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Bipolar disorders

Understanding bipolar disorder, their symptoms and possible treatments.

Définition et symptômes

Definition of bipolar disorder

Bipolar disorders were formerly called “manic-depressive psychosis”. Bipolar disorder is one of the mood disorders like recurrent depression (or unipolar disorder).
Bipolar disorders, in their most typical form, have 2 phases:

  • the manic phase: episode of pathological excitement. The person is then hyperactive, excessively euphoric.

  • the depressive phase: mirror of the manic phase, during which the subject is very sad, has no taste for anything and sometimes has dark ideas.

The risk of suicide is one of the reasons that make this disorder dangerous for the patient.

Symptoms of bipolar disorder

Bipolar disorders are characterized by cycles of mood phases (manic and depressive), of a pathological nature, which mark a break with the normal functioning of the person concerned.
While the manic crisis is a very intense state of mental and motor restlessness which can lead to the hospitalization of the subject, depressions in bipolar illness can be dominated by a motor slowdown, characterized by emotional and behavioral instability.
Between crises, residual symptoms persist and affect the quality of life of patients. The fact that the patient is not aware of the pathological nature, at the beginning of the disease and during certain crises, can lead to his unwilling hospitalization in order to protect him or her.
During the course of bipolar disorder, the subject’s autonomy may be impaired. Protective measures (safeguard of justice, curatorship, guardianship) can then be ordered by the judge of the protected adults.

The figures to remember about bipolar disorder

Here are several key figures about bipolar disorder :

  • Only 1% of the population suffers from a typical bipolar disorder and 2-3% from an attenuated form of the disorder (bipolar spectrum). This represents a total of 1.5 million people in France. 

  • Contrary to popular belief, women are affected as much as men, but they have more depressive episodes. It is estimated that almost 10% of bipolar people die by suicide.

  • The life expectancy of a bipolar person is reduced by ten years compared to the national average.

  • Bipolar people frequently suffer (about half the time) from addictions to substances (alcohol, tobacco, cannabis, cocaine).

The causes of bipolar disorder

Bipolar disorder is not a genetic disease. Several factors (some of which are actually genetic) are involved in the development of these disorders. The abnormal functioning of the brain networks involved in the regulation of emotions can be identified by current technical tools. They make it possible to deduce the implication of these dysfunctions in the appearance of the disorder.

Emotional hyper-reactivity is a manifestation of the temperament of bipolar patients; it is expressed during pathological crises. The expression of bipolar disorder results from an interaction between stressors, emotional trauma and pre-existing brain vulnerability.

How to treat bipolar disorder?

To accompany a person suffering from bipolar disorder, it is advisable to personalize the treatment, and to take into account the age, the sex, the frequency of crisis episodes, as well as the tolerance with possible already prescribed drugs.

Drug therapy is usually essential to reduce the impact of bipolar disorder in the long term. The treatment of seizures must be distinguished from that of the prevention of relapses. Lithium remains the reference drug, although it is most often prescribed in combination with other molecules.

Psychological care plays a major role in improving the prognosis of the disease and in the quality of life of patients. Biological treatments and psychological therapies must be combined to effectively fight bipolar illness.

It is desirable that, in the long term, follow-up be provided by a specialist doctor.