What happens after diagnosis? : understanding the experiences of patients with newly-diagnosed bipolar disorder

Bipolar disorder is chronic condition involving episodes of both depression and elevated mood, associated with significant disability and high relapse rates. Recent estimates suggest a lifetime prevalence of 5%. Little is known about the subjective experiences of patients after receiving a diagnosis of bipolar disorder, and the impact of these experiences on patientsââ"šÂ¬Ã¢"žÂ¢ willingness and ability to work with their health professionals to find the most effective combination of treatments and to set up self-management plans. Objective: This paper describes a qualitative study exploring the experiences and difficulties faced by patients after they have received a diagnosis of bipolar disorder, as expressed online to expert patients trained to provide informed support. Design: Qualitative study. Setting: Online communication within a public health service setting. Participants: Twenty-six participants with recently-diagnosed bipolar disorder communicated online with Informed Supporters, people who had been managing their bipolar disorder effectively for 2 years or more, as part of an online psycho-education programme. Results: Participants cited unwanted side-effects of medication, coping with unpleasant symptoms, positive and negative reactions to the diagnosis, identifying early warning signs and triggers of the illness, the loss of a sense of self, uncertainty about their future and stigma as issues of major importance after diagnosis. Conclusions: Personal concerns and difficulties following diagnosis can undermine effective treatment, thwart self-management efforts and interferewith effective functioning. Such data are important for clinicians to take into account when they work in partnership with their patients to fine-tune treatments and help them set up self-management plans.