Date of Award


Degree Name

Doctor of Philosophy


Interdisciplinary Health Sciences

First Advisor

Dr. Nickola W. Nelson


The specific aims of this study were to gain a broader understanding of the lived experience of adults with bipolar disorder and to explore how people diagnosed with bipolar disorder used cognitively, affectively, and spiritually oriented strategies to cope with life stressors and circumstances. The cognitive domain in this investigation was defined as those activities related to how one knows, thinks, or perceives phenomena in a way distinct from emotion. The affective domain referred to the feelings and emotions associated with phenomena that are distinct from cognitive reasoning or knowledge. The spiritual domain was defined as values, attitudes, and beliefs related to the sacred or holy that are distinct from cognitive and affective elements.

Eight English-speaking people age 18 or over who had been diagnosed with bipolar disorder for at least one year participated in hour-long, semi-structured interviews. The interviews were recorded and transcribed. A phenomenological method was used to analyze the transcripts. The four themes that emerged are: (a) diagnosis brings understanding accompanied by irrevocable change, (b) finding effective treatment is an interminable process, (c) bipolar disorder is the third partner in every relationship, and (d) caring for oneself is as important as receiving formal treatment.

Participants reported a wide variety of coping strategies. Cognitive means centered on self-monitoring of symptoms, managing the stigma of a bipolar diagnosis, and a conscious decision to care for oneself. The participants who were pregnant spoke of the challenges of living without their medications, constantly balancing their needs, and seeking information on bipolar disorder and pregnancy. Allowing oneself to feel hope for the future, joy in caring for a pet or in service to others, or satisfaction being alone or with others reflected affective means of coping. Participants frequently mentioned activities that had spiritual meanings for them, such as music, journaling, listening to nature, and formal practices such as prayer.

The findings from this study contribute to a broader understanding of living with bipolar disorder. They point to the importance of assessment and nurturance of client self-care strategies by mental health care providers.

Access Setting

Dissertation-Open Access