and historically an ongoing cause for professional contests for control of this warm body cold case.

It was never in much of a real sense 'my suffering' so much as profound systemic failings in all of the prevailing models; personal, familial and social. I confound these at every turn without effort which has never been a bad thing for these systems. Because it has failed so utterly it is aware of a real and total failure which I just as visibly do not willingly share in. Fondly, the path of irony.

RE: Bipolar Disorder and The Cycles of Insight
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20/03/09 21:35 en respuesta a Daniel M. Ingram.
I know most every other neurosis and psychosis, human and institutional, intimately. This mind never could fabricate a convincing self identity and instead has an adaptively reflexive and 'sponge-like' imitative capacity. Give me anyone with any form of crazy talk and I can have a sensible two way conversation within five minutes. I can give you the satipatthana for most of the commonly prescribed psycho actives and many of the less common in all of the highest known dosage ranges in multiple combinations. All of this drug use was compusory and unwillful on my part and prescribed without consultation. I have never caused myself nor any other being physical harm. I can maintain full awareness and nervous system control after four ccs of haladol. Think about that if you are thinking about knocking me down a notch.

Ask away. I will elucidate any of it as fully as you like. Psychiatry has endless models for delusion and dysfunction. It has no models for awakening and that is what can make it powerfully oppressive. Shooting into the dark is like that. I'm awake to all of this and hip to nuts. This generated a whole meta layer of political concern as I observed the system feeding on suffering as well as it's half assed attempts at mediating it and I have become a soft power activist by force of circumstance. More than anything this experience has proven extensively useful when helping others through to the other side of these kinds of highly multifaceted hells. I've become a veteran dark night yogi wise to the heaviest of dukkhas with a lot of street sense. I can do more for the mentally ill than any doctor ever could hope to do right under their noses. Accredited arrogance and blindness renders this invisibility as well. Conditionally ennobled and disabled. No big thing.

RE: Bipolar Disorder and The Cycles of Insight
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20/03/09 21:53 en respuesta a Daniel M. Ingram.
Hey Kenneth, get this, the last time I was in hospital was about 3 years ago directly from a monastery. Couldn't sleep for days. Drove off at 4 am. 10 hours on the road. Got to emerge, got in, got dosed and compelled to stay a week for observation.

First guy I meet is a young vietnamese kid, about 16, locked onto a pure land jhana and chanting Amitabha mantra endlessly in a thick accent that resulted in something very lewd sounding if it were taken for english words. We would go for long walks and he chanted, he chanted all day.

One day a senior gentleman arrived looking tired and concerned. The young man stopped chanting and explained to me that this was his uncle who was very worried about him. He explained that he was in the pure lands and enjoying this life as it was a gift for past good kamma. Great kid. Very positive and energetic. Completely on another planet, entirely socially dysfunctional apparently near autistic but lucid with me. Pure trippin'. Probably never feels any of the drugs at all.

RE: Bipolar Disorder and The Cycles of Insight
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20/03/09 22:01 en respuesta a Daniel M. Ingram.
oops. transmission error

RE: Bipolar Disorder and The Cycles of Insight
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21/03/09 4:32 en respuesta a Daniel M. Ingram.
Dear TripleThink,

Thanks for your detailed histories and insights. Very interesting and useful. I myself have been lucky in that most side effects that really would have looked out there were brief and I had the sense to keep my mouth shut and just keep doing relatively normal things, but I can see how in various places one could easily do otherwise and have the world consider it too out there for comfort or understanding.

The Western Psychological models really do need something more sophisticated regarding insight territory and concentration territory, and I have always wondered why there are so many psychotherapists and psychiatrists and mental health workers on insight retreats in the West and yet apparently so little trickle down of that into the standard cultural and conceptual paradigms of its standard practice. Perhaps the likes of Jack Kornfield and the like who are cross-trained in both are doing more behind the scenes than it appears, but whatever is happening, it is clearly too little.

RE: Bipolar Disorder and The Cycles of Insight
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21/03/09 5:00 en respuesta a Daniel M. Ingram.
Jack Kornfield writes about some of the "abnormal" states and experiences of meditation in his latest book, The Wise Heart. He describes what it is like for him to experience concentration jhanas (though only 1 - 6), and he also attempts to legitimize psychic powers. I find that he mostly attempts to legitimize aspects of the path that people find useful. Aside from MCTB and this forum, I have yet to hear anyone go in to detail about how some stages can really mess with your life in a profound way. More could be done, and more NEEDS to be done.

This is a big part of why I decided to start studying psychology, and will be apply to Ph.D. and Psy.D. programs this year. The prevailing psychological models are too mechanistic and inflexible, which I think is a side effect of the scientific materialism that plagues the greater Western scientific community. It would be great to establish relationships with local contemplative communities in order to be a resource for people experiencing difficulties in life due to their spiritual undertakings. It's highly unlikely that I could build a whole practice around that, but a guy can dream ;-)

RE: Bipolar Disorder and The Cycles of Insight
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21/03/09 6:16 en respuesta a Daniel M. Ingram.
Author: marinr

I don't know. My first memory in this life is somewhat 'mystical' and that state seems to repeat in jhana practice. My first spiritual experience was when I was 14. I've been a little unstable since then, and I recognize some of the symptoms, but it has never gotten extreme. I just got a little bit dark, introvert and addicted to silence.

I feel that there are some very weird, inexpressible states in the insight cycle that fall into my limited understanding of 'mental illness'. And also, around the very end of the cycle, it feels like those states also come to an end.

Anyway, there was a siddhi-like experience somewhere in the path where I saw 'gods & demons' fighting with each other and I associated this with these states. It helped, something in the way of: 'Ah, let them play, it has nothing to do with me.'

