The Social Construction of BiPolar Disorder: The Interrelationship Between Societal and Individual Meanings
by Susan G. Goldberg
Fielding Graduate University, School of Psychology, Clinical Psychology Program
November 21, 2007

Viewed through the perspectives of individuals diagnosed with bipolar disorder, this qualitative study investigated how American society has constructed the diagnosis of bipolar disorder and what the implications may be for individuals labeled with this diagnosis. The study involved narrative interviews of five women and one man who were diagnosed with bipolar disorder. Participants were in their 30s to 50s and identified as European Americans. Hermeneutic, social constructionist, and Lacanian approaches influenced the analysis.

One area of findings involves a mutual interaction between individual experience and societal labels. Language, culture, and society limited the choice of labels for "depression" and "elevation." Another area of findings involved the challenges to self and identity faced by participants. It was difficult for participants to develop a cohesive sense of self in light of the particular way the psychiatric community defines bipolar disorder and society understands it. The "biochemical imbalance" explanation for bipolar disorder affected participants' sense of identity and personal control because this explanation seemed to suggest that their feelings and behavior are controlled by an external entity (biochemicals) rather than their conscious will.

These findings may link to larger societal issues. One issue involves a blurred and fluctuating boundary in American society between "normal" exuberance and "crazy" mania and how this societal confusion affected participants' meaning-making. Another is the Western challenge in bridging mind-body dualism. Participants grappled with this issue when trying to understand how many of their bodily, sensory, or emotional experiences were simply labeled as symptoms of a "mental" illness.
Download the PDF