Denna kvalitativa studie syftade till att undersöka upplevelserna av att ha vuxit upp med en förälder som har bipolär sjukdom, med hjälp av intervjuer från sex deltagare. Med hjälp av Bronfenbrenners utvecklingsekologiska perspektiv har resultatet från intervjuerna analyserats tillsammans med begreppen ”risk- och skyddsfaktorer”. Det som framkom genom resultat och analys var att tiden som barn tillsammans med en förälder som har bipolär sjukdom präglades av ambivalenta känslor och instabilitet, samtidigt som det fanns trygghet i form av annan vårdnadshavare. Sällan eller aldrig fanns det stöd utöver den andra föräldern och inga insatser från samhället erbjöds dessa barn varken under tidig barndom eller tonår. Alla som deltog i studien uttryckte dock att de hade behövt fångas upp på ett eller annat sätt och att de som vuxna önskade att de fått någon typ av samtalsstöd för att kunna förstå och bearbeta sin förälders sjukdom, då detta påverkade deras barndom kraftigt. Upplevelserna var även att barndomen hade påverkat intervjupersonernas vuxenliv på olika sätt och ofta i negativ riktning. Under intervjuerna uttryckte dock intervjupersonerna att de i dagsläget befann sig på en plats i livet som kändes bra för dem, och att en del dessutom kände sig stärkta av sin barndom. / This qualitative study aimed to examine the experiences of what it is like to have grown up with a parent who has bipolar disorder, with help from interviews of six people. Together with Bronfenbrenners ecological systems theory the results have been analysed with the concept “risk- and protective factors”. What came out of the result and analysis was that being a child of a parent with bipolar disorder was featured by ambivalent emotions and instability, at the same time as there was safety in the shape of another guardian. Rarely or never were there any support beyond the other parent and no help from society was offered these children during either their childhood or youth. Everyone who participated in the study expressed that they felt the need to have been seen somehow and that as adults they wished that they had gotten some sort of counselling to be able to understand and process their parent´s disorder, since this affected their childhood vigorously. The experiences were also that the childhood had affected the participants adulthood in different ways and often in a negative direction. During the interviews though, the participants expressed that they were now in a place in life where they wanted to be and that some of them even felt strengthened by their childhood.

Bakgrund: Vid bipolär sjukdom är de framträdande symtomen perioder av manier och depressioner och risken för suicid kan vara hög. Forskning har visat att när en person drabbas av bipolär sjukdom påverkas inte bara individen utanäven deras närstående. I familjefokuserad omvårdnad inkluderas närstående i vården och ses som en viktig resurs i återhämtningen. Det behövs mer kunskap inom den psykiatriska vården om närståendesupplevelser och deras behov. Syfte: Syftet var att beskriva närståendes upplevelser av att leva med personer som har bipolär sjukdom. Metod: Kvalitativ litteraturöversikt med systematisk ansats där Thomas och Hardens metod för tematisk analys använts vid datanalysen. Primärpublikationer söktes i databaserna PubMed, CINAHL samt PsycINFO. Fjorton artiklar med kvalitativ ansats inkluderades i resultatet. Resultat: Analysen av inkluderade studier utmynnade i tre teman med tillhörande subteman. Teman var ”Ett förändrat liv, ”Kontakten med sjukvården” och ”Att överleva själv”. Slutsats: Slutsatsen är att närstående till personer med bipolär sjukdom upplever att livssituationen påverkas av sjukdomen. En ständig oro, känsla av ensamhet och att sätta sina egna behov åt sidan kan leda till att den egna hälsan riskeras. För att minska på bördan har närstående behov av att känna sig delaktiga i vården och behöver stöd från både sjukvården och andra i deras omgivning. Sjukvården behöver därför bjuda in närstående och ge adekvat information och erbjuda anpassat stöd. / Background: The prominent symptoms in bipolar disorder are periods of mania and depression, and the risk of suicide can be high. Research has shown that when someone suffers from bipolar disorder, others close to them are also affected. In family-focused nursing relatives are included and are seen as an important resource in the recovery process. More knowledge is needed in psychiatric care about family experiences and their needs. Aim: The aim was to describe family experiences of living with people who have bipolar disorder. Method: Qualitative literature review with a systematic approach where Thomas and Harden's method for thematic analysis was used. Primary publications were searched in the databases PubMed, CINAHL and PsycINFO. 14 qualitative studies were included in the result. Results: The analysis of included studies resulted in three themes and associated subthemes. The themes were “An altered life”, “The contact with healthcare” and “To survive oneself”. Conclusion: The conclusion is that family to persons with bipolar disorder experience that the disease can have a substantial impact on life. Constant worry, a feeling of loneliness and putting one's own needs aside can lead to one's own health being risked. To reduce the burden, family members need to feel involved in the care and need support from both health services and others around them. Therefore, healthcare professionals need to invite those close to the patient and provide adequate information and offer customized support.

