Bipolar disorder is a mental illness and it is characterized by manic episodes and alternating with extreme mood swings from depression to extreme elation. Bipolar disorder can be very difficult but due to pharmacological treatment, the mood swings can be controlled, however, the bipolar person still has to live with the condition and manage it as well as prevents episodes from recurring.
Since the bipolar patient does not need to be institutionalized and it is possible for them to continue living normal lives, their ability to handle the daily stresses of life must be enhanced. Treatment options have often recommended that therapy and the use of medicines should go together, besides, an awareness of the disease and the conditions which contribute to it have been proven to improve patient recovery and results to lesser occurrence of episodes (Atkinson & Caldwell, 1997).
An interesting aspect of bipolar disorder is that it can be difficult to diagnose as it can coexist with other conditions like depression, substance abuse and ADHD, thus most patients identified as bipolar are adults who have led functioning lives even with the presence of the illness. Most bipolar patients try to go back to their old lives but often find it difficult and frustrating, while there have been others who have managed quite well and have stopped taking medication or therapy (Kusznir, Cooke & Young, 2000).
The quality of life of a bipolar individual is influenced by his/her ability to manage the illness and to prevent the occurrence of symptoms and episodes. Quality of life as a concept refers to the degree or level of well-being of the individual in terms of his/her social, physical, emotional, occupational and spiritual aspects. Quality of life is either good or bad, but defining what constitutes good quality of life has been difficult, there seem to be disagreement among researchers on how to define quality of life and how to measure it.
Studies however suggest that quality of life is an important predictor of health well-being (MacQueen, Young, Robb, Marriott, Cooke & Joffe, 2000), which means that identifying the level at which the patient perceives his/her life to be will help determine which treatment option will be successful and effective for the patient. Quality of life had been investigated in mental illnesses but according to bipolar literature, this has not been the case (Robb, Cooke, Devins, Young & Joffe, 1997).
There seem to be very few researches that tackle quality of life in patients with bipolar disorders, thus this study attempts to determine the quality of life of bipolar patients in psychotherapy through the grounded theory approach. The study of quality of life in bipolar patients have shown that most of it measured quality of life using an inventory which assessed the patient’s perception of his/her life in more or less the following domains, social, emotional, physical, mental and occupational well-being.
The aim of most of the studies was to determine the predictive ability of the instrument as a means of accurately identifying the quality of life of the subject. On the other hand, one of the most common themes in the study of quality of life and bipolar disorder is to assess and compare the patient’s quality of life to that of other populations who also are suffering from depression and other clinical conditions (Namjoshi & Buesching, 2001).
Thus we know so much about quality of life of those with schizophrenia and anxiety disorders, while we know so little of bipolar disorders. Meanwhile, the literature on bipolar disorder and quality of life indicated that studies were usually conducted to evaluate treatment efficacy and predict patient outcomes. This would mean that quality of life was measured in concordance with pharmacological or alternative treatments, thus it is assumed that quality of life would be high when patients respond well to the treatment contributing their over-all sense of well-being.
From the existing literature, it is evident that the study of quality of life of bipolar disorders had been problematic, the use of quality of life scales for other conditions like depression to measure that of the bipolar patient would not be appropriate in fact a number of researchers had pushed for the development of a bipolar disorder specific quality of life instrument (Michalak, Yatham, Kolesarm & Lam, 2005).
Moreover, the study of quality of life in two related but different conditions would tend to differentiate the one from the other, but it would not lead to a better understanding of why the condition occurs and how it can be treated. Lastly, the focus on treatment outcomes has limited the exploration of quality of life as it is perceived by the bipolar patient and to what other factors it could be associated with and linked to. There is so much more to learn about quality of life of bipolar patients and how it predicts a perceived sense of well-being (Vojta, Kinosian, Glick, Altshuler & Bauer, 2001).
Future studies recommended include the development of disease specific type of quality of life instrument, the roles of psychotherapy in improving quality of life and more longitudinal studies that would track the progress of the patient at varying times of his/her illness. Psychotherapy plays a major role in the person’s belief and mental functioning and ultimately it would lead to improved quality of life thus this study would help identify the different aspects of quality of life of bipolar disorder patients and contribute to better means of helping the patients improve their quality of life.
Students in the counseling profession would therefore become aware of their role in the need to contribute to the well-being of the patient and psychiatrists would learn what aspects of the patient’s life are more important to them thereby increasing the effectiveness of the treatment procedure. Use of Theory Quality of life is a loosely defined concept and for the most part, the empirical studies on the concept have used a quantitative perspective wherein domains from the general definition of quality of life are taken to represent various aspects of the patient’s life.
This research study would therefore use a grounded theory approach wherein the quality of life dimensions will be identified from the person who has bipolar disorders (Strauss & Corbin, 1990). This is in keeping with the positivist tradition and which is qualitative in nature. Thus the study methods would include the interviewing patients and how they define quality of life, what is good and bad quality of life and what contributes to the improvement of quality of life.
The aim is to generate a theory of quality of life of patients with bipolar disorder and from which a more appropriate instrument can be developed, as well as a better means of designing treatment programs that would consider the needs of the individual. Purpose Statement The purpose of this study is to determine the quality of life of patients with bipolar disorder and to identify the different aspects of their quality of life using the grounded theory approach.
References
Atkinson, M. & Caldwell, L. (1997). The differential effects of mood on patients’ ratings of life quality and satisfaction with their care. Journal of Affect Disorders, 44:169–175. Kusznir, A. , Cooke, R. & Young, L. (2000). The correlates of community functioning in patients with bipolar disorder. Journal of Affect Disorders, 61:81–85. MacQueen, G. , Young, L. , Robb, J. , Marriott, M. , Cooke, R. & Joffe, R. (2000). Effect of number of episodes on wellbeing and functioning of patients with bipolar disorder. Acta Psychiatrica Scandinavica, 101, 374–381.