Treatment of Bipolar Disorders

Life can be rather traumatic. The uncertainties of daily living can be triggers for anxiety, depression, fears, and constant grief. Our joys can turn quickly into aggressions, sadness, and worries. How does one fight the constant sword of unprecedented thoughts over one’s head, and encountering the vice grip of previous ones numbing your voice in the background. In the mind/body separation, there is a distinct break between what we feel and what we think. In that separation the doubt of actually having control of our situation or our own emotions, strikes a familiar dread that we are afraid to feel again.

And then the anxiety begins, and then when the control is lost the sadness begins.

In bipolar disorders, the anxiety phase when control is slipping, can drive people to exorbitant extents to grasp upon all the control they have. It can be seen as flights of fancy, emotional outburst, extravagant expenditures, or even violence.

When the final realization of control is addressed, the depression begins and so does the regret, and personal turmoil. Unceasing thoughts, and voices that echo a negative state become difficult to turn off and the body begins to shut down in an overload.

In polyvagal theory, Stephen Porges, breaks down how in autonomic makeup, our flight and fight responses have become exhausted, and that we then surrender to another of our limbic brainstem functions, that off freeze and play dead. This is a crucial animal instinct that we have. It is a defense mechanism for ensuring a last chance grasp at life.

I am not a psychotherapy expert, but in that loss of trying to establish some sort of control of our life, in the manic phase the flight or fight instinct gets exhausted, so that all that remains when faced with the reality of the current situation is freeze and play dead. One can play dead for a day, two days, and for some it can be weeks or even months.

There are many questions as to whether serotonin reuptake approaches to treatment of depression or bipolar disorders are the answer. The research is inconclusive. Close monitoring of medications and mood stabilizers as well continual psychotherapy is the current treatment for bi-polar disorder.

In Chinese medicine, bipolar disorder has been termed Kuan-dian.

In the Ling Shu, the Spiritual Axis, a chinese text of 2000 years, Kuan-dian is explained as

“When Dian first appears, there is lack of joy, heavy and painful head, red eyes, eyes looking up. When Kuang first appears, there is little sleep, no hunger, glorification of the self as if one were the most knowledgeable person, shouting at people, no rest in day or night.”

There is a similarity between both pathologies. The fact that something like bipolar disorder existed before our modern conception, points out to the roots of the illness.

In Chinese medicine, a rubric of patterns are treated. They are a simple expressions of different presentations in the body where the goal of healing would be of balance within. Yin and yang are counterbalanced, as well as hot and cold, blood and qi, and the inner and the outer. The emotions are seen as an interplaying cycle of different element of where a linked correspondence in the body occurs. Mind and body are interlinked where an excess of one element to the other creates a deficiency in another.  An excess in the Heart can create a deficiency in another part of the body, say the Lungs, or the Kidneys. The role in healing would be to establish balance a between the excess and the deficiency, so a stability would develop, where one could find strength to tread upon.

In the next part, how Chinese medicine looks at how our emotions are established in the body would be examined as well as how those emotions are treated when they are in excess or in deficiency.






Continuing Depression

Managing depression can be a difficult thing, especially when you are uncertain as to the cause of it. Using a simple calendar or a diary, is one of the ways of chronicling when your episodes happen and what your episodes were about. One can simply step back and look at a month or week in question and possibly see a pattern arising. Another use of the diary, is that one could try to build a narrative, and through that narrative make a break-through. As one begins to see a story form, one can begin to understand the possible context that the depression came from. This is the easiest way, of putting it all together in one piece. And in the future, one can also relate it to others so that they may easily understand you, sympathize, and help you out.

The DSM-V, divides depression into different categories, categorized by severity, frequency, and mixed presentation. Major, Manic, Mixed, Hypomanic, Major recurring, Disthymic, Cyclothymic, Bipolar 1, and Bipolar 2. Each one has a varying degree of severity with mixed presentations, or whether they stem from an event, or from a conditioned state. Each one is medicated differently according to its presentation. Likewise in Chinese Medicine, the depression is looked at according to its presentation and symptomatology. The emotional state that one is in, while in the depression, or out of it, gives a the practitioner a sense of what is the base emotion that the patient is overwhelmed in. There are five different “spirits” or psychical states that one may find themselves in according to Chinese Medicine. These are the emotions commonly expressed as Anger, Joy, Worry, Grief, and Fear. One may have a predominant “spirit” which their personality may dictate. Usually these emotions are in a harmonious relationship and when one emotion overtakes the other, the self and the body becomes overtaxed. Excessive anger may rage and burn one out, over elation repletes instantly, excessive worry hampers action, and denies expression. Also animproper response or inaction to one of these emotions may stultify or depress another. When one does not act within the moment of the occurrence of anger, depression may arise, or when one conceals their joy, depression may arise also. When one doesn’t heed caution to worry, depression may arise, and so forth. These imbalances take a toll on the body, and produce lethargy, anxiety, over-compulsion, lack of self esteem, and so forth.

Acupuncture is a way in which the body can heal itself and the mind also. Acupuncture opens up the flow of the body’s channels to experience movement again, it rejuvenates, and releases tension. It clears the mind, and shows the mind where the body is tensed, and where trauma may have hidden itself. There have been situations where one has cried after a treatment, or was so relaxed and relieved that they “felt like their old selves again.” This is where one can remember themselves, and who they have been and pick up the pieces and start all over again. Courage and strength with support can then lead the way to a new beginning.