January 2025

Introduction Let’s talk about mental health and Catholic pastoral care. Living with mental health challenges often leads us to important questions. These include questions related to purpose, hope, and how we fit into our communities. In the Catholic Church, these questions are met with a unique blend of care and faith. Catholic pastoral care offers not just spiritual support, but also practical help to those who are struggling. Recently, BP Harmony founder Imran Ghani sat down for a heartfelt conversation with Father Francis Clooney, a Catholic priest and Harvard professor. Together, they explored how the Catholic tradition approaches suffering, why community matters so much, and how saints provide comfort to people facing mental health struggles. Imran asked Father Clooney three big questions about mental health and Catholic pastoral care: How is suffering understood in light of the Bible’s teachings, especially when it relates to mental illness?  How can Catholic communities better support individuals with mental illnesses in a way that reflects Christ’s love? Are there saints or figures within Catholic tradition who exemplify how to embrace mental health struggles? The journey through mental illness is often marked by profound questions, not just of health but of meaning, hope, and resilience. Within the Catholic tradition, the intersection of suffering, faith, and pastoral care offers a deeply rooted perspective that can guide individuals navigating these challenges. Father Francis Clooney, a Catholic priest and scholar of Comparative Theology at Harvard University, reflects on the role of suffering in the Catholic worldview, the importance of community in embodying Christ’s love, and the example of saints who found holiness amidst mental health struggles.   For more guidance on mental health, check out our book and masterclass to reclaim control of your life. You can also check out our free resources.  Understanding Suffering Through the Bible The Bible doesn’t ignore pain; instead, it faces suffering honestly, from Adam and Eve’s exile to the hardships of Job and even Christ’s crucifixion. Father Clooney points out that the Bible tells us pain is part of being human, but it never says suffering takes away a person’s value. Job’s story, for example, teaches us that even when we can’t understand why we’re suffering, we can still trust in God’s care. This message is so important for anyone struggling with mental health—it reminds us that God’s love is bigger than our pain. Fostering Christ’s Love in Catholic Communities Mental illness can make us feel alone, but Catholic pastoral care reminds us that we belong. Jesus reached out to people who were isolated—he not only healed them, but also brought them back into their communities. Father Clooney believes Catholic parishes should mirror this, working to include everyone, especially those facing mental health difficulties. He talks about the importance of the Eucharist and other sacraments in offering healing and welcome to all. Many parishes now have groups, counseling, and outreach programs focused on mental health. But sometimes, what helps most is just a kind word, a listening ear, or an invitation to share a meal. These small acts show Christ’s love in a real way and help break the stigma around mental illness. Saints as Models of Resilience and Holiness The Church holds up saints who faced their own sufferings, including mental health struggles. Saints like St. Dymphna (patron of mental illness), St. Benedict Joseph Labre, St. Therese of Lisieux, and St. John of God show us that holiness and hope are possible, even in hard times. Their stories remind us that suffering can deepen our faith and help us connect with others in need. St. Dymphna: She is known as the patron saint of mental illness. St. Dymphna’s story is one of enduring love amidst suffering. When her father’s mental instability led to tragic consequences, her unwavering faith and compassion became a beacon for those facing similar trials. St. Benedict Joseph Labre: He was labeled by some as “dysfunctional” due to his erratic behavior. St. Benedict was repeatedly turned away from monasteries. Despite this, his deep spirituality shone through. He is now remembered as a saint who found God amidst personal turmoil. St. Therese of Lisieux: She is often called the “Little Flower”. St. Therese experienced profound sensitivity and depression, particularly as she faced the physical decline brought on by tuberculosis. Yet, her “Little Way”—finding God in small, everyday acts—offers a path to holiness for those battling inner struggles. St. John of God: He lived on the streets and battled personal demons. St. John of God’s compassion for the marginalized transformed him into a model of Christ-like love. His legacy underscores that mental illness does not preclude one from a life of profound service and sanctity. These saints remind us that suffering, while deeply challenging, can also be transformative. It can deepen empathy, strengthen faith, and inspire acts of love that ripple outward into the world.  Mental Health and Catholic Pastoral Care | A Call to Action and Hope Father Clooney and Imran’s conversation is a reminder that mental health and Catholic pastoral care go hand in hand. The Church sees each person as worthy of love and support, no matter what they’re facing. By offering acceptance, kindness, and faith, Catholic communities can be places where all are welcome and no one struggles alone.