RE: Bipolar Disorder and The Cycles of Insight
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21/03/09 8:13 en respuesta a Daniel M. Ingram.
thanks for sharing your very interesting first-person experiences. i now know who to contact should i plunge into the "unhealthy" side of awakening emoticon

on a more serious note, it's a sad state of affair that psychiatry/psychology (not to mention neuroscience) are still lagging very far behind as far as models of awakening are concerned. this is the challenge that Ken Wilber had been taking on since he wrote his first book. to his credit, he has already laid out a model called "Integral Psychology" (see http://bit.ly/10lZGp ). the jargons are a bit complicated (what field of science doesn't have any jargons?) but it looks promising to me.

it's also good to know that people like Jack Kornfield, Shinzen Young, and Christine Skarda are taking on the challenge too. (on a side note: speaking of Skarda, she's working on revamping perceptual theory in neuroscience. see "The Perceptual Form of Life " - http://bit.ly/skEo - when you get the chance, would love to hear your thoughts based on your first-hand experience.)

keep it flowing...

~C

RE: Bipolar Disorder and The Cycles of Insight
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21/03/09 12:05 en respuesta a Daniel M. Ingram.
Author: chrisb483

Psychiatry and western medicine is farther ahead than you think.

But the knowledge is not needed. Just sit and be mindful.

RE: Bipolar Disorder and The Cycles of Insight
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21/03/09 12:37 en respuesta a Daniel M. Ingram.
can you explain how far it is? could you cite an example we can learn from? is it farther than Wilber's "Integral Psychology"? or maybe "Spiral Dynamics"? i'm always open to new information.

knowledge is not needed? from the absolute perspective maybe, but not in the relative. there's a reason why the "nanas" are called "knowledge of".

~C

RE: Bipolar Disorder and The Cycles of Insight
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21/03/09 13:20 en respuesta a Daniel M. Ingram.
Author: chrisb483

Brain plasticity is increased with anti-depressants and is replicated with the calorie restriction encouraged by the 10 precepts.
http://websites.afar.org/site/PageServer?pagename=IA_b_cal_19_r_brain

Cognitive Behavioral Therapy is Buddhism.
http://www.buddhistchannel.tv/index.php?id=10,1649,0,0,1,0

Psychiatrists apply them together, like the Buddha prescribed. They just use different and less loaded words.

Knowledge of nanas is not a conceptual knowledge.

You do not need to know "how" enlightenment works to become enlightened.

RE: Bipolar Disorder and The Cycles of Insight
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21/03/09 14:25 en respuesta a Daniel M. Ingram.
I've met with highly skilled private (and expensive) doctors, therapists and counselors. I have had help from some highly qualified specialists and the advice of some exceptional biochemists. In contrast the public health care system is operated as an industry. They give out numbers and drugs and deal with this as a mass process. The mass of public clients, climbing well beyond 10% of the population doesn't get much individual attention at all. Maybe 15 minutes over two weeks of hospitalization. The drug regime is deployed and the patient is released with prescriptions.

There is one particularly powerful drug that they put me on about seven years ago. It builds up in the system for two weeks as many of them do. By about day three you are in an unnaturally highly pleasant state of mind at all times. It took a while to see how this one worked. It was intensely pleasant to experience anything, even the obviously naturally unpleasant. It became clear that what stopped functioning was the capacity to adjudicate the mean of experience, everything was equally acceptable and wonderful. One could sit down to tea or step out into the path of a bus with equivalent peace of mind. It made rational thought impossible until it was again stopped for two weeks after leaving and its primary effect had subsided.

Later after months of hard work in the summer sun I contracted skin cancer. The drug I had been given weakens the cell walls and ultraviolet rays became far more carcinogenic in the months following use. I had to be treated for the skin cancer and discover for myself that this known side effect is in fact something that one needs to take steps to deal with. I was never informed about any side effects of the medication when it was administered. It can be very important to know quite a few things these days.

RE: Bipolar Disorder and The Cycles of Insight
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21/03/09 14:35 en respuesta a Daniel M. Ingram.
Chris,

thanks for the links. bookmarked for reading. that said, neuroscience is still lagging when it comes to its model of perception, not to mention the nature of consciousness. most are still looking for consciousness in the brain (http://bit.ly/saJwH).

i agree. we "do not need to know "how" enlightenment works", same way as as i don't need to know how a microwave works to get benefit from it. but to me, "enlightenment" is not the end game. eventually, we would need knowledge in order to express it more fully. just because someone's enlightened doesn't mean that he's an expert in mathematics, physics, cooking, or even deep meaningful conversations.

~C

RE: Bipolar Disorder and The Cycles of Insight
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21/03/09 14:44 en respuesta a Daniel M. Ingram.
where can i sign up? i'll just bring an umbrella to avoid the sun emoticon

seriously, thanks again for sharing your very interesting experiences. i've always wondered whether, in the far future, that it would be possible to create an "enlightenment" pill or something similar to the God helmet (http://bit.ly/3A5Wemoticon which would render the long-term practices obsolete. BUT, of course, everyone will interpret the experience differently depending on their level of psycho/physio-energetic development. so it would be imperative to have a good psycho-social developmental model to introduce the "enlightenment" experience in a gradual way. what a different world it could be, for better or for worse, i believe no one can say.

~C

RE: Bipolar Disorder and The Cycles of Insight
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21/03/09 14:55 en respuesta a Daniel M. Ingram.
Nathan, thanks for your courage and generosity in sharing your experience. I learn a lot from your posts. The "happy pill" you describe sounds like some kind of hell realm masquerading as heaven. It seems to me there is a parallel with some of the prevailing views of "happy-all-the-time" enlightenment. In any case, I feel fortunate to have you as part of this community.

Kenneth