Experience of being the spouse/cohabitant of a person with bipolar affective disorder: a cumulative process over time

Abstract

The aim of the study was to identify and describe spouses'/cohabitants' experiences of living with a partner with bipolar affective disorder over time. Qualitative research interviews were conducted with eight spouses/cohabitants. Transcribed interviews were analysed structurally based on Ricoeur's phenomenological hermeneutics as described by Lindseth and Norberg. The participants' shared lives ranged from 6 to 51 years, and the study found three major aspects that characterized their experience along this time-dimension; experience formed part of a cumulative process containing up to 14 experiences. Each experience created a preunderstanding that affected how subsequent experiences were perceived, and mastered. These three major aspects had a reciprocal influence on the following 14 experiences over time: Fear and the incomprehensible. Accusations. Self-doubt and doubt about own powers of judgement. Care and information vs. being overlooked or turned away by health personnel. Stigmatization and loss of social network. Uncertainty, powerlessness and hope. Loneliness. Anger and despair. The persistent threat. Own health problems. Grief over loss. Dawning acceptance. Reconciliation. New hope. A theoretical understanding using gestalt therapy theory suggests that burdensome experience can be seen as an inner imbalance in the spouse/cohabitant when she/he cannot find meaning in their experiences. When only parts of the whole are perceived, an incomplete gestalt is formed in the person's lived-experience that counteracts the equilibrium of the organism. Insight and meaning can protect them against burdensome experiences and nurses can empower them through care, health-promoting education and guidance. Nursing research should develop methods of education and guidance sensitive enough to help each spouse/cohabitant, regardless of where they are in their cumulative process.

Dyadic Adjustment Among Healthy Spouses of Bipolar I and Ii Disorder Patients

“…These outcomes (especially first and second conclusions) agree with those obtained by Janowsky and his colleagues (1970), but also by Tranvåg and Kristoffersen (2008), who showed that manic behaviour (associated with BD I) had a great impact on functioning of marriage and spousal burden. What is interesting, bipolar I disorder is associated with a lower likelihood of men getting married (Lieberman et al 2010).…”

Burden as the bridge to resiliency in mental illness: Effectiveness of the Strengthening Families Together family education intervention.

“…In a more recent study by Tranvag and Kristoffersen (2008), they concur that the negative experiences of those affected by mental illness can lead to new understanding through the process of grief, acceptance and reconciliation. Dyer and McGuiness (1996) go on to say that at least one caring individual to validate a person's worth is needed help develop resilience during adversity.…”

“…In a more recent study, Tranvag and Kristoffersen (2008, p. 12) found family members "experienced a mixed feeling of uncertainty, powerlessness and hope" (Tranvag & Kristoffersen, 2008, p. 12). However, Tranvag and Kristoffersen (2008) found that the more positive aspects of the caregiving experience emerged over time including acceptance, reconciliation and hope. This finding is supported in an earlier study of male caregivers of mentally ill relatives who also "expressed improvement in role development over time" (Mays & Lund, 1999, p. 24).…”

“…The primary consequence of resilience is effective coping in one challenging situation leading to a "hardiness" and ability to cope with future challenges more effectively (Dyer & McGuiness, 1996). Tranvag and Kristoffersen (2008) found that grief over loss in mental illness was the beginning of a healing process for family members. The journey of recovery moved family members towards dawning acceptance and eventually coming to terms or reconciliation with the affects of mental illness (Tranvag & Kristoffersen, 2008).…”

Families with parental mental illness: supporting children in psychiatric and social services

“…Research into the situation of relatives living with someone with an SMI reveals how vulnerable that position is. A spouse or partner who bears the responsibility for the household and the children, may feel taken advantage of by psychiatric services if they find they have to care for their seriously mentally ill counterpart with no outside help (Ostman 2000;Ostman and Hansson 2004;Tranvåg and Kristoffersen 2008). As a result, the responsibility placed on the healthy member of the household can be overwhelming and the burden may result in such individuals having their own psychiatric problems (Wittmund et al 2002).…”