THE ESSENTIAL
- Ranked among the 10 most disabling pathologies according to the World Health Organization, bipolar disorder generally begins in adolescents or young adults.
- It is a complex disorder, difficult to diagnose: it takes on average 10 years between its appearance and the implementation of an appropriate treatment.
- 1 out of 2 patients will make at least one suicide attempt in their lifetime and 15% will die by suicide. The risks are heightened when the patient is not treated.
“There are days when you feel like you’re a child of God, you can fly over anything, that the world is yours. And at other times, you experience very intense phases of depression that can last several weeks or even months. This winter, the depressive phase, Ibtissam is going through it once more. In early October, this young math student was diagnosed with bipolar disorder.
Bipolar disorders, also called manic depression, are characterized by alternating phases of depression and euphoria, disproportionate in their duration and intensity. The behavioral disorders that accompany these phases profoundly disorganize the life of the person affected and often damage their family and professional relationships. They start most of the time in the last years of adolescence, between 15 and 19 years old.
“I thought my overreactions were just a personality trait”
For Ibtissam, it was when he was 16 that the troubles began to break out. “In first class, I became very outgoing and I was addicted to jogging. At the same time, I started to be very saddened by trifles, such as a bad grade in French for example. One day, during a school outing, we met homeless people in the metro. Thinking regarding it once at home, I felt terrible and ended up breaking down in the shower.” A period of intense depression followed, nourishing a search for meaning that would follow Ibtissam throughout his life, “inevitably linked to [s]has bipolarity”according to her. “I thought at first, like many, that my exacerbated reactions were just a personality trait and not a disease, following all, there are shy people, angry people… When you think of it as a personality trait, we do not think of going to consult. I was in total denial, until the day it went too far.
These behavioral changes were exacerbated following the death of his father from lung cancer in June 2018: “When he died, for months, I didn’t even mourn him. I clung to the idea that he continued to exist and watch over us. Looking back, I think I was in a hypomanic phase because that’s not healthy behavior in that situation. Result: a few months later, I fell back into a fairly hardcore phase of depression”. A period of depression that led her several times to thoughts of suicide.
“My first psychiatrists thought it was just depression”
In 2019, she tries to see psychologists – “It didn’t help me at all”she underlines – then moves on to psychiatrists the following year. “I changed 3, 4 times psychiatrist. The first two thought it was just depression.” It took regarding thirty sessions, spread over 2 years, for Ibtissam to finally be diagnosed definitively. Since depressive episodes are predominant in bipolar disorders, compared to episodes of mania, they can in fact go unnoticed by doctors as well as for the patient who suffers them, or be confused with other psychiatric pathologies (addiction, anxiety disorders, conduct disorders, etc.).“When we are in a phase of euphoria, we do not see the harm, since for us everything is fine in the best of worlds and we are in great shape. As a result, when we turn to health professionals only when things are not going well, we are often diagnosed with depression”constate Ibtissam.
However, moments of euphoria can also be problematic. “Hypomania is extravagant ideas: we tell ourselves that we are the best, that we can run all the marathons in the world in one day”, she explains. For example, last spring, this great lover of running decided to take part in a trail. “I had far too excessive ambitions: I was not at all prepared for 70 km sporting events. The reality gave me a little slap”, says the 23-year-old student.
What frightens him the most in his disorder are the moments of extreme rage. “I don’t know how it can be defined in psychiatric jargon, but I know how to explain it well: I have an extreme intermediate phase between mania and depression, a state of monstrous anger where I have the physical strength ‘one can have in the hypomanic phase and the sadness and the desire to die that one can have in the phases of depression. A sort of synthesis of the worst of these two phases.”
“I freaked out a bit because of the Covid pandemic”
To the point of sometimes putting themselves in danger. “In 2020, I lost my mind a bit because of the Covid pandemic. At one point, I wanted to be a superhero: I thought to myself, ‘well the police don’t do the job, so I’m going to play the KickAss outside’, and I really seriously intended to becoming it.” Ibtissam then starts going out at night with a hammer: “I wandered the streets of Paris to see if there was any danger and if I might not go and beat the face of an attacker.” These peregrinations one day led him to end the night in police custody. “I had climbed the doors of the Louvre Museum. I was drunk, it was 2am. I then said to myself, ‘Damn, I feel too bad, I want to go to a place where I feel good (the Marly courtyard)’ and I wanted to go there at this precise moment. Ibtissam is not the only one to climb the walls: she found several similar stories in the testimonies of other bipolar people she consulted. And problems with alcohol use are also very common in affected patients. “There are moments of intense sadness where you just want to annihilate yourself. Which led me to consume very large amounts of alcohol, sometimes until blackout.”
In her hypomanic phases, this student from Bondy did not only put herself in physical danger. But also in financial danger on several occasions because of compulsive purchases, a behavior frequent in the euphoric phases of bipolar disorder. “We have certain impulses and as soon as there is the possibility, you do not restrain yourself. Your brain will find justifications for you, like ‘you only live once’, or ‘you need it to find the answers to your questions’.” One morning, this passionate regarding philosophy realizes that she misses The Republic from Plato to his collection of books that pile up in his bedroom. “I went straight to Fnac following getting up, without even showering. really on a metaphysical quest.” Another impulse spend, his first time at the casino, right following seeing the film The Cart Counter : “A little drunk, I went alone right following the movie when I didn’t even know the rules. I lost a hundred euros.”
“You can’t imagine how much weight the diagnosis can take”
Once back in the depression phase, these irrational behaviors led Ibtissam to feel a lot of guilt, reinforcing his suicidal thoughts. “Today, I continue to see a psychiatrist and I finally manage to put words on what I experienced. I can finally say to myself: it’s not my fault, I’m just sick.” She encourages people who have suspicions regarding their mental health to consult a professional. “It’s difficult because we are often in denial, but you can’t imagine how much of a burden it can take to know what we have and how we can try to fix it. We know that the treatments are not perfect, that there are complications, side effects, but it is still better than not treating our bipolarity, especially when we know how many of us commit suicide when they are not not processed.”
To encourage herself, Ibtissam concludes the story of her patient journey with this metaphor that suits her love of the marathon well: “Diagnosis is only the first step. I haven’t finished my race, I know that I haven’t stabilized yet and I know very well that I still have miles to run. But at least I’m already in the race, I’m already on my way, and you have to keep moving forward, running and trying to go all the way.”
