Illness Narratives in Manic-Depressive Disorder: Issues of Self and Identity

Abstract

This paper considers the illness narratives of four research participants, each of whom had a diagnosis of manic-depressive disorder. Manic-depressive disorder is characterised by prolonged and sometimes severe changes in mood in the direction of both depression and abnormal elation, so it might be expected that the research participants would experience a sense of fragility or instability of self or identity. The paper examines to what extent this is revealed in their illness narratives. Introduction Manic-depressive disorder is a severe mental illness characterised by changes in mood in the direction of depression or elation to a pathological degree and is often associated with other profound changes in biological and psychological functioning. The symptoms of the disorder are such that sufferers can come into conflict with other people and as a result experience significant disruption in their social circumstances. Though there are some recent autobiographical accounts of the experience of manic-depressive disorder (see Jamison, 1996; Garner, 1997 for example) the research literature on illness narratives in severe mental illness concentrates on people with a diagnosis of schizophrenia (for example Saris, 1995; Baker, 1996; Roe and Ben-Yishai, 1999). The present study was conceived as an attempt to begin to fill this gap. Ethical Issues The local research ethical committee of the district health authority granted ethical approval for the study. Patients were recruited as research participants from my outpatient clinic, but were only approached if they were relatively mentally well at the time. I explained the nature and purpose of the research, invited questions about it, and left them a copy of the participant informatio