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Syftet med arbetet är att undersöka vuxna barns upplevelser av att växa upp med en förälder som har bipolär sjukdom. Studien har utgått från en kvalitativ ansats och semistrukturerade intervjuer med åtta vuxna deltagare för att undersöka deras upplevelser under uppväxten, påverkan över vuxenlivet och skyddsfaktorer under uppväxten. Tematisk analys användes för att analysera respondenternas utsagor och de teman som identifierades var: utmaningar under uppväxten, trauma, skyddsfaktorer och uppväxtens påverkan på vuxenlivet. Resultatet visar att sju av åtta respondenter upplevt uppväxten som mer eller mindre traumatisk samt att de upplever att uppväxten på olika sätt påverkat dem i deras vuxenliv, både gällande deras psykiska hälsa och i deras relationsskapande. Särskilt framträdande för alla respondenter har varit deras upplevelser av skam, tabu och isolering till följd av förälderns diagnos, vilket har medfört att inga respondenter erhållit stöd från myndighet eller skola trots de trauman som uppstått i barndomen. Slutsatsen är att uppväxten med en förälder som har bipolär sjukdom påverkar barn på flertalet sätt, de barn som har ett stort skyddsnät mår ofta bättre i vuxen ålder medan för de barn som levt mer isolerat har det ofta påverkat deras psykiska mående på ett negativt sätt. / The aim of the work is to investigate adult children's experiences of growing up with a parent who has bipolar disorder. The study has been based on a qualitative approach and semi-structured interviews with eight adult participants to investigate their experiences during childhood, impact over adulthood and protective factors during childhood. Thematic analysis was used to analyze the respondents' statements and the identified themes were: challenges during growing up, trauma, protective factors and the childhood’s impact on adulthood. The results show that seven out of eight respondents experienced their upbringing as more or less traumatic and that their upbringing has affected them in different ways in adulthood, both in terms of their mental health and in their relationship building. Particularly prominent for all respondents have been their experiences of shame, taboo and isolation as a result of the parent's diagnosis, which has meant that none of the respondents received support from authorities or schools despite the traumas that occurred in their childhood. The conclusion is that growing up with a bipolar parent affects children in several ways. Children who have a large safety net more often feel better in adulthood, while for those children who have lived more isolated, it has often affected their mental well-being in a negative way.

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Genome-wide association studies (GWASs) have reported numerous associations between risk variants and major psychiatric disorders (MPDs) including schizophrenia (SCZ), bipolar disorder (BPD), major depressive disorder (MDD) and others. We reviewed all of the published GWASs, and extracted the genome-wide significant (p<10) and replicated associations between risk SNPs and MPDs. We found the associations of 6 variants located in 6 genes, including L type voltage-gated calcium channel (LTCCs) subunit alpha1 C gene (), that were genome-wide significant ( ) and replicated at single-point level across at least two GWASs. Among them, the associations between MPDs and rs1006737 within are most robust. Thus, as a next step, the expression of the replicated risk genes in human hippocampus was analyzed. We found had significant mRNA expression in human hippocampus in two independent cohorts. Finally, we tried to elucidate the roles of venlafaxine and ω-3 PUFAs in the mRNA expression regulation of the replicated risk genes in hippocampus. We used cDNA chip-based microarray profiling to explore the transcriptome-wide mRNA expression regulation by ω-3 PUFAs (0.72/kg/d) and venlafaxine (0.25/kg/d) treatment in chronic mild stress (CMS) rats. ω-3 PUFAs and venlafaxine treatment elicited significant up-regulation. We concluded that might confer the genetic vulnerability to the shared depressive symptoms across MPDs and CACNA1C might be the therapeutic target for depressive endophenotype as well.

Bipolar disorder is a condition rarely approached in anthropological research, and even less so through the eyes of people living with the disorder. Therefore, to focus on understanding the experience of the state in-between episodes, here referred to as a “white space”, is rare and in need of further examination. The aim of this study was to explore the various experiences of a “white space”, how it is constructed, disrupted, and maintained. The thesis is also an attempt to look at what factors affect these experiences using the anthropology of becoming, and concepts of power and agency. With the interviews of eleven individuals that have experienced different lengths of “white spaces”, a representative of a non-profit organization, a clinical psychologist, and minor participant observation, the author explores the complex views, interpretations, and experiences of a life within a “white space”. Apart from the sub-field of medical anthropology, the thematic framework and concepts involve the anthropology of becoming, agency, and power to explain and discuss the “white space” experience. The analysis shows that a “white space” has many different forms and that agency and power have a great impact on the experience. What the author also discusses in the analysis is the dynamic between what they define as knowledge-production and knowledge-sharing, alongside agency and power in relation to these “white space” experiences. The author emphasizes the importance in using these concepts to further understand and affect the experiences of “white spaces” positively. The conclusion summarizes the findings and emphasizes the need to explore this form of research further.

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