Life with bipolar disorder and alcohol abuse : an interpretative phenomenological analysis

Abstract

Bipolar disorder and alcoholism comorbidity is a common clinical presentation and individuals living with it often face unique challenges due to the complex interactions involved. Both conditions are individually significant, but in co-occurrence, they can exacerbate each other's effects, creating a difficult-to-break cycle. This study aimed to gain a clear understanding, and interpret the essence, of participants’ experiences living with this comorbidity and its objectives were to understand how alcoholism can exacerbate the condition and quality of life of persons who are living with bipolar disorder, to identify the strategies used by persons living with this comorbidity to cope, and to explore their perceived means of support. A qualitative approach guided by an IPA methodology was used. Two female and four male adults, all diagnosed with bipolar disorder, and abusing or abused alcohol, were recruited through two intermediary persons. Data was collected through one-on-one, in-depth semi-structured interviews. This was followed by an IPA data analysis. Interviews were conducted in the participants homes (n=4), or in a quiet public cafeteria (n=2), depending on the participants’ preferences. Six superordinate themes emerged from the data analysis: ‘A turbulent life’, ‘Reaching the far edge’, ‘Wearing the label’, ‘Reasons for drinking’, ‘Behind the symptoms – seen or not seen?’ and ‘Gaining ownership over one’s life’. Participants described lives marked by chaos and instability due to the impact of their condition. Diagnoses were often complex, with some having initially been wrongly diagnosed. Many resorted to alcohol to cope with stress or to self-medicate, but alcohol misuse exacerbated symptoms, leading to hospitalization, job loss and strained relationships. Loved ones and health carers played a crucial role in the lives of these people. Quitting alcohol improved the quality of life for most participants, highlighting the importance of personalized care plans and support.