Bipolar disorder or otherwise known as manic-depressive disorder is defined by the presence of one or more episodes of uncharacteristically elevated energy, cognition, and mood with or without one or more depressive episodes. The elevated moods are clinically referred to as mania or if milder circumstances, hypomania and can last for days, weeks, or even months. People who experience the manic episodes also typically experience depressive episodes and in some mixed episodes that feature mania and depression at the same time. These episodes will be separated by a somewhat “normal” mood but can be disturbed by rapidly alternating moods of mania and depression, which is known as rapid cycling. In extreme cases symptoms can eventually lead to psychotic experiences of hallucinations and delusions. Bipolar disorder is generally caused by genetic heredity, psychological complications (reduction of brain volume and disturbances to the prefrontal cortex) and environmental circumstance. Studies have shown that one-third to one-half of effected individuals where abused as children or experienced traumatic events.
Allopathic treatment of bipolar disorder consists of psychotherapy and mood stabilizing medications which are commonly lithium carbonate or lamotrigine. Lithium is considered the only anti-depressant that reduces the possibility of suicide. Other commonly used drugs are sodium valproate and carbamazepine, which are anti-convultants. Anti-depressants are up for debate as some studies suggest that they may induce more episodes or increase the onset of rapid cycling. Counseling techniques such as Cognitive behavioral therapy, family-focused therapy, and psycho education have many positive results and are still being developed in theory and practice today. Bipolar has long affected many artist and eccentric personalities. The following is a list of people who have been diagnosed with bipolar disorder.
Kurt Cobain, Vincent Van Gogh, Mel Gibson, Macy Gray, Jack Irons, Ozzy Osbourne, Edgar Alan Poe, Jackson Pollock, and Catherine Zeta-Jones. Ayurvedic treatment of bipolar disorder is centered towards building ojas and decreases stressors as much as possible. Due to the irregular and spontaneous outburst of bipolar, vata must first be addressed. This expresses the importance of set routines, waking and resting at appropriate times and set meal times every day. Appropriate sleep cycles are of great importance, getting to bed every night before 10pm and waking no later than 6am sleeping with feet to the east and head to the west. Dinacharya must be established and very detailed for the entire day and must include regular abyanga (ama appropriate), nasya, pranayama, meditation and asana. The home must be clean, clutter free, well maintained, with sufficient sunlight, ideally with fresh flowers. There can be sweet gentle music in the evenings (Indian ragas, Celtic songs, soft piano) with little to no electronic activity.
Foods should favor the sweet, sour, and salty taste and nourish majja dhatu. Ghee, milk, yogurt, peeled almonds, almond milk, dates, figs, and baked apples will help build good quality ojas and ground the individual. There should also be a restriction of stimulants such as coffee, caffeinated teas, alcohol, and recreational drugs, as well as, pungent foods and spices.
For herbal treatment nervine tonics work best for building mental clarity and stamina leading to optimal quality ojas. These herbs are Brahmi (Bacopa and Centella), Shankapushpi, Shatavari, St. John’s Wort, Jatamamsi, Ashwagandha, Valerian Root, and Ginseng.
Due to the vata nature of bipolar it would be best start a program of set bastis in order to keep the colon clean of toxins and vata from disturbing majja dhatu. Of all panchkarma therapies, shirodhara has the most powerful effect and should be performed on a regular basis. Depending if the individual is sama or nirmama oil can be used in the basti and depending on the season and present vikruti heating or cooling oils should be used for shirodhara. If ama is low an ayurvedic practitioner can evaluate if the individual qualifies for panchakarma, which should be performed on a regular seasonal basis.
Exercise must be calm and soothing to the nervous system, as well as non-competitive. Tai Chi, gentle yoga, swimming, Pilates, brisk walking, and hiking are all positive exercise routines. As bipolar effects not only the annamaya kosha, it disturbs monomaya and pranamaya kosha, which must be treated through regular meditation and pranayama. Regular practice of moving prana through the organism will cultivate proper quality prana and stable ojas. Meditation will cultivate a deeper relationship with anandamaya kosha ultimately leading to less severe manic episodes.
Due to such a deeply rooted disorder, treatment must be well attended and practiced over the course of life. Outlets are important as family and friends should be up to date with current whereabouts, behavioral changes, and public activity. Those close to the individual should have an abundance of compassion and see the negative outburst as the manifestation of a psychological imbalance and not as hatred for the unusual behavior. Regular check up’s with a therapist is important and with practice the problems will diminish.