Know thyself: bipolar disorder and self-concept

ABSTRACT

This paper addresses an important yet neglected existential issue sometimes faced by persons with bipolar disorder (BD): confusion about the extent to which what one is like is influenced by BD. Although such confusion is common in psychiatric illnesses, BD raises idiosyncratic difficulties due to its intricate interactions with personality, cognition and behavior. The fluctuating mood phases of BD can generate inconsistency in one's self-experience and sense of self. One way to resolve this confusion would be to coherently account for BD within one's overall self-concept. To facilitate this task, this paper introduces a heuristic taxonomy of different relationships wherein BD can be viewed in light of self-related beliefs. The relationships are as follows: (1) BD contributes to the self, (2) BD scaffolds the self, (3) BD gradually becomes part of the self and (4) BD is not part of the ‘real self’. As the individual presentation of BD varies extensively, the type of relationship one feels holds true depends on one's personal experience of managing and living with the disorder. These relationships act as an organizing framework for one's self-related beliefs about how to account for the effects of BD on personality, behavior, cognitive patterns and other self-expressions.

KEYWORDS:

• Bipolar disorder
• self-concept
• self-illness ambiguity
• self-concept clarity

Acknowledgements

The author thanks Nina Atanasova, Glenn Carruthers, Ivan Gonzalez-Cabrera, Alice Laciny, Neil Levy, Thomas Memmer, Isabella Sarto-Jackson, Ariel Schlesinger, Matthew Shorrock, Christian Simhandl, Özlem Yilmaz, and the Clinical Psychology Colloquium at the University of Konstanz and the Centre for Psychiatry-Reichenau. Special thanks go out to Mary Angeline Carls-Diamante.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 On this note, it is worth investigating whether persons with an infused self may have a tendency to prefer identity-first (‘bipolar person’ or ‘I am bipolar’) over person-first (‘person with BD’ or ‘I have BD’) language when referring to oneself.

2 It is also possible that the real self is associated with what one is like either during elevated or depressed periods, particularly when these are prolonged. In this case, however, it appears more likely that the relationship exhibited is either scaffolding or an infused self.

3 Again, this claim is largely speculative at this point. To substantiate it, independent empirical investigation on whether this particular presentation or experience of BD can be linked to not regarding BD as part of the real self would be helpful. Moreover, persons with other presentations of BD that appear to exert more influence on what one is like could nevertheless view BD as not being part of the real self.

Additional information

Funding

This study was funded by the Federal Ministry of Education and Research (BMBF) and the Baden-Württemberg Ministry of Science as part of the Excellence Strategy of the German Federal and State Governments.

Notes on contributors

Sidney Carls-Diamante

Sidney Carls-Diamante is a Postdoctoral Fellow at the Zukunftskolleg and the Department of Philosophy at the University of Konstanz. Her main research foci are cognition and consciousness in octopuses, and the philosophical issues arising from bipolar disorder.