First episode psychotic mania and its aftermath: the experience of people diagnosed with bipolar disorder

BackgroundOptimal intervention for people diagnosed with bipolar disorder (BD) is seen as a priority within early intervention psychosis services. This is the first study to explore the experience of first-episode psychotic mania and its aftermath for people diagnosed with BD, and the potential implications for treatment.MethodSemi-structured interviews were conducted with 11 young adults following first-episode psychotic mania and analysed using Interpretative Phenomenological Analysis (IPA).ResultsTwo overarching themes were identified: (i) “Changing states of self during first episode”; (ii) “Struggling with loss of self during episode aftermath”. Participants experienced exceptional, persecutory and angry states during psychotic mania, leading to identity disruption and low feelings or depression post-episode. Some mourned the loss of their exceptional manic self, and attempted to relapse into mania, while others struggled with the loss of who they had been prior to their episode.DiscussionResults emphasise the importance of understanding identity change during first-episode psychotic mania and how that might be used to address identity disruption and low feelings during recovery. This process is likely to be pertinent to early intervention and prevention of manic relapse following first-episode BD.