Date on Master's Thesis/Doctoral Dissertation

12-2021

Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Department

Counseling and Human Development

Degree Program

Counseling and Personnel Services, PhD

Committee Chair

McCubbin, Laurie

Committee Co-Chair (if applicable)

Alagaraja, Meera

Committee Member

Mitchell, Amanda

Committee Member

El-Mallakh, Rifaat

Committee Member

Siegel, Rebecca

Author's Keywords

Internalized stigma; recovery; bipolar I; serious mental illness; grounded theory; qualitative

Abstract

Mental illness stigma occurs at multiple levels in Western societies. Internalized stigma, the application of negative stereotypes and prejudice about mental illness to self-concept, has deleterious effects on mental health for adults living with a serious mental illness. Historically, research on stigma in serious mental illness has centered on schizophrenia. Recently, researchers and clinicians have drawn attention to bipolar disorder I, an affective disorder that creates disruptions in functioning and increased risk for substance abuse and suicide. Despite the growing literature establishing the relationship between recovery in serious mental illness and identity, little is known about how adults in long-term recovery from bipolar I manage experiences of internalized stigma. Additionally, few qualitative studies have examined how lived experiences of internalized stigma may affect recovery in bipolar I disorder. This study aimed to understand how lived experiences of internalized stigma influenced identity and recovery processes in bipolar disorder I. Charmaz’s constructivist grounded theory methodology was used to create a novel theory about how individuals navigated a diagnosis of bipolar I, internalized stigma, and the recovery process. Semi-structured interviews were conducted in-person and via video conferencing with a sample of 13 adults undergoing current treatment for bipolar I. The data yielded seven themes related to navigation of the bipolar diagnosis, symptoms, and internalized stigma. Findings revealed that identity development occurred while participants reconciled internalized stigma with understanding of self in relation to bipolar disorder. This reconciliation process and identity development involved negotiation with family members and romantic partners. Throughout the recovery process, participants drew from gifts of bipolar disorder and acquired strengths that fostered self-acceptance and embracing of a transformed, unified identity.

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