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  Key Messages

  • Spirituality and/or religion can be important for health and quality of life for some people
  • Both positive and negative coping styles can occur in spiritual/religious practice
  • Some bipolar disorder symptoms (e.g., hyper-religiosity) can complicate spiritual/religious life

  Take Action

  • Spirituality/religion is highly personal – no ‘right’ way to practice
  • Openly discuss spiritual matters with healthcare providers, and health with spiritual advisors

  Learn more

Why spirituality may be important to your quality of life

First, let’s talk about what spirituality means – no easy task! Ninety percent of people in the world participate in some sort of spiritual or religious practice1. ‘Spirituality’ captures a wide variety of things that can give life hope, meaning, direction and fulfillment.  It includes feelings of connection, compassion and belonging with the universe around us, or with something that an individual feels to be sacred or awe-inspiring. While some people engage in spirituality through a religion, many others express spirituality outside of formal religious practice.

Spirituality often becomes more important to people in times of difficulty, discouragement and distress, when life feels scary, out of control and full of suffering. People facing illness can turn to spirituality to help make sense of their suffering and cope with the stress of their condition. Spirituality looks at the whole person and the big picture: it asks if we can learn and grow from difficult situations, rather than simply relieving the symptoms of our conditions or solving the things that are stressing us.

Spirituality can be expressed in a range of ways, such as2:

  • Belonging to a faith tradition or community
  • Ritual or symbolic practices and other forms of worship
  • Retreats and pilgrimages
  • Meditation or prayer
  • Reading spiritual teachings
  • Deep engagement with music
  • Acts of compassion
  • Deep reflection or contemplation
  • Yoga, Tai Chi and similar practices
  • Engaging with and enjoying nature
  • Thoughtful reading of literature, poetry, etc.
  • Engaging in creative activities, including art, cooking, gardening, etc.
  • Maintaining stable family relationships and friendships (especially those involving high levels of trust and intimacy)
  • Group or team sports and recreational activities

Spiritual practices have been shown to have many benefits for emotional wellbeing, especially during stressful times, such as providing social support and a sense of belonging3, offering a sense of meaning and purpose3, increasing self-confidence3, promoting optimism and hope; helping to improve the ability to protect yourself (your ‘resilience’)4 , and developing stronger coping styles5.

Additionally, studies have shown that spirituality relates to many physical health benefits, such as6 a better immune system, better function of hormones, lower blood pressure, cholesterol, heart disease, and risk of stroke, less cigarette smoking, more exercising, lower rate of death from cancer, and increased lifespan. Specifically, participating in spiritual practices has been linked to benefits for mental health problems, such as6, recovery from depression, reducing risk from suicide, lessening feelings of anxiety and fear, and reducing substance misuse. There is also some evidence of less depression7 and better wellness over time8 in people living with bipolar disorder.

Research has identified two different styles of practicing spirituality or religion. Positive spiritual/religious coping can be described as using spirituality as a source of comfort, compassion, direction and growth. This positive style of coping is linked to many of the benefits already discussed here7. Negative spiritual/religious coping, on the other hand—which is less common than positive coping—can be harmful to health. Where negative coping styles occur, spirituality can be a source of guilt, close-minded thinking, shame, fear, or feeling you or others are to blame for things.

Another possible challenge is that some people living with bipolar disorder may sometimes find that their spiritual beliefs don’t agree with accepting medical treatment and advice9. For example, you may feel that you shouldn’t take medications or accept therapy or professional support because your faith should be sufficient to help you cope with your condition. Or you may delay seeking medical help to explore spiritual solutions first.

Some religious systems of belief can also make people feel bullied or discriminated against10. For example, some people may be rejected for their sexual orientation. In rare occasions, people can become involved in religious cults that can misuse them through unnecessary emotional dependence and separation from society10.

Increased thinking about or practicing spiritual or religious activities can be a symptom of bipolar disorder, making things complicated. Increased spiritual experiences, often called ‘hyper-religiosity’, can be a symptom of mania or psychosis; therefore, many people living with bipolar disorder (and the healthcare providers working with them) wonder whether their spiritual experiences are “real” or a symptom of their illness11. Problems separating spiritual experiences from psychotic symptoms may lead to misdiagnosis—and that could be harmful if, on one hand, people get unnecessary treatments, or, on the other, if a manic episode is allowed to continue untreated.

It gets even more complicated as different cultural factors also determine whether spiritual experiences are seen as a sign of illness or not. Having visions or hearing voices may be admired in one culture and seen as a sign of severe illness in another. Because of this, the psychiatric diagnostic manual (the DSM) has separate ways of thinking about spiritual problems to try not to turn spiritual beliefs into medical problems. At the same time, it acknowledges that symptoms of illness can have a spiritual content that may need to be explored. For example, the DSM recognizes a true delusion as a firmly held, false belief that is not “shared by members of religion/culture/subculture”, such as an “article of religious faith” would be12.

How you can take action

If you are interested in spirituality, there are many possible ways to include spiritual practice in your life. Spirituality is very personal so there is no ‘right’ or ‘perfect’ way to practice. Exploring your options to find what’s the best fit for you may take some time. Perhaps you may want to start with asking yourself about what keeps you going during difficult times. This might include important inner resources or outside supports from your community.

You can find out about different spiritual practices from a wide variety of spiritual organizations in your community. There are many secular (not related to a formal religion) communities to choose from as well. People also vary in the level of their involvement in organized spiritual practice—that is, joining a group of like-minded people—versus learning about and experiencing spiritual practices on their own (such as studying spiritual books or having a quiet time everyday for reflection, prayer, or meditation). In general, finding a community can be a healthy way to nurture and support your spirituality.

One example of spiritual practice that has become very popular, especially for coping with mental health challenges, is mindfulness. Mindfulness practice tries to develop an attitude of acceptance and purposeful awareness of the present moment to cope with life’s suffering and to increase overall wellness. Mindfulness can be practiced with a community or on your own. It can be practiced with an emphasis on Buddhist teachings and community, or in a secular (non-religious) way, such as through groups at a medical clinic or community centre.

It can be helpful to openly discuss spiritual matters with your healthcare team and other supports so that others can have a fuller understanding of who you are and what’s important to you. Additionally, finding healthcare providers and spiritual counselors or advisors that can work together allows you to include all the aspects of wellness that are important to your recovery. This helps with the potential problem of only focusing on one thing—either spiritual practice or medical treatment—at the cost of ignoring the other very important piece of treatment and recovery.

Finally, as spiritual ideas or activities can be very intense in times of mania or depression, remembering to include these topics when you talk with your healthcare providers and support people can help identify early symptoms of an episode, even though spiritual matters may feel unrelated to how you are managing your healthcare. Having discussions with trusted others about intense spiritual events experienced in a mood episode can help you make sense of these experiences, perhaps helping you to tell the difference between what parts of the experiences may be explained by symptoms of your bipolar disorder.