What is bipolar disorder?
Bipolar disorder, also known as manic depression, is an illness that causes shifts in a person’s mood, energy, and ability to function. Its characteristics are alternating episodes of mania (abnormally elevated mood) and depression, which may be separated by phases of ‘normal’ mood.
In general, men tend to have more frequent elated or manic episodes, while women more often depressive episodes. The peak age of onset is in the early thirties.
It has an extensive amount of symptoms and manifestations that can vary greatly depending on the constitution, environment and imbalances of the individual.
Traditional Ayurveda has no specific equivalent disease for the diagnosis of bipolar disorder written in the classical Ayurvedic texts. One of the main ancient treatises on Ayurveda is the Charaka Samhita. It uses the term “Unmada” as a very general term for insanity. Insanity according to the author Charaka is “wandering about of mind, intellect, consciousness, knowledge, memory, inclination, manners, activities and conduct.”
Bipolar disorder manifests due to imbalances in the three fundamental biological qualities that govern the body and mind; vata(air and space), pitta(fire and water) and kapha(earth and water); and the mental principles of sattva, rajas and tamas, which are the “qualities of consciousness.”
In the case of bipolar disorder, vata moves from the plasma and blood and relocates to the mano vaha srota (pathway of the mind) resulting in loss of awareness of one’s situation and fluctuations in emotional states. It also secondarily relocates into the majja dhatu (nervous tissue) and majja vaha srota (pathway of the nervous system), resulting in biochemical changes to the neurotransmitters being released effecting our thoughts. Once vata has taken root in these tissues and pathways, it starts to manifest the myriad of signs and symptoms of bipolar disorder.
The elated and vata symptoms of bipolar disorder include talkativeness, excessiveness, racing thoughts, hyper-sexuality, euphoria and impulsive over-spending (of money, time, and energy). Some other manic and more pitta type symptoms include over-confidence, irritability, aggression or anger directed outwardly against other people, under-sleeping and hyperactivity. On the other side of the coin are the depressive (more kaphic) symptoms of bipolar disorder, including feelings of sadness, lethargy, lack of enthusiasm, apathy, lack of appetite, lack of sexual interest, over-sleeping and hypoactivity.
Etiology and Pathology (Nidana and Samprapati)
In western medicine the exact cause of bipolar disorder is unknown. Genetics are a substantial factor in the disease manifestation, but it rarely appears without environmental circumstances such as traumatic life events or extreme social stressors. It is found to be more common among individuals who are affluent, extroverted, achievement-oriented and use activity to combat depression. Outwardly, bipolar disorder is two opposing high and low conditions that have a pendulum effect on each other. While multiple doshas will likely be involved in the oscillations of bipolar disorder, the very changeability of this disease points to an underlying variable vata imbalance as the principal doshic disturbance.
More specifically, the cause is primarily samana vayu (vayu is another word for vata). Dr David Frawley refers to samana vayu as “the equalizing life energy.” Samana vayu literally means “balancing air.” “In the mind, the role of samana vayu is to balance and stabilize the other vayus. When it is healthy, the other vayus find greater stability. When it is disrupted, a person loses control of his thoughts and feelings.
Samana vayu is also responsible for absorbing sensory impressions into the workings of the brain and mind.” The other two vayus that play an essential role in this disorder are prana and vyana. When prana vayu is disturbed it affects our thoughts and emotions. Prana is also responsible for the intake of impressions into the brain and mind as well as movement of neurotransmitters through the nervous system. Vyana is also responsible for movement in the nervous system and circulation of thoughts and emotions.
As was mentioned previously, bipolar disorder usually doesn’t manifest until one’s twenties or thirties. As the patient moves out of the kapha phase of life into the busier more stressful pitta time of life, they lose the grounding of the water and earth elements and become more susceptible to the heat of pitta, which in turn contributes to the drying of vata. Changes in the underlying emotions are brought on by vata-provoking qualities in the individual’s lifestyle, habits, foods and activities. These qualities are dry, rough, light, cold, subtle and mobile.
Vata aggravating behaviour includes eating while anxious or depressed, eating on the run, taking in stimulants such as coffee or cigarettes, using intoxicants such as alcohol or recreational drugs, following irregular routines, traveling frequently, going to bed late, loud music or noise, engaging in excessive physical or sexual activity, failing to change with the seasons (especially autumn), overloading on stimulation such as TV, mass media, suppressing inner creativity and emotional sensitivity.
The fact is that we have more of these problems because our culture is over stimulating people.
Ayurvedic Treatment (Chikitsa)
In management of any psychological disease, Ayurveda works to change the energetics of the mind. The two main Ayurvedic treatments for managing bipolar disorder centre on increasing our ojas and reducing our stressors. The stronger our ability to cope and withstand the stressors of the world, the less likely our moods will fluctuate between highs and lows.
When ojas is strong we are less likely to be buffeted by the doshas. The more we identify our stressors and reduce them, the less ojas will be worn down. The patient’s therapist and family are good allies in helping the patient identify these stressors. The main tools used in managing the mind are “diet and herbs on a physical level, prana and the senses working at a more subtle level, and mantra and meditation working more at the level of the mind itself.”
The main thing that helps is to develop regular solid routines and stability.
Irregular patterns place stress on our body’s ability to function at its best. Some examples of this are regular mealtimes and bedtimes. When our body’s biological clock can anticipate meal or sleep times, it will release chemicals such as amylase, pepsin and acid needed to digest food in the former and chemicals such as melatonin needed to sleep in the latter.
