Bipolarity: the particularity of manic phases
Manic or hypomanic phases are particularly recurrent in persons with bipolarity.
They manifest themselves at various scales of intensity, and are defined by recurring disproportionate feelings such as elation, euphoria, or sometimes anger. Gaining energy with psychomotor arousal leads to reduced sleep needs, risky behaviour (financially, with reckless spending, for example, and/or sexually with risky behaviour) …
Between these episodes, there are symptomless phases. The duration of episodes varies from a few weeks to a few months, with depressive episodes often longer than manic episodes.
Not a disorder, but bipolar disorder
It is important to remember that there is not bipolar disorder, but bipolar disorder.
Many patients do not find themselves in the ‘ canonical ’ definition of this disorder, and miss a possible diagnosis that could have been raised by a knowledgeable professional about the existence of a spectrum of bipolar disorders.
As with many psychiatric disorders, it is in fact a spectrum of several disorders, which may vary in terms of the predominance of one or the other phase, the intensity of symptoms, the speed at which cycles alternate, or the duration of stable phases between thymic episodes (manic or depressive).
Bipolar Disorders: A Chronic Disease
Bipolar disorder is a chronic disease that cannot be cured, but can be treated over the long term.
New episodes of bipolarity are possible throughout life. It is, however, and often, possible to completely control episodes and symptoms with adapted treatments. Although they do not make the illness go away, the various treatments given to a bipolar person have a long-term goal: to make the symptoms go away. Moreover, if treatment is stopped, the disorder returns.
Bipolar disorder is a serious illness, not least because of the disability caused by thymic episodes, but also because of the high risk of suicide: about 5 per cent of patients with bipolar disorder die by suicide.
The term should not be misused. Bipolar disorder is a disease that causes significant suffering for patients and their loved ones. It is not an atypical psychic functioning or even a personality type. It is a pathology that requires care, drug treatment and psychotherapeutic management.
What is the proportion of bipolar disorder in the population?
It all depends on what we are talking about. In the case of typical canonical bipolar disorder, with well-characterized episodes of depression and mania, this represents approximately 1 to 2 per cent of the population. If we consider the broader spectrum of bipolar disorder, with patients, for example, having depressive episodes and atypical reactions to antidepressants without a frank manic episode, or cyclothymia, the existence of thymic fluctuations without reaching the intensity of a depressive or manic episode, the prevalence is probably over 5%.
In recent years, we have seen an increase in the incidence of bipolar disorder in the literature, not so much because of an “epidemic” of bipolar disorder, but because it is better diagnosed and has shifted from the idea of a single disease to a spectrum of diseases. Many patients who were previously undiagnosed with bipolar disorder are now diagnosed with bipolar disorder.