title: The lived experience of adults with bipolar disorder and comorbid substance use disorder.
abstract: There is a high incidence of comorbid substance use in the bipolar population. Co-occurring substance use in this population increases negative outcomes and changes the illness presentation. Currently there is a lack of insight into the lived experience of adults with bipolar disorder and comorbid substance abuse. This descriptive phenomenological study describes and enhances the understanding of what it is like to live with bipolar disorder and comorbid substance used disorder. The data were collected using face-to-face in-depth interviews. Six distinctive themes were developed and validated by the descriptions of the experiences of the participants. The six themes that emerged from analysis of formulated meanings were: (1) Life is Hard; (2) Feeling the Effects; (3) Trying to Escape; (4) Spiritual Support; (5) Being Pushed Beyond the Limits; and (6) A Negative Connotation. All the themes came from the interconnection of bipolar disorder and substance use disorder. This study has implications for nursing practice, research, and education. If nursing and health care professionals understand the problem as these patients' perceive it, management of mood swings and relapses from periods of sobriety along with selection of treatment modalities will be improved.
authors.affiliation: Duke University, School of Nursing, Durham, North Carolina, USA. terry.ward@duke.edu
authors.forename: Terry Dionne
authors.initials: TD
authors.lastname: Ward
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001294:Attitude to Health; D001714:Bipolar Disorder / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D015897:Comorbidity; D017281:Cost of Illness; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009657:North Carolina / Q000453:epidemiology; D015404:Nursing Methodology Research; D011568:Psychiatric Nursing; D011569:Psychiatric Status Rating Scales; D036301:Qualitative Research; D012648:Self Care / Q000379:methods / Q000523:psychology; D012944:Social Support; D029181:Spirituality; D013240:Stereotyping; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D011795:Surveys and Questionnaires