A qualitative exploration of how people with bipolar disorder consider risk-taking in everyday decisions

Bipolar Disorder (BD) is characterised by shifts between episodes of mania, hypomania and depression. BD is considered a lifelong diagnosis and individuals with BD are estimated to be symptomatic for almost half their life. Individuals with BD can have excessive involvement in activities that have a high potential for adverse consequences. Such activities include spending sprees, sexual indiscretions, shoplifting and aggression. The consequences of these actions can often have a severe impact on their social, educational, occupational and daily functioning.   Section 1 is a qualitative systematic literature review that explored how self management strategies are perceived by individuals with BD. A meta-ethnography approach was used to synthesise 18 qualitative research studies. Three themes were identified; "The Process of Successful Self-Management Skills", "Self-management: Symptom-management or Lifestyle-management" and "The Fear of a Relapse". Implications of the findings suggest that self-management strategies should encourage individual adjustments so that the individual can adapt their behaviour in different contexts. It may also be helpful to change the focus on lifestyle rather than symptoms. Finally, an underlying fear may be impacting the adherence to self-management strategies.   Section 2 is a qualitative research study that explored how individuals with BD consider risk in everyday decisions. Eight participants were interviewed. Interpretative phenomenological analysis was used to analyse the interviews. Four themes were identified that impacted an individual's consideration of risk: identity, control, fear and supporting network. Implications include individual explorations of how the four themes may be impacting on the risk-taking decision-making process.   Section 3 is a reflexive critical appraisal of the thesis process. It gives a summary of the two papers before reflexively discussing three topics that involved key decisions and learning points. The three topics explain why I chose this topic, how I ensured quality and trustworthy findings and my reflections on the thesis process.