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.