When the body is subject to irregularity, we will be prone to problems like indigestion and insomnia that put great stress on our bodies and reduce ojas. This is especially true of digestion.
Sleeping times are also important. Going to bed around 10:00pm and awakening near sunrise will help the body change mental states in the kapha times of day when it is more stable. The morning should be devoted to steady and healthy morning routines, including meditation and exercise. Since vata has the qualities of: cold, light, mobile, dry and piercing, and follows a transverse course, it is necessary to implement the opposite qualities in any treatment, an emphasis on warm, heavy, stable, moist, oily and dull qualities should be made.
The most important factor concerning meals is eating at regular times each day and also making sure not to go without eating. Food pacifies vata and diet should emphasize whole grains, cooked vegetables, mung beans, meats, fresh dairy, ghee, nuts and oils in order to ground the patient and build up ojas. Generally, sweet, sour and salty tastes should be emphasized, as well as the qualities of warm, moist and heavy foods.
When one is having a pitta manic phase, then cooler and blander foods may be useful, and during depressive states, spicier foods can be used. Canned, frozen, old, processed, microwaved and rancid foods should be avoided.
It is also important to stabilize blood sugar. Increasing the ratio of fats and proteins in relation to carbohydrates and keeping simple carbohydrates to a minimum will help with this. Coffee and other stimulants should be avoided since they will only serve to keep someone going artificially without getting true rest and will lead to more vata imbalance.
Lunchtime should be the main meal of the day. It should last at least one hour and be taken at the same time, every day while seated in a peaceful, distraction free environment in order to let food settle and digest before moving on to other activities.
Some positions are calming and others, energising. Postures like back bends, which open up the chest, increasing lung capacity, are especially useful for depression. During a manic phase, it is advised to employ calming positions while energetic positions are for those who are in the depressive cycle.
- Proper breathing helps in controlling extreme mood swings. In a depressive state, practise breathing sessions through the right nostril, while it helps to breathe through the left nostril during the manic phase.
Meditation is one of the best complementary therapies for bipolar disorder. As one meditates, the mind becomes still, clearing depression and bringing a greater balance in functioning of the brain.
Yoga tatva mudra vigyan (yoga of elements) states that the five constituents of the physical body are fire, air, ether, earth and water which are represented by our thumb, index, middle, ring and little finger. A particular mudra activates a subtle but powerful energy flow and interaction, which reverses and cures the imbalance within our bodies.
Gyan mudra is effective for the depressive cycle and is formed by touching the tip of the index finger with the tip of the thumb. Practising this mudra controls the level of depression, increasing the level of confidence and inner bliss.
Brahmi is a great choice for any mood state since it can both act as a mild stimulant and sedative depending on what mood state needs to be balanced. Ashwagandha is very useful for building ojas and pacifying vata in the nervous system and mind.
All of these herbs should be taken with herbs that aid in their digestion and absorption. Triphala is a useful combination of three fruits that not only strongly reduces vata in the intestines, but also helps with the absorption of the other herbs and foods that are being taken and will exponentially multiply their effects.
Since bipolar disorder is partially rooted in the nervous system, medicated ghees are an ideal medium for enabling these herbs to penetrate deeply into these tissues. (Akasha has many different medicated ghees or Ghrtihams available)
Shirodhara helps reduce agitation, aggression, and sleeplessness. (Carly performs this treatment in her Cooroy clinics, along with abhyanga herbal oil massage and other dosha pacifying ayurvedic treatments.) Carly has many herbal formulas available to help with bipolar.
My most commonly prescribed would be brahmi, asvagandha, triphala, manasamithravatika, sumana syrup with vacha, magnolia, valiya rasanadi kashyam, rhodiola rosea, shatavari, chyavanaprasm. Herbs vary depending on individual.
The five sense therapies (vision, sound, taste, touch and smell) can be used to place the patient in balancing and restorative surroundings. Colour therapy may be useful for the visual sense. Yellow, green, gold, blue, white, violet, and pastels in general are considered sattvic colours; gold and brown are considered to raise ojas; and yellow, green, gold, brown and purple are considered to decrease vata. Colours can be applied to clothing, home décor, meditation and flowers.
Music that the patient finds enjoyable or mantra therapy may be beneficial sound therapy.
Regular, gentle and steady massage with lots of oil is also an excellent therapy for the touch sense. While professional massage is also excellent, daily self-massage with sesame oil is more affordable, easier to implement and offers the added benefit of self-love needed for more insecure vata type individuals. Aromas that may be useful to calm the mind during elation include sandalwood, chamomile, clary sage and jatamamsi. For depression, rosemary, cinnamon, thyme, mint and eucalyptus may be useful to help get moving. Rose, basil and lavender may add balance to bipolar disorder.
They can be taken in the form of essential oils with an infuser, or by adding a few drops to a warm bath. (Akasha Therapies sells a range of essential oils for diffusers, and the diffusers as well, and herbal massage oils for abhyanga.
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Is bipolar a gift!?
Bipolar individuals are usually gifted and experience bouts of creative genius, especially during the manic phase.
Vata dosha types usually tend to be very sensitive, erratic, passionate, unpredictable and creative. And these types usually are more prone to bipolar.
Some individuals include Ludwig Von Beethoven, Sylvia Plath, William Blake, Ted Turner, Jimi Hendrix, Catherine Zeta Jones, Kurt Cobain and Vincent Van Gogh.
God acts in strange ways and maybe a bipolar diagnosis is just his way of showing that you are special!
So, pacify the vata, and balance that wonderful creative power within.
Adv. Dip Ayur
Cert 4 Ayur