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Cited by 128Bipolar Disorder and TreatmentPersonality Disorders and PsychopathologySchizophrenia research and treatment

Self‐management strategies used by ‘high functioning’ individuals with bipolar disorder: from research to clinical practice

Murray, Greg, Suto, Melinda, Hole, Rachelle, Hale, Sandra, Amari, Erica, Michalak, Erin E.·2011·Clinical Psychology & Psychotherapy
DOI 10.1002/cpp.710
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Abstract

Introduction: Bipolar disorder (BD) is a complex mental illness that results in substantial costs, both at a personal and societal level. Research into BD has been driven by a strongly medical model conception, with a focus upon pathology and dysfunction. Little research to date has focused upon strategies used to maintain or regain wellness in BD. Here, we present results from a qualitative study of self‐management strategies used by a Canadian sample of ‘high‐functioning’ individuals with BD. The aims of the present paper are two‐fold: (1) To provide a description of the self‐management strategies identified as effective by this sample of high functioning individuals and 2) to explore these results from a clinical perspective. Methods: High functioning (determined as a score of either 1 or 2 on the objectively‐rated Multidimensional Scale of Independent Functioning) individuals with BD type I or II (N = 33) completed quantitative scales to assess depression, mania, psychosocial functioning and quality of life, and underwent either an individual interview or focus group about the self‐management strategies they used to maintain or regain wellness. Results: The specific self‐management strategies that individuals enacted are contained within the following categories: (1) sleep, diet, rest and exercise; (2) ongoing monitoring; (3) reflective and meditative practices; (4) understanding BD and educating others; (5) connecting to others and (6) enacting a plan. These strategies are discussed in the context of current treatment interventions and research findings, offering clinicians a broad range of potential techniques or tools to assist with their efforts to support individuals with BD in maintaining or regaining wellness. Conclusions: The strategies adopted by a sample of people coping well with their BD show remarkable overlap with the targets of existing adjunctive psychosocial interventions for BD. The clinician can use this information to motivate clients to engage with such strategies. The present findings also serve to remind the clinician of significant individual differences in the personal meaning and concrete application of superficially similar strategies. Copyright © 2010 John Wiley & Sons, Ltd. Key Practitioner Message: • People who function well despite a significant history of bipolar disorder identify a range of strategies that are critical in their wellbeing. • Key wellbeing strategies are: (1) managing sleep, diet, rest and exercise; (2) ongoing monitoring; (3) reflective and meditative practices; (4) understanding BD and educating others; (5) connecting to others and (6) enacting a plan. • These strategies constitute ‘tips from the experts’ that can be offered to clients to increase hopefulness and improve engagement with psychosocial interventions. • Clinicians will be familiar with these strategies as elements of existing psychosocial interventions—the present qualitative data provides significant cross‐validation of the importance of these behaviours.

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  • Self-management in BD encompasses a broad range of strategies, and the present analysis may not address all potential targets of apps in BD, such as crisis management/safety planning, medication reminders, fitness and nutrition, amongst others.

    “Self-management in BD encompasses a broad range of strategies (Murray et al. 2011), and the present analysis may not address all potential targets of apps in BD, such as crisis management/safety planning, medication reminders, fitness and nutrition, amongst others (Murnane et al. 2016).”

    From Evaluating the quality, safety, and functionality of commonly used smartphone apps for bipolar disorder mood and sleep self-management (2022) · cites this paper as Murray et al. 2011

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Authors
Murray, G., Suto, M., Hole, R., Hale, S., Amari, E., & Michalak, E. E.
Affiliations
  • Swinburne University of Technology (AU)
  • University of British Columbia (CA)
  • Vancouver Coastal Health (CA)
Corresponding author
Michalak, Erin E.
ORCID
Venue
Clinical Psychology & Psychotherapy
Publisher
Wiley
Published
2011-03
Volume
18
Issue
2
Pages
95-109
ISSN
  • 1063-3995 (ISSN-L)
  • 1099-0879
DOI
10.1002/cpp.710
OpenAlex
W2144450676
Cited by
128
References
78
Citations by year
2026: 4 · 2025: 13 · 2024: 4 · 2023: 8 · 2022: 6 · 2021: 9 · 2020: 12 · 2019: 4 · 2018: 8 · 2017: 10 · 2016: 10 · 2015: 6 · 2014: 8 · 2013: 9 · 2012: 7
FWCI
5.67
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Clinical Psychology & Psychotherapy (publishedVersion)
  • PubMed (publishedVersion)
  • Swinburne figshare (Swinburne University of Technology) (submittedVersion)
Funders
Canadian Institutes of Health Research
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
bipolar disorder, self-management strategies, symptom monitoring, social support, psychosocial interventions, quality of life, medical model critique, clinical practice implications
MeSH terms
Adaptation, Psychological, Adult, Bipolar Disorder, Canada, Diet, Female, Health Education, Humans, Male, Patient Participation, Self Care, Sleep, Social Support, Health Behavior, Exercise, Clinical Medicine, Meditation, Behavioral Research

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