Bipolar disorder is a mental illness that affects 1% of the French population, i.e. approximately 660,000 people, a figure that is certainly underestimated because the diagnosis is difficult, which is manifested by significant changes in behavior in the form of an alternation periods of elation and others of depression. According to the World Health Organization, bipolar disorder is one of the ten most disabling conditions. This disease strongly impairs the quality of life, especially social relationships, of people who are affected and can go as far as suicide attempts.
Bipolar disorder, more often used in the plural (bipolar disorder) and also called manic depression or manic-depressive psychosis , is a chronic mental illness that causes disproportionate mood disorders in their intensity and over time. These are the cause of a profound disorganization in the lives of people who are affected and in particular a deterioration of their family and professional relationships.
Bipolar disorder affects 1% of the population, and as many women as men, as indicated by the Public Health Information Service. It most often occurs in young adults between the ages of 15 and 25, and sometimes even earlier in adolescence, but this disease can also appear in people over the age of 60 or even after 70.
In women, bipolar disorder most often occurs following a depressive episode, while in men, this illness rather follows a manic episode, that is to say a period when the mind is marked by a fixed idea.
A patient with bipolar disorder goes through states of elation and depression that can be intense and last for a long time. These behavioral disorders manifest themselves in two stages, first by a phase of hyperactivity, aggressiveness and lack of inhibition (the so-called manic phase), then by great sadness, overwhelm and total demotivation, i.e. a phase of depression. This alternation of contradictory psychic states explains the name "bipolar" disorder given to this illness.
Manic episodes correspond to phases of elation during which the person with bipolar disorder is euphoric, elated, shows megalomania, experiences significant attention problems, can embark on a large number of projects, spends without count, etc. This phase can also be marked by irritability.
Following this phase of exaltation comes the depressive episode which is manifested by a progressive fall in mood, deep sadness, lack of desire for activity, loss of interest and vitality. This episode of strong dejection lasts in principle two to three times longer than the phase of exaltation, from several weeks to several months. During this depressive episode, a marker of bipolar disorder, sick people frequently develop suicidal thoughts.
Each of these episodes, manic and depressive, can be of high intensity. And the higher the manic phase, the deeper the depression.
Between these two phases that prevent patients from having a normal life, a person with bipolar disorder can regain a normal mood. Periods called remission intervals.
The origin of bipolar disorder still remains an enigma. However, in some people affected, it is possible that this disease is caused by biological factors related to the functioning and communication of brain cells which results in a vulnerability of mood and an inability to regulate one's emotions. These biological causes can themselves be explained by genetic factors.
If a bipolar disorder can develop without clearly identifiable triggers, events can explain the occurrence of this disease in people predisposed to this pathology.
Thus, stress caused by a divorce, separation from relatives, death, dismissal, moving, night work, etc., can cause bipolar disorder to begin. In the same way, the appearance of an illness, the consumption of alcohol, tobacco, drugs, or even the lack of sleep can be at the origin of the occurrence of a bipolar disorder.
More rarely, this disease is due to taking medication. But some of them, such as corticosteroids, anti-inflammatories, antidepressants, or even drugs to treat Parkinson's disease in particular, can sometimes trigger bipolar disorder.
If bipolar disorder is manifested by recognizable symptoms, the diagnosis of this disease is most often difficult to make. In any case, it can take many years, often ten years, before this disease is recognized with certainty and therefore able to be treated.
A bipolar disorder cannot be really cured, but there are basic treatments, called mood stabilizers based on lithium salts, which make it possible to regulate and stabilize the mood of the patients, and thus to improve their quality of life in reducing the frequency and intensity of manic and depressive phases. Patients with bipolar disorder must most often take these treatments for several years, and in some cases all their lives, because their effects are very slow and their cessation must be gradual over time.
In addition to this background treatment, patients may be prescribed antidepressants during the depressive phases of bipolar disorder. These prescriptions are made with caution by doctors because these drugs can themselves promote the onset of a manic phase.
On the other hand, in the most serious cases, and more precisely the acute phases of a bipolar disorder, or when the latter is resistant to treatment, care based on convulsions provoked using electric current (l electroshock), a method called seismotherapy, may be prescribed.
In addition to these mood regulators, patients with bipolar disorder most often follow psychotherapy in parallel. The most recommended is psychoeducation, an educational therapy that consists of explaining the disease and its treatments so that the patient respects the doctor's prescription as best as possible, and to learn how to quickly spot the signs of relapse.