Holistic Understanding of Bipolar Depression Introduction Looking for a holistic understanding of bipolar depression? You’ve come to the right place! Bipolar disorder is a complex mental health condition that affects millions of people worldwide. We have previously written about the difference between bipolar and unipolar depression. In this blog post, we will delve into the intricacies of bipolar depression, drawing insights from a lecture by Dr. Shefali Miller, who was at that time a Clinical Assistant Professor of Psychiatry and Behavioral Sciences at Stanford University Medical Center.  Placing BP Depression along the Bipolar Spectrum When we think of bipolar disorder, many of us immediately picture dramatic mood swings – soaring highs followed by crushing lows. However, the reality is far more nuanced. Dr. Miller explains that bipolar disorder is characterized by fluctuating periods of depression and mood elevation, with the latter manifesting as either mania or hypomania. It’s crucial to understand holistically that bipolar disorder is not just a matter of emotional instability. It’s a serious mental health condition that can have profound impacts on a person’s life. In fact, individuals with bipolar disorder face a suicide risk that’s 20 to 30 times higher than the general population. This sobering statistic underscores the importance of proper diagnosis and treatment. The Challenges of Diagnosis One of the most significant challenges in treating bipolar disorder lies in its diagnosis. Dr. Miller points out that 40% to 60% of patients with bipolar disorder are initially misdiagnosed with unipolar depression. This misdiagnosis can lead to delayed or inappropriate treatment, potentially exacerbating the condition. Why does this misdiagnosis occur so frequently? There are several reasons: Similarity of Symptoms: Depression looks remarkably similar whether it’s part of bipolar disorder or unipolar depression. Onset of Illness: About half of bipolar patients experience depression as their first mood episode, making it difficult to distinguish from unipolar depression initially. Lack of Awareness: Patients may not remember or recognize past manic or hypomanic episodes. However, there are certain risk factors that might indicate a higher likelihood of bipolar disorder: Early Onset: A first major depressive episode before age 25 doubles the likelihood of bipolar disorder. Family History: Having a first-degree relative with bipolar disorder increases the risk by 2.5 times. History of Psychosis: This triples the likelihood of bipolar disorder. The Genetic Component One intriguing aspect of bipolar disorder is its strong genetic component. Dr. Miller highlights that bipolar disorder is significantly more heritable than major depressive disorder. While having a first-degree relative with major depression increases your risk by about three times, having a first-degree relative with bipolar disorder increases your risk tenfold. This genetic link is even more pronounced in identical twins. If one twin has bipolar I disorder, the other twin has a 40% to 70% chance of also having the condition. This high concordance rate suggests that genetics play a crucial role in the development of bipolar disorder. The Burden of Bipolar Depression While mania and hypomania are often considered the hallmark symptoms of bipolar disorder, it’s actually depression that accounts for the majority of the illness burden. Dr. Miller presents data showing that patients with bipolar disorder spend a significant portion of their time in depressive states. For individuals with Bipolar I disorder, about a third of their time is spent in depression, while those with Bipolar II disorder spend nearly half their time in depressive states. This predominance of depression has significant implications for treatment and quality of life, but its prevalence helps us with a holistic understanding of bipolar depression better.  Impact on Functioning and Suicide Risk Understanding that bipolar depression can have a devastating impact on an individual’s life is an important step. It affects occupational functioning and overall quality of life, often more profoundly than manic or hypomanic episodes. Even milder, sub-threshold depressive symptoms can lead to significant functional impairment. Moreover, the risk of suicide attempts is significantly higher during depressive or mixed episodes compared to manic or hypomanic states. Individuals who experience more depressive episodes over time are at a higher risk of suicide attempts. The Ripple Effect: Impact on Caregivers It’s important to remember that bipolar disorder doesn’t just affect the individual diagnosed with the condition. It also has a significant impact on caregivers – family members and friends who provide support. Dr. Miller notes that bipolar depressive episodes are associated with a greater caregiver burden than manic or hypomanic episodes. This increased burden can lead to depression and health problems in caregivers themselves. It’s a stark reminder that support systems are crucial not just for patients, but for their caregivers as well. Treatment Approaches When it comes to treating bipolar depression, there’s no one-size-fits-all approach. Treatment strategies are typically tailored based on the phase of the