Bipolar disorder is a condition associated with mood changes that can have serious disabling consequences.
According to the High Authority of Health, 1 to 3% of people are bipolar in France. There bipolarity is a psychiatric illness long to diagnose which is characterized by chronic mood disorders. In September 2023, Sylvain Augier, bipolar type 1 diagnosed at the age of 35, spoke about his illness in the PAF show on C8 on September 14, 2023: “It’s genetic. My father and grandfather were bipolar.” He then thinks about ending his life: “I was devastated, I thought I wouldn’t make it, I placed my life in front of a TGV, telling myself that it was better to end it right away, to escape this unbearable pain” says the former presenter of “The Treasure Map”. He manages to raise his thoughts thanks to those close to him.
What is bipolar disorder?
Bipolar disorder is a recurrent mood disorder with alternating mood expansion phases with increased energy and activities (mania or hypomania), and mood swings (depression), with free intervals of varying length. It is a severe psychiatric illness which can lead to suicide, recalls the HAS.
► Bipolar disorder type 1 are characterized by the presence of at least one manic or mixed episode.
► Bipolar disorder type 2 are characterized by the occurrence of one or more major depressive episodes and at least one episode of hypomania.
What are the symptoms of a person with bipolar disorder?
Bipolar disorder manifests as a chronic mood disorder with alternation of euphoric phases, sometimes even delirious, and phases of depression. The psychologist Marine Bienaimer specifies, however, that “these pathological episodes are interrupted by periods when the mood is normal”. These states, taken to the extreme, can produce delusions and hallucinations or even dangerous behavior that can sometimes lead to compulsory hospitalization.
► Symptoms of the depressive phase are in particular:
- a deep sadness,
- a despair
- a lack of desire,
- a loss of vitality
- a psychological and motor slowdown.
- guilt or depreciation
- a withdrawal into oneself which can go as far as suicidal thoughts.
► Those of a manic phase are in particular:
- L‘euphoria,
- the exaltation of the mood,
- psychomotor excitement (multiple projects, disinhibition, extravagant presentation, flow of words (logorrhea),
- flight of ideas,
- insomnia without feeling tired
The maniac never stops. He demonstrates a overflowing optimism, of a feeling of omnipotence and disinhibition. We thus witness an acceleration of psychic functioning, sometimes accompanied by delirium and a risk of endangerment. In the manic phase, the subject is in denial of his disorders and, after a manic episode, he can even experience a certain nostalgia for a period during which everything seemed possible. It is common for a depressive phase to appear after the manic episode.
What are the risk factors for bipolarity? A genetic disease?
On this question, Marine Bienaimer specifies that “Genetic factors are sometimes mentioned, at least in certain cases where several members of the same family are affected. But no genetic study has to date made a direct link and the transgenerational psychological weight is a factor which must not be neglected..
Bipolar disorder is diagnosed through an investigation during which the psychiatrist measures the duration of phases of exaltation and phases of depression. It will also be a matter of taking into account the family history and theenvironment in which the patient evolves. The questioning of those around you is very informative, the affected person is rarely aware of their disorder. Diagnosis is often difficult and long leading to late treatment of people with bipolar disorder. On average it would take around ten years between the first symptoms and the prescription of appropriate treatment, a situation increasing the risk of complications.
Are there any tests?
No biological or imaging examination, in the absence of a clinical point of call or genetic test, is, at present, useful for making a diagnosis.
Depression or bipolar disorder?
You have to do the difference between bipolar disorder and a depressive episode, whether isolated or recurring because the treatment is different. During bipolar disorder, there is a break with previous psychological functioning with an episodic nature of the manifestations. It is also essential to assess suicidal risks. Adolescents suffering from a depressive episode and with a family history of bipolar disorder require monitoring.
Treatment: what to do in case of bipolarity?
Marine Bienaime explains that “medications and psychotherapy are complementary. It may be a behavioral or cognitive therapy, psychotherapy but also family or marital therapy due to the impact of the illness on those around them.. The psychologist insists on “the importance of a good therapeutic alliance and long-term compliance with treatment as well as a healthy lifestyle”. The success of the treatment also requires therapeutic education so that the person recognizes the warning signs. In terms of medication, once the diagnosis has been made, treatment is often prescribed over very long periods. The most commonly used molecules are lithium saltsof the neuroleptics and medicines antiepileptics.
Complication: preventing suicide
The opinion of a psychiatrist is essential when the diagnosis of bipolar disorders is considered in order to confirm it and put in place the most appropriate treatment. Hospitalization is sometimes considered before referral to a psychiatrist, for example during a manic or mixed episode presenting serious criteria or a risk of suicide.
Thanks to Marine Bienaime, psychologist. / High Authority of Health.