• acceptance;
  • bipolar disorder;
  • chronic illness;
  • identity;
  • self;
  • self-management

inder m, crowe m, moor s, carter j, luty s & joyce p (2011) Journal of Nursing and Healthcare of Chronic Illness 3, 427–435 ‘It wouldn’t be me if I didn’t have bipolar disorder’: managing the shift in self-identity with bipolar disorder

Aims and objectives.  To explore how bipolar disorder is integrated into one’s sense of self and identity.

Method.  Two case studies are drawn from a larger randomised controlled trial of two psychotherapies for bipolar disorder. Data were collected during 18 months of psychotherapy from 2006 to 2009. The study used a purposive sampling process by selecting two cases from different developmental stages and age of onset of mood disorder. The case studies address the questions: How does bipolar disorder impact on one’s sense of self? and how do two people from different age groups integrate bipolar disorder into their identity? The material was drawn from therapy sessions that were taped, transcribed and analysed.

Results.  Bipolar disorder created confusing contradictory experiences of self, compounded by the external consequences on relationships, how others viewed them, and disruptions in areas such as education and work. Self-acceptance encompassed a process reflecting ambivalence, experiencing grief and loss and acknowledging limitations. Shift in self-identity was reflected in seeing illness as a part of self, having a self grounded in reality and actively reengaging in life. Different emphasises in the cases reflected different developmental perspectives and age of onset of illness.

Conclusions.  Attention to the impact of chronic illness such as bipolar on self and identity is important to help people make sense of and integrate their experiences of the illness, facilitate increased acceptance and enabling a shift in self-identity that incorporates the illness as outlined in the facilitating shift in identity framework.

Relevance to clinical practice.  Managing the shift in identity is an important component of successful self-management of chronic illness. Finding ways to help facilitate a positive shift in identity that incorporates the illness is necessary. The facilitating shift in identity framework may be useful in clinical practice to guide this process.