This presentation provides an overview of a 2010 CREST.BD study exploring differing understandings of recovery in bipolar disorder: from no hope of recovery, to clinical recovery characterized by a diminishing of symptoms, to personal recovery characterized by meaningful quality of life. The researchers engaged in participatory research with a sample of Canadian individuals living with bipolar disorder using qualitative research methods. The presentation highlights the methods, results, and conclusions which include prioritizing quality of life in the treatment process and emphasizing an individual’s capacity to engage in self-management strategies. Originally presented by CREST.BD member Sharon Hou at a poster session during the International Review of Bipolar Disorders in Nice, France (May 21-23, 2012).

1. “Recovery is Such a Huge
Word”: Understandings of
‘Recovery’ in People with
Bipolar Disorder and
Implications for Psychiatric Care
Hou, Sharon; Michalak, Erin; Hole, Rachelle; Holmes, Cindy;
Velyvis, Vytas; Austin, Jehannine; Pesut, Barbara; and CREST.BD
Department of Psychiatry, University of British Columbia, Canada
International Review of Bipolar Disorders
May 21, 2012

2. Recovery in Bipolar Disorder (BD)
• There are differing understandings of recovery
• One concept of recovery is clinical recovery (a linear
process: rate of relapse into depressive or manic
episodes, reduction of symptoms)
• Another concept of recovery is psychosocial recovery
(a non-linear process: quality and meaningfulness of
life)
“Recovery is Such a Huge Word”: Understandings of ‘Recovery’ in People with BD and Implications for Psychiatric Care

3. Objective
• Very little is known about how people with BD
define recovery from their own perspectives
• This study explored what the term recovery meant
to a sample of Canadian individuals living with BD
via qualitative research methods
“Recovery is Such a Huge Word”: Understandings of ‘Recovery’ in People with BD and Implications for Psychiatric Care

4. Method
• Three focus groups (N= 13; 3 men and 10 women)
• Focus groups were digitally recorded
and transcribed
• Transcripts were coded manually and analyzed
thematically
Focus Group Questions:
1. What does recovery mean to you?
2. What strategies have helped/hindered your recovery?
3. Have you experienced recovery?
“Recovery is Such a Huge Word”: Understandings of ‘Recovery’ in People with BD and Implications for Psychiatric Care

5. Results
Four dominant themes were identified:
1. Re-thinking the Language of Recovery
• To accurately reflect the complexities of living with a chronic mental
health condition
2. Shifting the Framework
• Toward wellness, quality of life, and self-management strategies
3. The Art of Managing BD
• Such as getting exercise, taking medication, accepting peer and family
support, etc.
4. Understanding the Journey
• Gaining a sense of self, accepting loss and letting go of stigma
“Recovery is Such a Huge Word”: Understandings of ‘Recovery’ in People with BD and Implications for Psychiatric Care

6. In Their Own Words…
“So there is hope but “I could use
it’s moving “I think each one of us should [recovery], but to
forward as have the opportunity to me I think
opposed to trying to determine for themselves what management is a
get the past back. it means to be well, what it really good word …
That’s my means to be recovered.” because it is
interpretation of chronic. You’re sort
recovery.” of in-between
recoveries...”
“...What recovery
means is tools, it
means finding ways
of bringing more
health to myself in
“I need...work that I different ways
can manage... whether it’s, you
it shows me how know, diet, exercise “For me, the end result
important it is to and all these of recovery like
stay within your things, medication… is…bipolar being a part
abilities and not be .So it’s acceptance.” of what I am and not a
overwhelmed...” tattoo on my
forehead….”
“Recovery is Such a Huge Word”: Understandings of ‘Recovery’ in People with BD and Implications for Psychiatric Care

7. Practice Implications
• It is important to find a language of recovery that reflects
the complexities of living with a chronic mental health
condition
• Quality of life should be given priority in the treatment
process
• Emphasis should be placed upon the capacity of people
living with BD to self-manage their condition
• A collaborative therapeutic relationship is foundational
to enabling individuals to rebuild a sense of self and
lower the stigma associated with living with BD

8. Conclusion
• Insights such as these into the meanings of recovery for
individuals living with BD are essential to high quality care
• Limitations: Sample size was relatively small, all self-
referred and not ethnically diverse
• Research is required to further our understandings of
recovery in more diverse populations
“Recovery is Such a Huge Word”: Understandings of ‘Recovery’ in People with BD and Implications for Psychiatric Care