Abstract
Questioning a diagnosis of bipolar disorder is not surprising given the chronic and fluctuating nature of the illness. Qualitative research using thematic analysis was used to derive an understanding of the process patients used to make sense of their diagnosis of bipolar disorder. The findings suggested that receiving a diagnosis was an active process. Factors such as fluctuating moods, changing diagnoses or misdiagnosis, difficulties patients have differentiating self from illness, mistrust in mental health services, and experiences of negative side effects of medication can contribute to ambivalence about the diagnosis and lead to relapse. These findings highlight the need for clinicians to focus on patients’ perceptions of bipolar disorder and work with the ambivalence in the process of facilitating greater acceptance. This has the potential for reducing relapses through increased adherence with treatment.
Similar content being viewed by others
References
Frank E, Swartz HA, Kupfer DJ: Interpersonal and social rhythm therapy: Managing the chaos of bipolar disorder. Biological Psychiatry 48:593–604, 2000
Hirschfield RM, Lewis L, Vornik L: Perceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic depressive association 2000 survey of individuals with bipolar disorder. Journal of Clinical Psychiatry 64:161–174, 2003
Sachs GS, Rush AJ: Response, remission and recovery in bipolar disorders: What are realistic treatment goals? Journal of Clinical Psychiatry 64 [suppl 6]:18–22, 2003
Goodwin FK, Jamison KR: Manic Depressive Illness—Bipolar Disorders and Recurrent Depression, Second edn. New York, Oxford University Press Inc, 2007
Boyatzis RE: Transforming Qualitative Information: Thematic Analysis and Code Development. California, SAGE Publications Inc, 1998
Pope M, Scott J: Do clinicians understand why individuals stop taking lithium? Journal of Affective Disorders 74:287–291, 2003
Clatworthy J, Bowskill R, Rank T, et al.: Adherence to medication in bipolar disorder: A qualitative study exploring the role of patients’ beliefs about the condition and its treatment. Bipolar Disorders 9:656–664, 2007
Lam D, Jones S, Hayward P, et al.: Cognitive Therapy for Bipolar Disorder: Therapists Guide to Concepts, Methods and Practice. London, Wiley, 1999
Inder ML, Crowe MT, Moor S, et al.: “I actually don’t know who I am”: The impact of bipolar disorder on the development of self. Psychiatry: Interpersonal and Biological Processes 71:123–133, 2008
Pollack LE, Aponte M: Patients’ perceptions of their bipolar illness in a public hospital setting. Psychiatric Quarterly 72:167–79, 2001
Licinio J: The experience of bipolar disorder: A personal perspective on the impact of mood disorder symptoms. Molecular Psychiatry 10:827–830, 2005
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. Washington, American Psychiatric Association, 1994
Crowe M: Constructing normality: A discourse analysis of the DSM-IV. Journal of Psychiatric and Mental Health Nursing 7:69–77, 2000
Parker G: How should mood disorders be modelled? Australian and New Zealand Journal of Psychiatry 42:841–850, 2008
Kutchins H, Kirk S: Making Us Crazy New York. USA, Free Press, 1997
Arkowitz H: Toward an integrative perspective on resistance to change. Journal of Clinical Psychology 58:219–27, 2002
Sajatovic M, Davies M, Bauer M, et al.: Attitudes regarding the collaborative practice model and treatment adherence among individuals with bipolar disorder. Comprehensive Psychiatry 46:272–277, 2005
Davies M, McBride L, Sajatovic M: The collaborative care practice model in the long-term care of individuals with bipolar disorder: A case study. Journal of Psychiatric and Mental Health Nursing 15:649–653, 2008
Van Korff M, Gruman J, Schaefer J, et al.: Collaborative management of chronic illness. Annuals of Internal Medicine 127:1097–1102, 1997
Bauer M, McBride L, Williford W: Collaborative care for bipolar disorder: Part I. Intervention and implementation of a randomized control trial. Psychiatric Services 57:927–936, 2006
Acknowledgments
The Psychotherapy for Bipolar disorder study is funded by the Health Research Council of New Zealand. We thank Andrea Bartram and Robyn Abbot for their assistance in the recruitment of patients and management of the project.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Inder, M.L., Crowe, M.T., Joyce, P.R. et al. “I Really Don’t Know Whether it is Still There”: Ambivalent Acceptance of a Diagnosis of Bipolar Disorder. Psychiatr Q 81, 157–165 (2010). https://doi.org/10.1007/s11126-010-9125-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11126-010-9125-3