These two illnesses share the symptoms of depression. But they are not treated in the same way, with the risk of worsening the patient’s condition. Le Figaro” takes stock on the occasion of World Bipolar Disorder Day.
These two illnesses are seemingly so similar that it is very difficult to differentiate them. This confusion can be dramatic for patients. “Many studies show that treating bipolar disorder with an antidepressant alone worsens the illness, increases the frequency of relapses and the risk of suicide, warns Professor Raoul Belzeaux, a psychiatrist at Montpellier University Hospital. However, while the search for the correct diagnosis is a priority, studies show that 10 to 40% of patients diagnosed with depression auffer from bipolar disorder. This is a pitfall that must be avoided, Professor Belzeaux, a specialist in bipolar disorders, explains to Le Figaro on the occasion of World Bipolar Disorder Day.
Age of onset and occurrence of a manic phase
We should not admit defeat, however, because bipolar disorders leave clues. The first is the age at which the first symptoms appear, generally between 15 and 25 years old. While this illness is very heterogeneous, certain signs are quite suggestive. It generally begins with a depressive episode. From there, we must watch for the possible appearance of a so-called “manic” phase, characterized by an exaltation of mood, as we explained in a previous article “Bipolar disorders and depressive disorders have depression in common. But it is the occurrence of at least one manic phase that will reide the diagnosis,” emphasizes Professor Belzeaux. This manic phase can, however, be very short-lived (only a few days) and very mild (we then speak of “hypomania”), far from the spectacular image that we have of it, which makes the illness even more difficult to identify. Unlike what happens in classic depression, the depressive phases of bipolar disorder have abrupt developments. “The beginning and end of these episodes are generally quite abrupt,” explains the psychiatrist. Schematically, the illness manifests itself by an alternation of manic, hypomanic, depressive, and mixed phases. A minority of patients have as many manic as depressive episodes, but the majority suffer more from depressive episodes. In any case, the recurrence of highs and lows (or only lows) should point to bipolar disorder.
