Shared Dilemmas in the Management of Bipolar Disorder

Abstract

A hermeneutic phenomenological analysis reveals the complexity of bipolar disorder. Operating at biological, psychological, and social levels this phenomenon creates dilemmas and people must account for their choices in a moral order. Two participants suffer from the condition, whereas a third is employed to deliver mental health treatment. Three themes are identified showing that all the participants struggle to feel they are competent and consistent decision makers. They feel exposed, fearing that others will impose interpretations on their behavior. They resist the imposition of a medical model, wanting to believe that choices are personal and related to life experiences. This person-centered interpretation is favored because it offers the potential for learning, for achieving autonomy, and growth. By attending to the interpersonal aspects of emotion and subjectivity, this analysis challenges the idea that autonomy can be undermined by a disease process in a simple manner. It is suggested that mental health care systems need to deliver services in which the personal and interpersonal aspects of recovery are adequately managed.