The experience of mood change over time for people diagnosed with bipolar disorder: a longitudinal interpretative phenomenological analysis

Living with episodes of mania and depression is recognised to instil profound instability in people diagnosed with bipolar disorder, but little is known about how these mood changes arise through a person's trajectory over time. This longitudinal study aimed to investigate the experience of mood change within and between bipolar disorder episodes. Semi-structured interviews were conducted with three women at two time points and were analysed using longitudinal interpretative phenomenological analysis to form idiographic trajectories. Three longitudinal themes illustrated the changing experiences of participants during periods of depression, euthymia (stability) and mania: (i) Extreme changes in activity and agency, (ii) Changes in feelings and connectivity, (iii) Shifting sense of the future disrupts momentum. The findings highlighted trajectories of change in key areas of the participants' lives including activity levels, routine and agency, intensity of feelings and connectivity, and their sense of the future and progression. Changes experienced during episodes were cumulative, impacting participants' ability to reconnect, take control and move forward during euthymia. The clinical value of mapping a client's sense of change across BD phases is indicated, along with the need to build agency, progression and connectivity during euthymic periods. Suggestions for research and practice are discussed.