Bipolar disorder and spirituality

How Faith Helps People With Bipolar Disorder

A strong commitment to spirituality may help people with bipolar disorder cope and build a foundation of greater self-worth.

“Religion can be supportive social support and resources and the internal means of being able to cope with the impact of the illness on their lives,” says psychiatrist Mario Cruz, MD, associate professor of psychiatry at the University of New Mexico School of Medicine in Albuquerque.

While excessive religious behavior was once seen as a symptom of psychosis, Dr. Cruz says, there’s little evidence to support this. Rather, his research, which involves interviewing people who have bipolar disorder, suggests that people who are bipolar often use religious activities, especially prayer and meditation, as ways to cope with distress.

A study of 168 people with bipolar disorder published in 2013 in Bipolar Disorders found that those who report the ability to cope through spirituality, such as feeling a spiritual connection with others and believing in a fundamentally benevolent world, have a higher quality of life and less depression.

Benefits of Faith and Spirituality

Cruz says his research also shows that when depressive symptoms become severe, religious participation drops off.

The benefits of religious participation for people with bipolar disorder, Cruz says, can include:

  • A supportive network of friends and acquaintances
  • Financial and other types of practical support
  • Uplifting messages and activities that may help regulate emotions and provide a source of hope
  • Scriptural messages that interpret the challenges of bipolar disorder as a way to grow closer to God or to grow spiritually
  • Reinforcement of the messages of many substance-abuse programs, especially 12-step programs

In a study published in 2014 in The Gerontologist, researchers looked at mood and faith participation in more than 7,000 adults and found that those who were active in their faith communities or prayed often had less risk for depression over a two-year period. Another study, published in 2013 in the Journal of Religion & Health, reviewed existing research and found that faith participation is particularly beneficial for people with depression (but found no benefit or harm for people with bipolar disorder).

Further, belonging to a religion that has a moral objection to suicide may be protective against acting on suicidal feelings. Psychiatrist Maria Oquendo, MD, a professor of clinical psychiatry at Columbia University Medical Center in New York City and co-author of several papers exploring the relationship between religiosity and suicide risk, published the results of a literature review in the July 2015 issue of the Archives of Suicide Research that found a possible protective effect of religion against suicide attempts, though religious participation did not protect against thinking about suicide.

RELATED: 6 Ways Spirituality Can Make You Healthier

The relationship between religiosity and mood is mixed, however. If you are conflicted about your faith or have conflict in your faith community, that can negatively affect your mood, Dr. Oquendo says.

“If you’re really struggling to understand how your core beliefs can be reconciled with broader faith-based beliefs, that can contribute to anxiety,” says psychiatrist Holly Swartz, MD, a professor of psychiatry at the University of Pittsburgh in Pennsylvania. She recommends making an effort to address those conflicts to find some resolution.

Finding Hope and Meaning in the World: Julie’s Story

Julie Fast, author of Loving Someone With Bipolar Disorder, says she had her first psychotic episode when she was 19. She had a vision of herself walking into traffic, being hit by a car and thrown, dead, at her own feet. Despite her hallucinations, periods of paranoia, and the severe effect of bipolar disorder on her daily life, Fast learned she had bipolar disorder only at age 31.

Now 51, Fast describes herself as someone who was raised Christian, although she is not a practicing Christian today, and as someone who has a profound, connected feeling of the metaphysical depth of life. At her lowest point with depression, she says, she lost contact with that deeper positive spiritual meaning that had always been a support to her.

RELATED: How Prayer Strengthens Your Emotional Health

Fast says one strategy that helps her, and which she recommends, is to understand that bipolar disorder is like an added layer on top of a person’s identity. She says that if you know what your baseline beliefs and temperament are, it’s easier to know when bipolar disorder is affecting you. For her, knowing that she was losing her belief in the world as a positive place, which was her baseline belief, became a rally for change. She began to do the hard work of pulling out of severe depression and can now say that her strong foundation has returned.

“Maybe religion is not put on this Earth to stop suffering; maybe it’s to help you get through suffering,” Fast says. Dr. Swartz agrees that being part of a faith community and having a strong religious belief can buffer people with bipolar disorder against difficulty.

