Manic depression, post-traumatic stress, and addiction are all complex psychiatric disorders that many suffer concurrently. Those of us who have been diagnosed with one or more of these mental illnesses (co-occurring) contend with debilitating symptoms, which may include severe anxiety, dramatic mood swings, rage, ruminations, flashbacks, and nightmares. Our manic episodes are often life-changing and can result in death. Although there are no cures for any of these disorders, adopting a Buddhist practice that includes mindfulness and Tonglen meditations can augment our existing treatment protocol.
Mindfulness is simply being fully aware and present in the moment. It’s like having an orchestra conductor inside our heads, who also serves as a gatekeeper—intercepting negative thoughts, such as urges, ruminations, flashbacks, and addiction cravings. When we’re free of these triggers and symptoms, we can concentrate, reach a higher consciousness, and embrace insights, which can lead to emotional breakthroughs and healing.
Belly breathing is the core technique for practicing mindfulness meditation. Also referred to as “abdominal” and “diaphragmatic” breathing, this is our inborn way of respiring and it has distinct advantages over breathing from our chest. Belly breathing enables us to take in more oxygen with fewer breaths—with more carbon dioxide being expelled on the out breath. Increased utilization of our diaphragm to breathe lowers our heart rate and helps to stabilize our blood pressure. Belly breathing stimulates the area just below the navel, where our body stores chi energy. This is where our Buddha nature resides.
A Natural Mood Stabilizer
Those of us who suffer from bipolar disorder face challenges that our friends and family often have difficulties understanding. A genetic predisposition and chemical imbalance can result in extreme highs and lows as well as rapid mood swings. A mindfulness practice can help us gain better control—not only of our thoughts—but of our emotions as well.
Being attentive from moment to moment enable us to be fully conscious of changes in our mood, which may occur suddenly. Mindfulness serves as a potent coping mechanism for us. When we find ourselves in a stressful situation or sense that we are becoming anxious, overly sensitive, irritable, hyper, fearful, or aggressive, implementing mindful breathing immediately helps us to pause and focus, instead of panicking, retreating, acting out angrily, or resorting to high-risk or excessive behavior—such as compulsive gambling, hypersexual activity, or wild shopping sprees. This brings our mind to a relaxed state, where it can rest and recharge, while maintaining full awareness. Mindfulness meditation reduces our anxiety and acts as a natural mood stabilizer. It is a great way to cultivate loving-kindness for ourselves.
The Four Noble Truths and 12-Step Recovery
Buddhism and the 12-Step Recovery Program have a lot in common. Both traditions promote community (sangha), spirituality, humility, accountability, making amends, ethical behavior, and of course—abstinence from intoxicants. In fact, most of the literature used in recovery fellowships is in accordance with the Eightfold Path.
One major difference between 12-Step fellowships and Buddhism is that the former advocate surrendering to a higher power, while the latter emphasizes the power within each of us. Those unfamiliar with Buddhism may be surprised to learn that Buddha presented himself as a teacher and instructed his followers to think for themselves and not take his words at face value. He did not wish to be worshipped. So addicts who are atheists or agnostics can adopt a spiritual practice without any expectation to turn their will or their lives over to anyone or anything. The solution for our suffering lies in our true nature.
Another difference between the two traditions relates to the perception of time. “Take one day at a time” is synonymous with the Recovery Program, while mindfulness entails being alert and fully conscious moment to moment. In12-Step fellowships, we’re advised not to think too far ahead—but just focus on each twenty-four period. Offhand, that seems to make sense. Unfortunately, when we’re in the grip of our addiction, twenty-four hours still feels like an eternity to stay clean. Also, any period beyond the present moment is the future, which most of us will invariably expend our energy thinking and worrying about. We can also become complacent and at some point during the afternoon or early evening our ego starts celebrating a clean day early. We let their guard down, setting ourselves up for a relapse and hitting a new “bottom.”
The essence of mindfulness is that by being fully present, we’re able to attain and maintain equanimity. We are not resisting or directly suppressing intrusive thoughts. When something triggers us, instead of self-medicating, we focus on our breathing and the present moment. This enables us to pause, cease all thoughts, which instills calmness. Ruminations of getting a “fix” retreat back into our unconscious as seedlings without any drama. When our minds are rested, we reflect, analyze, and gain insight into the underlying cause of the craving episode. Mindfulness empowers us to respond instead of react.
Cultivating Compassion for Our Enemies
Those of us who have been traumatized by violence are at the mercy of our wounded monkey minds, which keep the psychic pains fresh through recurring flashbacks and nightmares. The Buddha believed that loving-kindness is the basis to end suffering. His teachings provide us with the resources we need. The following steps illustrate how our spiritual practice can help us cope and even recover from post-traumatic stress:
1. We embrace the concept of interconnectivity and acknowledge our antagonist as a fellow human being—someone’s best friend, son, brother, or husband—who entered the world as an innocent child. For example, a traumatized soldier alters his perception of the enemy combatant, viewing the adversary as someone merely defending their homeland, who is just as terrified as he is.
2. Next, we practice metta meditation, cultivating loving-kindness and compassion for ourselves, followed by friends and loved ones, and finally for the person who harmed us. We’ll call this person, “G.” G is no longer perceived as a threat but someone who has feelings and is suffering like we are. We commit to practicing metta for G on a regular basis. As our heart opens up more and more, it will let us know when we’re ready to proceed to the next level.
3. Metta meditation brings us closer to our inner Buddha. Now we are prepared to practice tonglen meditation, which is the art of taking in “suffering” and removing it—for ourselves, loved ones, as well as for our enemies. So starting with the in breath, we visualize G’s emotional and physical pain, and draw it in. We pause momentarily. On the out breath, we visualize the suffering being expelled. Practicing tonglen awakens our innate love for all beings.
4. We are now in a position to offer forgiveness that comes from the heart. We visualize G, verbalize our awakened feelings, extend our forgiveness, and wish him peace and happiness. The entire process provides closure, releasing all our pain and negativity. We will continue to cultivate compassion for G and embrace him or her as one of our spiritual "gurus."
Severe mental disorders such as manic depression and dual diagnosis are typically treated with psychotherapy and psychotropic medications. Although there isn’t a cure for these illnesses, committing to a Buddhist practice can help us attain a brighter prognosis.
(This article is for informational purposes only. It is not intended as a substitute for the advice of health care professionals.)
Bill Lee is the author of three memoirs. After decades of treatment involving different modalities of psychotherapy and being prescribed powerful psychotropic medications, he discovered a more-effective protocol for treating his co-occurring disorders, which are in remission. This was done under the guidance of his psychiatrist and detailed in his new book, "Born-Again Buddhist: My Path to Living Mindfully and Compassionately with Mood Disorders," which is available on Amazon Please visit his Facebook page or his web site: http://chineseplayground.com