Objectives: Although manydiagnosedwithBipolarDisorder(BD)choosetomanagetheirmoodswithout
medication atsomepoint,theirexperiencesofdoingsoarenotwellunderstood.Thispaperaimsto
exploretheprocessesbywhichpeoplemanagebipolarmoodswithoutmedication.
Methods: TenpeoplediagnosedwithBDwhodonotusemedicationwereinterviewed.Analysingtheir
accounts usinggroundedtheorymethodsledtodevelopingamodelofhowtheyperceivetheprocesses
involvedinmanagingmoodswithoutmedication.
Results: Participantsengagedinrepeatedevaluativeprocessesaroundtheirstrategiesformanaging
moods. Someparticipantsdecidednottoinfluence elevatedmoodsduetotheirperceivedadvantages.
Participants' intentionsandactionswereinfluenced bytheirperceptionsofthemselvesandbythe
meanings theyattachedtobipolarmoods,whichwereinturninfluenced byfeedbackfromothers.
Conclusions: The complexityoftheprocessesdescribedbyparticipantssuggeststhattraditionalmodels
of explainingnon-adherencemayover-simplifysomeindividuals'experiences.Futureresearchcould
focus onidentifyingfactorspredictiveofsuccessfulattemptstomanagemoodswithoutmedication.
Professionals shouldplacemoreemphasisonnon-medicationapproachesinordertoincreaseengage-
ment withpeoplewhodonotusemedication.Thismayinvolvefocussingonindividual'slonger-term
goals ratherthanonmodifyingmoodsinshorter-term.Conclusionsarebasedonparticipantswhohad
experiencedsignificant bipolarmoods,butwholargelyseemedsatisfied livingwithoutmedication.
Limitations: Futureresearchshouldascertainwhethersuchprocessesapplytoawidergroupof
individuals whodonotusemedicationforbipolarmoods.