In their own words: A qualitative focus group study of resilience in bipolar disorder

BACKGROUND: Bipolar disorder (BD) is a debilitating mood disorder. Empowering people to live well in the context of their illness represents an ongoing clinical challenge. Resilience research offers potential opportunities to address these complexities, yet debates regarding its definition and operationalisation limit interpretations of findings and future study designs. Including the voices of patients in this debate is crucial to understand resilience from a nuanced, multidimensional perspective. METHOD: We aimed to understand how patients with BD experienced resilience. Four focus groups including a total of 39 people with BD were held. Data was analysed using reflective thematic analysis. RESULTS: Four central themes and twelve subthemes related to resilience in BD emerged: (1) illness course - subthemes: chronic illness stages, tools and knowledge via lived experience, and pressure of successful stability; (2) self-awareness - subthemes: accepting diagnosis, embracing inevitable downfalls, self-exploration; (3) coping and growth strategies - subthemes: emotional first-aid kit, routine and available resources, and cultivating optimism; (4) support networks - subthemes: positive support outlets, communication and disclosure of needs, and stigma and rejection. CONCLUSIONS: The themes and subthemes highlight the need to assess and address resilience in BD given the unique challenges faced by people with this chronic condition. The insights from this qualitative study provide opportunities to redefine currently limited definitions and measurement of resilience in this population.