TY - JOUR
T1 - Why doesn't God say “enough”? Experiences of living with bipolar disorder in rural Ethiopia
AU - Demissie, Mekdes
AU - Hanlon, Charlotte
AU - Ng, Lauren
AU - Fekadu, Abebaw
AU - Mayston, Rosie
N1 - Funding Information: This work was supported by Addis Ababa University and DELTAS Africa Initiative [DEL-15-01]. The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)'s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa's Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust [DEL-15-01] and the UK government. The views expressed in this publication (manual) are those of the authors and not necessarily those of AAS, NEPAD Agency, Welcome Trust, the UK government, or Addis Ababa Uniersity.This dissertation study is also nested in the PRogramme for Improving Mental health carE (PRIME), which was funded by the UK Department for International Development (DfID) [201446]. The views expressed in this article do not necessarily reflect the UK government's official policies. Funding Information: This dissertation study is also nested in the PRogramme for Improving Mental health carE (PRIME), which was funded by the UK Department for International Development (DfID) [ 201446 ]. The views expressed in this article do not necessarily reflect the UK government's official policies. Funding Information: This work was supported by Addis Ababa University and DELTAS Africa Initiative [DEL-15-01]. The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)'s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa's Development Planning and Coordinating Agency ( NEPAD Agency) with funding from the Wellcome Trust [ DEL-15-01 ] and the UK government. The views expressed in this publication (manual) are those of the authors and not necessarily those of AAS, NEPAD Agency, Welcome Trust, the UK government, or Addis Ababa Uniersity. Publisher Copyright: © 2020 Elsevier Ltd Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
M1 - 113625
PY - 2021/2
Y1 - 2021/2
N2 - Rationale: 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. Objective: 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. Method: 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. Result: 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. Conclusion: 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.
AB - Rationale: 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. Objective: 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. Method: 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. Result: 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. Conclusion: 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.
KW - Bipolar disorder
KW - Ethiopia
KW - Lived experience
KW - Phenomenology
KW - Qualitative research
KW - Severe mental illness
KW - Stigma
U2 - 10.1016/j.socscimed.2020.113625
DO - 10.1016/j.socscimed.2020.113625
M3 - Article
SN - 0277-9536
VL - 270
JO - Social Science and Medicine
JF - Social Science and Medicine
M1 - 113625
ER -