Why doesn't God say "enough"? Experiences of living with bipolar disorder in rural Ethiopia.

Journal: Social science & medicine (1982)

Volume: 270

Issue: 

Year of Publication: 2021

Affiliated Institutions:  Department of Psychiatry, Addis Ababa University, Ethiopia; School of Nursing and Midwifery, College of Health and medical Sciences, Haramaya University, Ethiopia. Electronic address: mekdesdemissie@gmail.com. Department of Psychiatry, Addis Ababa University, Ethiopia; Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, Health Services and Population Research, King's College London, UK. Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA. Department of Psychiatry, Addis Ababa University, Ethiopia; Centre for Innovative Drug Development and Therapeutic Studies for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia; Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK; Center for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, King's College London, UK. Global Health & Social Medicine/King's Global Health Institute, King's College London, NE Wing Bush House, Aldwych, London WCB BJ, UK.

Abstract summary 

Little is known about the specific experience people living with bipolar disorder in rural, low resource settings, where conditions that disrupt normal social interactions are often highly stigmatized and evidence-based treatments are rare.To explore illness experience, coping strategies, help-seeking practices, and consequences of illness among people with bipolar disorder (PBD) and their family members in rural Ethiopia as an initial step for developing psychosocial intervention grounded by the experiences of PBD.A qualitative methods using in-depth interviews were carried out with 27 individuals (15 PBD and 12 caregivers). The participants were identified on the basis of previous community-based research among people with severe mental illness. Interviews were carried out in Amharic, audio-recorded, transcribed, and translated into English. Data were analyzed using thematic analysis. Our approach was informed by phenomenological theory.Three major themes emerged: expressions and experiences of illness, managing self and living with otherness, and the costs of affliction. PBD and caregivers were concerned by different forewarnings of illness. Stigma and social exclusion were entwined in a vicious cycle that shaped both illness experience and the economic health and social life of the household. Nonetheless, PBD and caregivers learned from their experiences, developed coping strategies, and sought relief from trusted relationships, spirituality, and medication.Our findings suggest that psychosocial intervention could be used to strengthen existing resources, in order to improve the lives of PBD and their family members. However, pervasive stigma may be a barrier to group and peer support approaches.

Authors & Co-authors:  Demissie Mekdes M Hanlon Charlotte C Ng Lauren L Fekadu Abebaw A Mayston Rosie R

Study Outcome 

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Statistics
Citations : 
Authors :  5
Identifiers
Doi : 10.1016/j.socscimed.2020.113625
SSN : 1873-5347
Study Population
Male,Female
Mesh Terms
Bipolar Disorder
Other Terms
Bipolar disorder;Ethiopia;Lived experience;Phenomenology;Qualitative research;Severe mental illness;Stigma
Study Design
Phenomenological Study,Grounded Theory,Cross Sectional Study
Study Approach
Qualitative
Country of Study
Ethiopia
Publication Country
England