The relationship between bipolar disorder and financial difficulties: a qualitative examination of patient’s views

Abstract

Objectives: Impulsive spending is listed as a possible symptom in the diagnostic criteria for a manic episode. However no research has examined whether those with bipolar disorder believe that their mental health and finances are related.

Methods: Qualitative data was obtained from two sources: qualitative questionnaire responses (n=44) and a focus group (n=6). These were thematically analysed by 2 independent reviewers.

Results: Seven key themes and 3 sub-themes were identified. Clients spoke of over-spending, impulse shopping and being excessively generous with money when elated in mood and this having a detrimental effect on finances. Participants reported experiencing severe anxiety, depression, suicidal thoughts, regret and guilt when recovering from a hypomanic/manic episode and realising the extent of their financial difficulties. During episodes of depression, participants reported comfort spending and avoiding dealing with their financial situation as a means to cope. Participants reported that having bipolar made maintaining employment difficult, resulting in taking on a less stressful role or being reliant on benefits. Finally, participants reported a vicious cycle with financial difficulties driving mental health and vice versa.

Conclusions: The present findings provide evidence in support of the impulsive spending diagnostic criteria for bipolar disorder. The research has identified a number of possible psychological mechanisms such as impulsivity, self-critical thoughts and avoidance behaviours. It may be that psychological interventions can help tackle these variables and reduce the impact of poor mental health on finances and vice versa in those with bipolar disorder.

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Identifiers

ORCID for Thomas Richardson: orcid.org/0000-0002-5357-4281

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