Use of self-care strategies in the management of bipolar disorder and their relationship to symptoms, illness intrusiveness, and quality of life

Background: The benefits of self-care have been reported in other chronic illnesses, but bipolar disorder research has focused primarily on medication management. This study explored the use of self-care strategies by people living with bipolar disorder and the relationships between the use of self-care strategies and symptoms, illness intrusiveness, and quality of life. Methods: Eighty participants with bipolar disorder were recruited to participate in an online survey. Participants provided clinical backgrounds and self-reported current symptoms of depression, mania, anxiety, stress, perceived illness intrusiveness and the frequency of use, and perceived helpfulness of 69 self-care strategies. Results: A range of self-care strategies were endorsed, including "spend time with your pet or other animal," as well as creative pursuits. "Abstain from recreational drugs" was the strategy most commonly endorsed as being used frequently, while "get enough sleep" was most commonly rated as being the most helpful. Greater frequency of use of self-care strategies was significantly associated with improved quality of life, reduced illness intrusiveness, and reduced depression, anxiety, and stress scores, but not self-reported mania scores. Conclusions: This study provides support for strategies relating to sleep, and drug and alcohol abstinence, and for several strategies yet to be explored such as spending time with pets. Future studies should explore the use of these strategies longitudinally and how depression symptoms may mediate the relationship between the use of self-care strategies, quality of life, and illness intrusiveness.