Living the life that you want following a diagnosis of Bipolar Disorder

Abstract

This thesis consists of a systematic review and a research study which sought to explore the factors involved in leading to distress, and in facilitating recovery, following a diagnosis of bipolar disorder. It comprises three standalone papers. Both papers one and two have been prepared for submission in accordance with the relevant journal guidelines. These guidelines have been adhered to as much as possible, with some additional material presented and extended descriptions for the purpose of the thesis. Paper one is a meta-synthesis of qualitative literature from studies in which people with a diagnosis of bipolar disorder discuss factors that they experience as distressing. Four electronic databases were systematically searched. Twenty-four studies were included within the review. Quality appraisals were conducted on each of the included papers to assist in providing context. The methodological approach of thematic synthesis was used to extract and analyse the data. Seven analytical themes to describe aspects that were experienced as distressing, emerged from the synthesis. Themes of stigma and fear of relapse appeared to crosscut themes of diagnosis, loss, uncertainty, threat and relationships. The review findings and limitations are discussed in relation to the existing literature. Paper two is a qualitative empirical study in which the factors and processes involved with facilitating recovery following a previous diagnosis of bipolar disorder were explored. Twelve individuals from international locations were recruited and interviewed. A diagnostic assessment was used to confirm that participants had previously met the criteria for a diagnosis of bipolar disorder. A constructivist approach to grounded theory analysis highlighted ten categories from the data. These included support as a foundational factor for the recovery process. Other categories such as believing things can change and not giving up, as well as becoming the director of your own life, were identified. A diagrammatic model was produced to represent these categories and the suggested relationships between them. This theoretical model is discussed with example quotations. Findings supported and extended on previous literature, the clinical implications of which are discussed. Paper three is not intended for publication and is an overall critical review of the research process. This paper discusses the rationales, and the strengths and limitations, of both papers. Discussion in regards to key decision points and the considered alternatives are also provided. The approaches to interviewing and the qualitative analysis across both studies are reviewed with consideration of researcher reflexivity. Paper three also includes personal reflections and implications of the research drawn from both papers.

Date of Award	31 Dec 2018
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Sara Tai (Supervisor) & Warren Mansell (Supervisor)