A quick pop-quiz: What do Carrie Fisher, Jean-Claude van Damme, Sinead O’Connor, Vincent van Gogh, Vivien Leigh, Mel Gibson, Russell Brand, Amy Winehouse, Brian Wilson, Edgar Allen Poe, Kim Novak, Mike Tyson, Ted Turner, Jesse Jackson Jr, Cheri Oteri, Ray Davies and Dick Cavett have in common? From music, film, sports and the fine arts these various celebrities represent one collective face of mental illness. They all suffer(ed) with bipolar disorder, a mental illness that represents the sixth leading cause of disability worldwide and results in 9.2 years reduction in expected lifespan with 20% of patients committing suicide.

Some celebrities have been very outspoken in their struggle, including:

Catherine Zeta-Jones: “If my revelation of having bipolar II has encouraged one person to seek help, then it is worth it. There is no need to suffer silently, and there is no shame in seeking help.”

Demi Lovato: “I felt relieved when I found out. Like, I’m not completely crazy; there’s a medical reason for all of it.”

Richard Dreyfuss: “The worst thing for me about manic-depression is that it is simply free-floating. You can have no reason whatsoever, and yet you are in the depths of an inarticulable sadness and grief and self-hatred.”

Attaching a famous name or glamorous headshot to bipolar disorder, however, doesn’t truly relay what it means to live with symptoms. A look at bipolar statistics reveals that this mental illness, characterized by alternating and unpredictable mood swings with symptoms of mania (excessive exuberance, over-the-top plans, racing thoughts, reduced sleep) or depression (excessive sadness, uncontrollable crying, loss of energy, increased sleep) affects approximately 5.7 million adults, most often becomes active around age 25 and, 66% of the time, contains a hereditary component.

On her award-winning blog, “Bipolar Burble”, Natasha Tracy, author of off-label: an unbalanced look at a bipolar life, explains, “I was diagnosed with bipolar disorder 17 years ago and, yet, I still can’t accept the fact that bipolar makes me sick on a daily basis. When the bipolar symptoms come, my natural inclination is to deny them, or at least deny that they are caused by a brain illness. I want to think to myself that I’m just having a bad day or I didn’t sleep well last night or I’m coming down with something. I want to think that something normal and transient is causing my symptoms. I don’t want to think it’s something out of my control and long-lasting. Even with all my experience, my mind still doesn’t want to accept that my bipolar is the thing making me sick.”

In the midst of symptoms it would be easy to say, “I hate my life,” but Tracy has a different approach. Her view illuminates the difficulties of living with the disorder plus contains seeds of acknowledgement and validation, proactive management and collaboration:

The difficulty of living with bipolar is unpredictability. “You never know what the next day, or sometimes even the next hour, will bring. I tend to rapid-cycle and this means my moods can be very unpredictable—hypomanic in the morning and then severe depression in the evening, for example. Or, sometimes, I can go through months of nothing but devastating depression. Not knowing what’s coming or when things will end is extremely challenging.”

There are ways to make life with bipolar easier. “Positive self-talk and self-awareness are very important. Therapies like cognitive behavioral therapy or dialectical behavior therapy can help with learning these. We also need to control what we can in our lives to try to regulate mood such as diet and exercise, plus maintaining a routine and getting enough sleep…Medical treatment is critical.”

Caregivers can help. “It’s critical to know the facts about bipolar disorder. Also it’s great if can take over small, but important, things in the life of the person with bipolar…Can the caregiver drive to psychiatric appointments? Can the caregiver make a healthy meal sometimes? Can the caregiver pick up medications at the pharmacy? These small things can make life easier for everyone.”

From Tracy’s view, education about the disorder is crucial for the general public, too. She points out that bipolar patients are not angry or violent. They can become agitated, but it’s important to remember that each bipolar patient is unique. While symptoms can be generalized individuals cannot.

“We are people first, not bipolar,” Tracy reminds. “I am a full-fledged human being with wants, needs, desires, fears, great attributes, not-so-great attributes and so much more and that has nothing to do with bipolar and everything to do with me as a person. We deserve to be treated with the same compassion and respect as anyone else…bipolar is just a piece of us, it is not what defines us.”

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