If mindfulness is the sharpening of one’s ability to notice, then perhaps this noticing can be applied to the subtle changes in thoughts, behavior, and emotions that precede or come concurrently with the onset of a mood change or a psychotic episode. One changes as one enters any psychiatric episode. Noticing these changes can enable the individual to take whatever steps are necessary, and effective, to head off a debilitating psychiatric break.
The first step is to have a plan. Supports are necessary to help as one enters an episode. If these supports are effective, the severity and frequency of episodes can be reduced or even eliminated. What to do when the mind begins to slip, or when an affective disorder becomes assertive, should be worked out in advance with psychiatrists, therapists, family members, and friends. While noticing changes and acting on them remain the individual’s responsibility, help from others is going to be necessary to fully deal with the consequences of increasing distress.
The second step is to learn how to notice the changes that lead to distress. Things deteriorate quickly, and the affected individual can lose perspective and judgment early on in an episode. So picking-up the subtle signals that tip off changes in personality or affect is key.
Daily meditation is a method others and I use to notice when things are slipping and help is needed.
In mindfulness meditation one simply notices what arises in the mind and in the body. While many maintain this should be done without judgment, scanning for trouble with a mental illness leads to a pretty big judgment call – get help or not. Also, traditional mindfulness instruction encourages the practitioner to release thoughts as they arise. Note them and let them go. In combating mental illness a more thorough inventory of the thoughts that come up is required.
One sits, stands, lies down, or walks and puts down the plans, worries, and fantasies that distract. Focus, possibly on the breath, follows. Then the individual just begins to notice. The quality of the breath, sounds, and sensations in the body are all to be noted. But, as anyone who has tried to meditate will tell you, thoughts will quickly and completely pull us away from whatever we are using as a focus of attention. It’s important not to chase these thoughts or begin a conversation with yourself. No need or benefit in rumination. But the thoughts that arise should be noted. Labeling them can help. Categories like judging, regretting, joy, anger, planning, or just wishing to be somewhere else are a few examples.
This time spent meditating can also be used to objectively inventory recent actions. Have you been acting in any ways that may raise a red flag or cause concern? I’ll note that when my thoughts are often about wishing I was doing something different with my life and a review of my day leads me to note that I’m spending a lot of time on web shopping sites or watching financial news, mania could be budding. We all have patterns. Regular meditation can help us notice when troubling patterns emerge.
Sensations in the body are also important to note. Often, the thoughts that signal mania may be ascending in me are often accompanied by a tingling sensation similar to what I feel after I have taken too much caffeine, or by distress in my GI system. Just being still, and noticing, can reveal much that the mind and body have to tell us about how assertive our illness is at any point in time.
Of course, if what we learn in our meditation session implies oncoming difficulty, we can put into play the plan we have made to head off an episode of significance. Mania, depression, anxiety, and psychosis all have precursors and triggers. Noticing them early on gives us control of a situation that, had we not noticed, could have easily spun out of control. This opportunity to have control over our illness can be a great help in becoming well and productive. It can also lessen the burden we place on others, since we will be sick less often and with less severity.
Training yourself to notice this well takes time, but patterns that signal trouble often emerge very early in practice. So be still, note what you’re thinking about and feeling, and act, if necessary. I even take notes about my meditation sessions. Mood journals were very revealing in honing in on patterns early in my treatment. Journaling thoughts and feelings exposed during meditation can lead to similar insights. Critics will assert that this is not true mindfulness meditation. For it is meditating with a purpose instead of just being in our awareness without judgment. But I’ll shoot for being well rather than being enlightened.
Lost in much of the modern mindfulness movement, with its focus on awareness, acceptance, and non-judgment, is the idea of intention. I intend to be and stay well. Meditation is simply one tool I can use to help me get there. So I spend some time thinking about what I’m thinking. I spend some time noticing, and noting, what comes up. I use that information as feedback on the state of my mind. Then I act. Self-knowledge and self-awareness are possible, and necessary, if one is to live successfully with a mental illness. Meditating daily, with purpose, can help you get there.