A Picture of Spirituality in Youth Living with Bipolar Disorder
Abstract
There is a paucity of literature concerning how youth living with bipolar disorder understand and experience spirituality. The management of bipolar disorder through psychosocial interventions such as spirituality is critical due to the chronic and complex nature of the illness and the fact that pharmacotherapy has not been found to fully restore mood and quality of life (Michalak et al., 2016; Miller et al., 2014; Sanchez-Moreno et al., 2009; Stroppa & Moreira-Almeida, 2013). Spirituality has been defined as being concerned with the ultimate questions in life; the meaning in life that a person gains in relation to something bigger than themselves (Huguelet et al., 2016; Mizuno et al., 2018). It is associated with improved physical and psychological well-being, lowered rates of depression, substance abuse, and suicide rates (Lowry, 2012; Stroppa & Moreira-Almeida, 2013). This is relevant as suicide is the second leading cause of death among Canadian youth between 15 and 34 years; and bipolar disorder has been found to have the highest rates of suicide compared to other psychiatric diagnoses (Miller & Black, 2020; Public Agency of Canada, 2023). The purpose of this study is to gain an understanding of how youth living with bipolar disorder describe their understanding of and experiences of spirituality to better support their mental health. Using photovoice methodology introduced by Caroline Wang and Mary Ann Burris (1994), seven youth in Ontario between 18 and 30 years living with bipolar disorder took photos of their understanding and experiences of spirituality. Photos were co-analyzed in individual interviews and five main themes were generated, spirituality as: connection, meaning in life, deciding who to be, changing with mood, and the work done to find balance. Through thematic analysis, value-added, and visual research analysis, and reflexivity, findings showed that youth are struggling with search for meaning in the face of mental illness, and photovoice is an important way to capture their experiences. Nursing implications are for a person-centered approach to spiritual development where metaphysical beliefs and values are identified, and youth are supported in psychological, emotional, and relational work to help transcend bipolar experiences and find stability in mood.