A phenomenological inquiry of the perceptions of people diagnosed with bipolar disorder of their illness

Introduction: Bipolar disorder (BD) is a major psychiatric disease with a serious impact on personal and public health, especially in the case of undertreatment. However, there are limited studies on patients’ perception and experiences regarding this disorder. Purpose: The purpose of this study is to explore the perceptions and experiences of people with BD. Method: A phenomenological methodology based on Munhall’s approach was applied. Thirteen individuals with BD attending community mental health services signed a consensus form in order to participate in the study. A purposeful sampling and the rule of thematic saturation were both applied. The collection of data took place through personal interviews, which lasted 30 minutes up to 1 hour during March of 2015. The rigor of the analysis was based on Munhall’s and Van Manen’s criteria. Results: The core theme of the experience of BD was the perception of the disease as “a course out of control”. This description appeared to be associated with the long-standing nature of the disease and the perception of lack of control attributed to the sudden alterations of the mood. In particular, these alterations were experienced as obstacles or traps, and represented the main source of discomfort, tension, fear, insecurity and despair. Furthermore, the various stages of the disease were described with clarity; what differentiated one from another was the degree of conscious awareness of the manifestation of psychopathological symptoms. Adaptation to the disease was described as an internal procedure leading to the acceptance of the limitations of the disease. The main characteristics of this procedure seemed to be the perception of the disease as a challenge, as well as a cognitive process leading to newly-acquired knowledge. Overall, this procedure was perceived as a means for participants to expand their self-awareness and none forward. Moreover, essential parameters of this procedure were adherence to pharmacotherapy and cognitive re-appraisal of prior experiences of relapse. Conclusions: Control over the trajectory of BD seems to be the primary need of people suffering from this disease, and mainly related to effective medication and collaboration with health professionals. Patient education on the disease, as well as cognitive re-appraisal of previous experiences of relapse,also appear to comprise an important part.