What is bipolarity?
Roman Padovani: “It is a disease that affects the central nervous system. It affects between 1 and 3% of the population and generally manifests itself in adolescents or young adults. It is mainly manifested by changes in mood in the patient. Depending on the severity of the disease, people may experience depressive episodes, which may last several weeks. But also manic or hypomanic episodes, which correspond to periods of euphoria, exuberance or even strong irritability. If they evolve from one patient to another, these periods last between 4 days and several weeks, even several months in certain cases”.
In concrete terms, how does it translate into everyday life?
RP : “In the most common situation, bipolar disorder alternates periods of remission, during which the patient is completely ‘normal’, and periods of depression or a state of mania. But it is a complex illness and sometimes, some people are in one state or the other all the time.”
And how are these bipolar disorders diagnosed?
RP : “We simply use clinical criteria. To retain the presence of bipolar disorders, it is necessary to observe periods of mania and depression, which are quite significant. Indeed, these disorders must have consequences on the daily life of the patient, his health or his autonomy. It is also important, in my opinion, to eliminate any physical illness that might be the cause of the symptoms and thus give a false diagnosis. These are obviously criteria that are likely to evolve over the years and as research progresses.”
Can stress be a trigger?
RP : The stress-vulnerability model is used. It highlights the link that exists between the onset of symptoms of the disease and stress. The person is considered to be born with this disease… this vulnerability. It is during adolescence, at puberty more precisely, that frailty appears more significantly. Also, the disease is sensitive to stress. The latter can obviously trigger the pathology and any stress can aggravate the disease”.
However, bipolar disorder remains an underdiagnosed illness. How is this explained?
RP : “Already, it must be said that, as with many diseases, not all cases are diagnosed. Also, psychiatrists are not always confronted with these patients and general practitioners are not necessarily sharp to establish a diagnosis. These last years, there has been a great deal of research in the field. I am thinking in particular of Professor Raoul Belzeaux, from the Montpellier University Hospital, who is interested in the biomarkers of mental disorders. He is working on a rapid test project for bipolar disorders from a A tool that aims to help improve the management of this still poorly diagnosed mental disorder”.
How are patients cared for? What treatments exist?
RP : “Hospitalization is, fortunately, reserved for the rarest clinical situations. The treatments most often prescribed for patients suffering from bipolar disorder are lithium, antiepileptics or even antipsychotics. Faced with certain mild forms, non-drug treatments can also be used to treat depressive states, such as health education, physical activity or diet.Some dietary supplements such as omega 3 and vitamin D have also been proven.However, it is important to remember that we do not treat bipolar disorder as we treat depression. Beware, for example, of antidepressants which can aggravate the manic phases and increase the risk of suicide”.
Can we heal?
RP : “We can estimate that a patient is cured when we observe symptomatic remission, the absence of treatment and a regain of autonomy. When the patient is in remission, it is recommended to maintain his treatment for 5 years. If the risk of relapse is not impossible, the healthcare professional can suggest stopping the treatment and the patient can be considered cured”.
A high risk of suicide
According to the High Authority for Health (HAS), bipolar disorder is one of the most serious psychiatric pathologies, which leads to suicide attempts: one in two patients will make at least one suicide attempt in their lifetime and 15% will die. by suicide. This is why it is necessary to identify cases of bipolar disorder as early as possible and thus ensure closer follow-up.
This disease leads to a chronic vulnerability for the patient and remains diagnosed too late. Still according to the HAS, in addition to promoting the risks associated with the disease such as suicide, hospitalizations or comorbidities, a late diagnosis can also have disastrous consequences on the social, family and professional life of patients.
