Yoga for Bipolar Disorder: Mental Health Awareness Month

As we honor Mental Health Awareness Month, we take a look at yoga for bipolar disorder. With a background in counseling, integrating yoga and mental health comes naturally to me.  We hear a lot about yoga for anxiety and even yoga for depression, but bipolar disorder is often overlooked.  People affected by bipolar disorder can benefit from yoga as well and it's time that we break down the barriers and the stigmas by opening the discussion of yoga and bipolar disorder.

What is bipolar disorder?

Bipolar disorder is a mental health condition that is categorized by severe mood swings.  It includes periods of extreme mania, hypomania, extreme depression or both. 

Manic Episodes

Manic episodes are periods that last at least one week when a person feels "up" which may look extremely happy or may look extremely irritable for the majority of the day.  During manic episodes people are usually full of energy and experience 3 or more of the following symptoms:

• decreased need for sleep
• racing thoughts
• rapid speech
• restlessness / increased activity
• increased risky behavior (excessive spending, reckless driving)

Hypomanic Episodes

Hypomanic episodes have the same symptoms as manic episodes, but they last for shorter periods of time.  Hypomanic episodes last at least four days in a row, but less than a week.

Major Depressive Episodes

Major depressive episodes last for at least two weeks and have at least five of the below symptoms, definitely including the first two:

• increased sadness, despair
• loss of interest in activities previously enjoyed
• fatigue
• feelings of worthlessness or guilt
• decreased or increased sleep
• decreased or increased appetite
• restlessness
• slowed speech or movement
• trouble concentrating
• frequent thoughts of death or suicide

Types of Bipolar Disorder

Bipolar disorder used to be known as "manic depression," and there are four categories of bipolar disorder:

• Bipolar I Disorder - Bipolar I disorder is a diagnosis given to people who have had at least one manic episode that may follow or be followed by hypomanic or major depressive episode(s).  Sometimes, manic episodes can lead to psychosis (detachment from reality)
• Bipolar II Disorder - Bipolar II disorder is a diagnosis given to people who have had at least one major depressive episode and at least one hypomanic episode but who have not experienced a manic episode
• Cyclothymic Disorder - Cyclothymic disorder is a diagnosis given to people who have had at least two years of multiple hypomanic episodes and periods of depressive symptoms but who have not experienced the low levels of depressive episodes and manic or hypomanic episodes to qualify for a diagnosis of Bipolar I or Bipolar II
• Unspecified Bipolar Disorder - Unspecified bipolar disorder is a diagnosis given to people who do not meet criteria for other bipolar disorder diagnosis but who have experienced manic episodes yoga and bipolar disorder

How Yoga Can Help Ease Symptoms of Bipolar Disorder

There is no denying that the mind and body are intricately connected.  We are able to change our emotions, our energy level and our mindset with our breath and our movements.  During spinal extension we are energizing our minds and bodies, and during spinal flexion we are calming our minds and bodies.  When we open our side bodies, we find a sense of overall well-being.  When we twist, we find release, freedom and growth.  Most importantly, regular yoga practice fosters a sense of mindfulness that lets us know we are safe and grounded in the present moment. 

Bipolar disorder begins in the brain although its effects are felt throughout the physical and emotional body as well.  Yoga is not a replacement or substitution for mental health treatment and should be viewed as a supplement.  Yoga cannot cure bipolar disorder but can help to relieve the symptoms of bipolar disorder.  Studies show that practicing yoga regularly to help manage symptoms of bipolar disorder has helped to bring a sense of ease.

Yoga for Bipolar Disorder During Periods of Mania

During periods of mania and hypomania, people can sometimes feel stuck in the sympathetic nervous system.  When people are operating in the sympathetic nervous system, they may experience problems with sleep, high levels of anxiety or restlessness.  This is where the fight, flight or freeze stress response takes place.  Our yoga practice can help us move from our sympathetic nervous system into our parasympathetic nervous system, which is where all the healing takes place.  

Calming pranayamas can be helpful to bring us from our sympathetic nervous system into our parasympathetic nervous system.  Slow, deep breaths can help to steady the mind and ground us in the present moment.  Relaxing yoga postures such as forward folds can also help us find our way into our parasympathetic nervous system.  Certain hip openers can be very calming during manic episodes and can help people release the tension and find a bit of rest and relaxation.  Calming inversions are also recommended during periods of mania and hypomania.  

During manic episodes, it is important to stay away from energizing pranayamas such as Kapalabhati or Bhastrika.  Breath retention, especially after the inhale, can be agitating during manic episodes.   Fast-paced transitions, rapid movements and backbends can be unhelpful during manic periods.  

Yoga for Bipolar Disorder: 10 Minute Sequence for Mania

• Begin in Sukhasana, easy pose
• Diaphragmatic breath (1 minute)
• Seated cat/cow
• Lateral bend in both directions
• Twist in each direction
• Tabletop
• Downward facing dog
• 3-legged dog 
• Transition to Pigeon pose 
• Downward facing dog
• Child's Pose
• Table top
• Staff pose
• Seated forward bend
• Reclined twist
• Legs up the wall Savasana (guided visualization and breathwork)

Yoga for Bipolar Disorder During Periods of Depression

When people are depressed, they are often feeling sluggish, fatigued and unmotivated.  The very last thing they may want to do is to roll out their yoga mat and come into their bodies.  They may even feel paralyzed in a state of despair.  During depressive episodes, the mind and body may feel disconnected.  Yoga is a practice that integrates the mind and body and helps people find connection within themselves.  We can use our yoga practice to help awaken the body and soothe the mind during periods of bipolar depression.  

It all begins with the breath when using yoga to ease the depressive symptoms of bipolar disorder.  Deep belly breaths can foster the mind-body union that is so needed for people who are feeling depressed.  Visualizations can be helpful during breath work so that the student can envision sending the breath to specific spaces in the body and awakening those spaces.  Moving the spine in all six directions can open up the lungs for healthy breathwork which is important in easing symptoms of depression. 

Once the body and the mind are in sync, it's safe to start gradually moving towards slightly more energizing postures.  Side bends can help find opening and space in the body and can prepare the body for gentle backbends.  Anytime that the chest is open, the spirit is lifted.  Heart openers are one of the best ways that yoga teachers can help to fight the symptoms of depression. Stretching the arms up overhead is another great way to elevate the mood.  If it's possible to practice outdoors in the sunlight, a little Vitamin D can go a long way.  

Yoga for Bipolar Disorder: 10 Minute Sequence for Depression

• Hero's Pose (with or without props)
• Diaphragmatic breath with visualization (1 minute)
• Hero's Pose with heart opener variation
• Hero's Pose with lateral bend
• Hero's Pose with twist
• Table top
• Cat/cow
• Sunbird
• Tabletop with half bow legs
• Gate pose
• Modified camel pose
• Child's pose
• Tabletop
• Staff pose
• Bridge
• Reclined twist
• Legs up the wall Savasana (guided visualization and breathwork)

Learn to Sequence Yoga for Bipolar Disorder and Other Mental Health Conditions

Understanding that yoga is never a substitution for mental health treatment, we as yoga teachers are able to act within our scope of practice to write yoga class plans that can help ease the symptoms of bipolar disorder and other mental health conditions.  To learn how to safely and effectively write a yoga class plan, join us in our 200 hour yoga teacher training online.  Whether you want to teach yoga to others or you just want to deepen your practice, our 200 hour yoga teacher training online can help you reach those goals.  Start your journey today!