BIPOLARIST
Research · The trace

What the people who stayed well actually did

Thirty-two people with bipolar disorder who were functioning well, asked what they do. Six categories, and they map almost line for line onto the Balance Planner.

The claim

“You can manage bipolar disorder with how you live.”

Partly holds People who stayed well used the same six kinds of strategy. The study describes wellness; it does not show what causes it.

Study
Qualitative interviews
Sample
32 adults
Peer review
Yes
Funding
BC Medical Services Foundation

Murray G, Suto M, Hole R, Hale S, Amari E, Michalak EE. Self-management strategies used by ‘high functioning’ individuals with bipolar disorder: from research to clinical practice. Clinical Psychology & Psychotherapy 2011;18:95–109. doi:10.1002/cpp.710.Funded by the British Columbia Medical Services Foundation, which had no role in the study.

What kind of paper this is

A qualitative study. Thirty-two adults with bipolar I or II in British Columbia (25 bipolar I, 20 women, mean age 41), screened on a functioning scale and interviewed individually or in focus groups about the strategies they use to maintain or regain wellness. Unlike an earlier study it built on, this one collected symptom and functioning measures rather than relying on self-report of wellness alone.

What it found

Six categories of strategy: sleep, diet, rest and exercise; ongoing monitoring; reflective and meditative practices; understanding the disorder and educating others; connecting with others; and enacting a plan. Within them, the recurring moves were accepting the diagnosis, identifying triggers, recognising warning signs, managing sleep and stress, and having a plan written before it was needed.

The six strategy categories, and the Balance Planner question that asks for eachSleep, diet, rest and exerciseQ2–3 Daily maintenanceOngoing monitoringQ6 Early warning signsReflective and meditative practicesQ5 and Q7 What you can doUnderstanding BD and educating othersQ11 What others should knowConnecting with othersQ10 Support peopleEnacting a planQ8–9 When things break down
Left: the six categories from Murray et al. 2011. Right: where the Balance Planner asks for each. The last row is the one people skip.
Table view
Strategy categoryBalance Planner
Sleep, diet, rest and exerciseQ2–3 Daily maintenance
Ongoing monitoringQ6 Early warning signs
Reflective and meditative practicesQ5 and Q7 What you can do
Understanding BD and educating othersQ11 What others should know
Connecting with othersQ10 Support people
Enacting a planQ8–9 When things break down

What it did not find

It is 32 people in one province who were already doing well, so it describes what wellness looks like from the inside rather than proving what causes it. It cannot say which strategy did the work, or whether the same strategies would have helped the people who were not in the room.

What you would change on Monday

Write the plan while you are well. Every one of the six categories is a question on the Balance Planner, and “enacting a plan” is the category people skip because it feels like admitting the next episode. The people in this study had admitted it. That is the finding.

Where it sits in the tools

Corrections

None. To challenge a claim, email [email protected] with the specific line.

One paper, read for what it can carry. Not clinical advice; the editorial policy and medical disclaimer apply.

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