Journal of Psychiatric Insight Review

Abstract

Bipolar disorder (BD) is a severe and chronic mental illness characterized by recurrent mood episodes, high suicide risk, and persistent cognitive impairment, and is commonly understood in scientific research as arising from complex interactions among genetic, environmental, and developmental factors. Despite advances in pharmacological and psychosocial treatments, the underlying mechanisms of BD, particularly those related to extreme fluctuations between emotional poles and cognitive dysfunction, remain unclear. The existing therapies often provide limited long-term improvement and may even exacerbate cognitive deficits. Therefore, this study explores BD through an alternative Dharma-based framework, presenting case evidence in which BD is interpreted as a karmic illness associated with karmic debts and “spirit” (ghost) attachment, and addressed through the Five Golden Buddhist Practices of Guan Yin Citta Dharma Door. The results from three representative cases suggest that sustained spiritual practice, especially Buddhist scripture recitation and the offering of “Little Houses” (a combination of four classic Buddhist scriptures) to repay karmic debts, may contribute to mood stabilization, reduction of depressive symptoms, improvements in cognitive and social functioning, and eventual full recovery. These findings highlight the potential role of complementary spiritual approaches in addressing aspects of BD that remain insufficiently explained or treated within conventional biomedical models.