illness the person is experiencing. This personalized approach is crucial given the complex and cyclical nature of bipolar disorder. While Dr. Miller’s lecture doesn’t go into specific treatment modalities, it’s generally understood that a combination of medication and psychotherapy is often most effective depending on the stage your doctor works with you: the broad stages being “acute” and “maintenance”. Mood stabilizers, antipsychotics, and antidepressants (used cautiously) may be prescribed, along with therapies like Cognitive Behavioral Therapy (CBT) or Interpersonal and Social Rhythm Therapy (IPSRT). She does name several medications, but we won’t mention them here because it is best to talk to your healthcare provider to have a nuanced conversation. At BP Harmony, we advocate for regularly cultivating Sleep, Nutrition, Movement, Mindfulness, and Community as a key part of recovering from the acute phases of bipolar disorder. The Importance of Support One aspect that Dr. Miller emphasizes is the importance of support, both for individuals with bipolar disorder and their caregivers. Support groups like those offered by the National Alliance on Mental Illness (NAMI) or the Depression and Bipolar Support Alliance (DBSA) can be invaluable resources. These groups provide a space for individuals to share experiences, learn coping strategies, and feel less isolated in their struggles. For caregivers, they offer much-needed

Bipolar Disorder & Anger: Understanding and Getting Control of Irritability Introduction Bipolar disorder presents itself for many as wild swings in emotions, and one of the most challenging aspects is managing anger and irritability. These intense feelings can wreak havoc on our relationships and careers if left unchecked. Let’s outline the many ways to tame our inner, emotional beast! Anger is a normal human emotion. But for those with bipolar disorder, it can feel like the anger dial gets cranked up rapidly to over 1000. During manic or hypomanic episodes, we might find ourselves snapping at loved ones over the tiniest things. And even during depression, that irritability can simmer just below the surface. The tricky part is that this anger isn’t just “in our heads.” When we get fired up, our bodies release stress hormones like adrenaline and cortisol. Over time, this can take a toll on our physical health, potentially leading to issues like heart disease and high blood pressure. Recognizing Your Anger Triggers One of the most powerful tools in our bipolar toolkit is self-awareness. Start paying attention to what sets you off. Is it lack of sleep? Poor food? Stress at work? Skipping your meds? Lack of exercise? Keep a mood journal and look for patterns. You might be surprised at what you discover! Some common warning signs that anger is building include: Feeling “on edge” or easily annoyed Feeling your heart race Clenching your fists or jaw Having racing thoughts Not being able to focus Feeling some level of chronic pain Feeling Fatigue Strategies to Cool Down the Rage Here are some tried-and-true techniques to help manage bipolar anger: Take a time-out: When you feel your temper rising, step away from the situation. Take some deep breaths, go for a short walk, count to ten, or find a quiet space to decompress. Get moving: Exercise is a fantastic way to burn off that angry energy. Go for a run, hit the gym, or move around rhythmically in your home. Practice mindfulness: Meditation and yoga can help you stay grounded and less reactive to triggers. Check out our resources on mindfulness. Communicate openly: Talk to your loved ones about your bipolar disorder and how it affects your moods. The more they understand, the better they can support you but also aspire to be merciful with them when they fall short in understanding. Create a family action plan: Work with your family to develop strategies for handling anger episodes. This might include agreed-upon cues for when you need space or when it’s time to seek professional help. Treat yourself to a nutrient-dense, hardy meal 3-4 hours before bedtime and hydrate sufficiently. The “I Am Worth It” Exercise Here is an exercise from Dr. Redford Williams’ LifeSkills program that goes by the mnemonic “I am worth it.”Ask yourself these four questions: I: Is this situation Important to me? A: Is my anger Appropriate given the facts? M: Can I Modify this situation? Worth It: Is taking action Worth It? If you answer “no” to any of these, it’s a sign to take a step back and cool down before proceeding. If it’s all “yes,” then you can address the issue calmly and constructively. Be Kind to Yourself & Others Remember, managing bipolar anger is part of the healing journey that can be overcome with practice and slow steps. There will be setbacks, and that’s okay. The important thing is to keep trying and to forgive yourself for past outbursts while also seeking the forgiveness of others we may hurt with our anger. With time and practice, you’ll get better at recognizing your triggers and keeping your cool. Living with bipolar disorder isn’t easy, but we’re all in this together. By understanding our anger, developing coping strategies, and maintaining open communication with our loved ones, we can lead happier, more stable lives. Stay strong bipolar warriors – you’ve got this!