Toward a psychology of (un)certainty : an interpretative phenomenological analysis of young people's accounts of receiving a diagnosis of bipolar disorder

Counselling psychologists are at the forefront of ongoing debate around the use of psychiatric diagnosis in clinical practice. Despite numerous concerns, diagnosis rates worldwide have increased exponentially in recent decades, particularly 'bipolar disorder' among young people (10-24 years). There is however no existing research examining young people's accounts of receiving this diagnosis in the UK. Given that UK mental health services continue to be structured around the biomedical model with diagnosis and powerful psychotropic drugs dominating 'treatment', it is important such accounts are examined. This study uses a qualitative research design, involving a purposive sample of six participants aged 12-22 years at time of diagnosis and 20-24 years at interview. Semi-structured interviews were conducted and transcripts analysed using Interpretative Phenomenological Analysis (IPA) to gain an in-depth understanding of participants' accounts. Main themes identified include Authority is knowledge (Doctor knows best); A poisoned chalice; and Being(s) on drugs (Pharmaceuticalisation). These findings highlight the overshadowing nature of authoritative knowledge in participants' sense-making, the paradoxical nature of the psychological and emotional consequences of this knowledge, and the fundamental role of psychiatric drugs in diagnosis. It is hoped inclusion of young people's accounts in this domain will help us understand the experience of receiving this diagnosis as a young person more fully and help shape professional approaches to young people's health problems accordingly.