Bipolarity : warning signs

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Extract from the article: Bipolar disorder, also known as manic-depressive psychosis, is a severe mental illness affecting a growing number of people worldwide. Yet, on average, 10 years elapse between the first signs of the illness and the initiation of appropriate trea...

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Bipolar disorder, also known as manic-depressive psychosis, is a severe mental illness affecting a growing number of people worldwide. Yet, on average, 10 years elapse between the first signs of the illness and the initiation of appropriate treatment. During this time, suffering can be immense, with a high risk of suicide : 1 in 2 people will make at least one attempt in their lifetime, and around 15% will die by suicide.

Bipolar disorder is characterized by alternating phases of exaltation (manic episodes) and deep depression. These episodes can last several weeks or even months, and their intensity varies from one individual to another.

There are many causes, including genetic factors, excessive consumption of alcohol or drugs, and intense stress.

Signs of a manic episode

During the manic phase, the person appears to be “on fire”. Euphoria overflows, and behavior becomes excessive. The main symptoms are excitement, considerable motor agitation, a rapid, uninterrupted flow of speech, and volubility (i.e., the person speaks quickly, fluently and without pause).

Other symptoms include an excessively euphoric mood, i.e. everything seems easy, the person is in a state of overflowing positive energy, impulsive and risky behavior, e.g. reckless buying, rash decision-making, disorganized thinking, flight of ideas. Constant hyperactivity, reduced need for sleep without apparent fatigue, excessive self-confidence, even megalomania, and talking to strangers inappropriately.

A person in a manic phase may, for example, decide in the middle of the night to climb a mountain or launch an unrealistic project, unaware of the danger or limits, or offer their basic necessities to complete strangers.

Symptoms of a depressive episode

In contrast to elation, the depressive phase plunges the individual into great suffering. The signs are sometimes mistaken for classic depression, but they are part of a cyclical alternation.

Intense fatigue and feelings of incapacity, insomnia or unrefreshing sleep, digestive problems and loss of appetite, loss of libido, difficulty concentrating and making decisions, feelings of worthlessness and excessive guilt are just some of the signs of this phase.

A gloomy view of the world, pessimism and recurrent suicidal thoughts, with a real risk of acting on them.The person may remain bedridden, unable to take on even the simplest everyday tasks. They feel useless, incapable, sometimes even guilty for existing, or that all the bad things that happen are their fault, even if they're not involved or concerned at all.

An altered link with reality

Bipolar disorder is also characterized by an altered link with reality during both phases. It's a psychosis. The sufferer is unaware that he or she is ill. They may be in total denial of their disorder.

Between episodes, however, the person may return to normal functioning. They can work, interact with others and appear to be fine. This makes diagnosis even more difficult. The duration and frequency of episodes vary from person to person.

Treatment and care

Treatment is based on a combination of medication and psychotherapy. Untreated, the phases can last up to 6 months. With appropriate treatment, improvement can be observed within a few weeks. In certain severe cases, compulsory hospitalization may be necessary, notably to prevent suicide or protect the person from dangerous behavior.

Bipolar disorder is a complex and serious illness, requiring early and appropriate treatment. Spotting the signs, understanding how the manic and depressive phases work, and providing non-judgmental support are essential steps towards lasting well-being.

If you, or someone close to you, has symptoms suggestive of bipolar disorder, don't hesitate to consult a healthcare professional. Early diagnosis can make all the difference.

Raymond DZAKPATA

Article validated by Adiel Lotri, Occupational therapist in mental health (Lomé)