BIPOLARITY DAY. March 30, 2023 is World Bipolar Disorder Day. This disease associated with mood changes can have debilitating consequences. Depression, hypomania… Discovery with the psychologist Marine Bienaimé.
[Mise à jour le 29 mars 2023 à 19h39] THE March 30, 2023 is World Bipolar Disorder Day.. In France, according to the High Authority for Health (HAS), its prevalence is estimated at around 1% to 2.5% in the general population. Bipolar people have a very fluctuating mood. Bipolarity is recognized as a psychiatric illness. It takes a very long time to diagnose. There is no objective assessment tool for the diagnosis of bipolar disorder. The diagnosis is based solely on a psychiatric clinical examination of the patient, carried out by a medical specialist. Depression, hypomania… How to recognize a bipolar person? What tests to do? When to consult a psychiatrist?
Bipolar disorder is a chronic and recurrent psychiatric illness, very variable clinical presentation and evolution, beginning mainly in adolescents and young adults. It’s a mood disorder alternating manic or hypomanic episode(s) (mood elevation, psychomotor agitation) and depressive episode(s) with remission intervals
Bipolar disorder manifests as a chronic mood disorder with alternation of euphoric phases, sometimes even delirious, and phases of depression. However, the psychologist Marine Bienaimé specifies that “these pathological episodes being interspersed with periods when the mood is normal”. These states, pushed 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, despair which result in a lack of desire, a loss of vital momentum and a mental and motor slowdown. We observe in the patient a loss of interest and motivation, pessimism, guilt or depreciation as well as a withdrawal into oneself which can go as far as suicidal ideas.
► Those in a manic phase are notably theeuphoria, exaltation of mood, psychomotor excitement (multiple projects, disinhibition, extravagant presentation, flow of words (logorrhea), flight of ideas, insomnia without feeling tired, etc.). The maniac never stops. He demonstrates a overflowing optimism, of a feeling of omnipotence and disinhibition. We are thus witnessing 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 may even experience a certain nostalgia for a period during which everything seemed possible. It is common that after the manic episode appears a depressive phase.
On this question, Marine Bienaimé 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 psychic weight is a factor that should not be overlooked..
Bipolar disorder is diagnosed through a survey in which the psychiatrist measures the duration of phases of elation and phases of depression. It will also take into account the family history and theenvironment in which the patient lives. The interrogation of the entourage is very informative, the affected person is rarely aware of his disorder. The diagnosis is often difficult and long resulting in late treatment for people with bipolar disorder. It would take on average ten years between the first symptoms and the prescription of an appropriate treatment, a situation that increases the risk of complications.
No biological or imaging examination, in the absence of a clinical call point or genetic test, is, at the present time, useful for making a diagnosis.
You have to do the difference between bipolar disorder and a depressive episode, whether isolated or recurrent because the management is different. During a bipolar disorder, there is a break with the previous psychic functioning with an episodic nature of the manifestations. It is also essential to assess the risk of suicide. Adolescents suffering from a depressive episode and presenting a family history of bipolar disorder require monitoring.
Marine Bienaimé explains that “drugs and psychotherapy are complementary. It can be a behavioral or cognitive therapy, psychotherapy but also family or marital therapy because of the impact of the disease on those around you”. The psychologist emphasizes “the importance of a good therapeutic alliance and long-term compliance with treatment as well as a healthy lifestyle”. The success of treatment also depends on a 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 of time. The most commonly used molecules are lithium saltsof the neuroleptics and medication antiepileptics.
The opinion of a psychiatrist is essential when the diagnosis of bipolar disorder is considered in order to confirm it and to set up the most appropriate care. Hospitalization is sometimes considered before referral to a psychiatrist, for example during a manic or mixed episode presenting criteria of severity or a risk of suicide.
Thanks to Marine Bienaimé, psychologist. / High Authority of Health.
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