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Bipolär sjukdom - ur ett existentiellt perspektiv
Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
2012 (Swedish)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Bipolar disorder - from an existential perspective (Swedish)
Abstract [en]

Aim: The overall aim was to create knowledge about what it means to live with bipolar disorder from an existential perspective, both for individuals with the diagnosis and for their close relatives.

Method: An existential perspective in this context entails that it is explored and described from a lifeworld perspective of individuals who in various ways experience that which is termed as bipolar disorder. The lifeworld phenomenological approach Reflective Lifeworld Research (RLR) was used in the four empirical studies. Meaning-oriented interviews and analysis were conducted following the leading methodological principles of the chosen scientific approach. A synthesis, based on lifeworld hermeneutic existential philosophy, then presents how it is possible to understand the perspective of individuals with bipolar disorder and their close relatives as a coherent whole.

Findings and conclusions: A magnitude and complexity of experiencing, which means that life with bipolar disorder is characterized by extra dimensions, specific tension and contradictions, has been elucidated. Knowledge of the meaning of these aspects enables for the persons with the illness and for their close relatives to understand, to put words to, and to communicate how their life is and what they need, which in turn enhances their ability to influence their lives. It also increases the opportunities for professional caregivers to develop care, both in content and organization, so that it can meet the actual needs of those concerned in an adequate way.

Living with bipolar disorder means so much more than the usual description with changes between episodes of depression and mania. The diagnosis “bipolar disorder” thus appears to be an inadequate label that only reflects the more obvious and visible dimensions of the illness, while those that characterize life in its entirety remain hidden.

The thesis also shows that the importance of the common everyday life of persons with bipolar disorder and their close relatives should be highlighted as the most important factor in a liveable existence. A change in the view of mental health care is thus needed; a change that is characterized by consensus, collaboration and transparent communication between the person with the illness, their close relatives and mental health care. The common goal should be about meeting actual needs, and to strengthen a profound connectedness in order to make everyday life more liveable.

Place, publisher, year, edition, pages
Växjö, Kalmar: Linnaeus University Press, 2012.
Series
Linnaeus University Dissertations, 99/2012
Keyword [en]
bipolar disorder, extra dimensions, existential perspective, lived experiences, phenomenology, close relatives
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
URN: urn:nbn:se:lnu:diva-21988ISBN: 978-91-86983-80-2 (print)OAI: oai:DiVA.org:lnu-21988DiVA: diva2:559705
Public defence
2012-11-16, Sal Myrdal, Hus K, Växjö, 10:30 (Swedish)
Opponent
Supervisors
Available from: 2012-10-10 Created: 2012-10-09 Last updated: 2017-02-14Bibliographically approved
List of papers
1. Towards a more liveable life for close relatives of individuals diagnosed with bipolar disorder
Open this publication in new window or tab >>Towards a more liveable life for close relatives of individuals diagnosed with bipolar disorder
2013 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 22, no 2, 162-169 p.Article in journal (Refereed) Published
Abstract [en]

The life of close relatives of persons with bipolar disorder (BD) is associated with emotional distress, depression and a high level of use of mental health care. Illness-related changes of the life situation endanger relationships, social life, finances and occupational functioning. Understanding of facilitating conditions for close relatives is still a neglected research area. The aim of the present study was thus to explore what makes the life of close relatives of persons with BD more liveable. A lifeworld phenomenological approach was used. The findings reveal that keeping distance, having stability in everyday life and strengthening equality through transparent communication are conditions that enable close relatives to influence the unpredictable and its consequences and thus make life more liveable. This implies contributions from close relatives, the person with BD and the caring services. We propose that healthcare support should not be divided in support for the patient and/or the close relatives but instead be designed as support for the 'patient and close relatives' as a unit. Professional caregivers need to take responsibility for creating intersubjective settings for the person with BD and their close relatives to share their needs and make joint plans for how to influence the illness-related life issues.

