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

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 information