The process of recovery from bipolar I disorder: a qualitative analysis of personal accounts in relation to an integrative cognitive model.

OBJECTIVES

This study explored the process of recovery from bipolar I disorder from a phenomenological and cognitive perspective.

DESIGN

A semi-structured interview was coded and analysed using interpretative phenomenological analysis.

METHODS

Eleven individuals over the age of 30 with a history of bipolar disorder were selected on the basis of having remained free from relapse, and without hospitalization for at least 2 years, as confirmed by a diagnostic interview (Standardised Interview for DSM-IV; SCID-I). This arbitrary and equivocal criterion for 'recovery' provided an objective method of defining the sample for the study.

RESULTS

The analysis revealed two overarching themes formed from four themes each. Ambivalent approaches referred to approaches that participants felt had both positive and negative consequences: avoidance of mania, taking medication, prior illness versus current wellness, and sense of identity following diagnosis. Helpful approaches referred to approaches that were seen as universally helpful: understanding, life-style fundamentals, social support and companionship, and social change.

CONCLUSIONS

These themes were then interpreted in the light of the existing literature and an integrative cognitive model of bipolar disorder. Limitations and future research directions are discussed.