Keyword
bipolar disorder, close relatives, phenomenology
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-20319 (URN)10.1111/j.1447-0349.2012.00852.x (DOI)000316294000008 ()22712875 (PubMedID)2-s2.0-84875035366 (Scopus ID)
Available from: 2012-06-20 Created: 2012-06-20 Last updated: 2017-12-07Bibliographically approved
2. The paradox of being both needed and rejected: the existential meaning of being closely related to a person with bipolar disorder
Open this publication in new window or tab >>The paradox of being both needed and rejected: the existential meaning of being closely related to a person with bipolar disorder
2012 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 33, no 4, 200-208 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to elucidate the existential meaning of being closely related to a person with bipolar disorder. A qualitative, descriptive and explorative design with a phenomenological meaning-oriented analysis was used. The findings reveal a paradoxical, existential exposure of close relatives to a person with bipolar disorder, being both needed and rejected whilst being overshadowed by the specific changeable nature of bipolar disorder. Psychiatric health care services are recommended to consider changes in attitudes and structures that may facilitate for close relatives` participation in the care and treatment of persons with bipolar disorder.

Keyword
Bipolar disorder, health care sciences, phenomenology, lived experiences, close relatives
National Category
Other Health Sciences
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-19440 (URN)10.3109/01612840.2011.653037 (DOI)2-s2.0-84859346163 (Scopus ID)
Available from: 2012-06-07 Created: 2012-06-04 Last updated: 2017-12-07Bibliographically approved
3. A dependence that empowers - the meaning of the conditions that enable a good life with bipolar disorder
Open this publication in new window or tab >>A dependence that empowers - the meaning of the conditions that enable a good life with bipolar disorder
2010 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 5, no 1, 4653Article in journal (Refereed) Published
Abstract [en]

The extensive suffering related to a complex life situation with bipolar disorder and the reported difference between care needs and the needs that are actually met implicates that there are still questions about management of life with bipolar disorder that need to be answered. The present study therefore aims to describe the meaning of the conditions that enable a good life with bipolar disorder. Ten persons, six women and four men, (aged 30 – 61), diagnosed with bipolar disorder were interviewed. A reflective lifeworld perspective based on phenomenological philosophy was used. The findings present the essential meaning of the conditions that enable a good life with bipolar disorder as a dependence that empowers, which is further described by its constituents: “turning the course of life”, “protecting oneself from running out of energy”, “being needed”, “being oneself through reliable others”, “personal landmarks for navigating through life”. A voluntary chosen dependence, as described in the present study, is a new approach of care that enables a good life with bipolar disorder, while enhancing own power, freedom and control. The conditions that enable a good life with bipolar disorder are more than separate supporting measures. Therefore a holistic perspective is preferable while providing care for individuals with bipolar disorder.

Place, publisher, year, edition, pages
Stockholm: Co-Action Publishing, 2010
Keyword
Bipolar disorder, caring science, dependence, empowerment, lifeworld research, phenomenology
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:vxu:diva-7112 (URN)10.3402/qhw.v5i1.4653 (DOI)
Available from: 2010-02-15 Created: 2010-02-15 Last updated: 2017-12-12Bibliographically approved
4. Extra dimensions in all aspects of life - the meaning of life with Bipolar Disorder
Open this publication in new window or tab >>Extra dimensions in all aspects of life - the meaning of life with Bipolar Disorder
2009 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 4, no 3, 159-169 p.Article in journal (Refereed) Published
Abstract [en]

Living with Bipolar Disorder (BD) greatly affects the whole life; still the meaning of it is poorly explored from the perspective of the individuals actually living with it. The aim of this study is thus to explore the existential meaning of life with BD. Ten persons, six women and four men, (aged 30 – 61), diagnosed with BD were interviewed. A reflective lifeworld perspective based on phenomenological philosophy was used. The findings show that living with BD entails experiencing extra dimensions in all aspects of life, expressed in terms of a magnitude and complexity beyond that which is perceived as pertaining to normal life. The essential meaning of the phenomenon is further described by its constituents: “a specific intensity”, “a struggle to understand”, “an illness that is intertwined with one’s whole being”. Living with BD means more for the individual than having episodes of depression and mania and must therefore be understood from a holistic perspective. Adequate care for persons with BD therefore includes places for safe and profound reflecting about existential issues, such as identity, trust and self-confidence. The present study recommends the caring services to change their ways to explain and talk about the BD illness.

Keyword
Bipolar disorder
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:vxu:diva-6496 (URN)10.1080/17482620902864194 (DOI)
Available from: 2010-02-15 Created: 2009-12-22 Last updated: 2017-12-12Bibliographically approved

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