Bipolar disorder: ten years to make the diagnosis

Armed with a razor, the man cut his ear. Seven months later, he ends his life. This course, all the French know it. It is that of Vincent Van Gogh, born on March 30. Long described as simply “crazy”, the painter actually suffered from bipolar disorder. Recognized as a great painter after his death, he is today the standard bearer for patients with this mental disorder.

The day of his birth has also become that of the world day dedicated to bipolar disorders. A mental illness which is considered, by the World Health Organization, among the 10 most disabling pathologies in the world. Why actor takes stock in four questions.

What’s this ? The term bipolar describes an alternation of two extreme phases in the patient: one called excitation – or manic – and the other called depressive. Several weeks, or even several months, can separate these phases. Most often for no apparent reason. Symptoms vary depending on the patient. But they considerably reduce life expectancy. Compared to the general population, people with bipolar disorder live 10 to 20 years less.

Who is affected? Figures vary. According to the Haute Autorité de Santé, 650,000 to 1.2 million French people suffer from bipolar disorder. The first symptoms usually appear between the ages of 15 and 25. But the time between these signs and the formal diagnosis is very long: 10 years pass on average. Some forms have a family origin and genetic causes may exist. But several genes are involved and influence the nature of the symptoms.

How is it treated? 70% of patients with bipolar disorder have an inappropriate diagnosis. This is based on two international classifications and has a major impact on the nature of the treatment. Three drug families are indicated: lithium salts, anticonvulsants and atypical antipsychotics. They are used to control the different phases of the disease, with an adjustment period. However, it is during the first 5 years that the chances of remission are greatest.

Is it recent? The disease itself is not recent. Vincent Van Gogh is the most illustrious example, but it already existed in Antiquity. In 1854, a first description intervenes: Jean-Pierre Falret evokes a “circular madness”, making it possible to differentiate the disorder compared to the depression. The terms followed one another until 1899. It was on this date that Emil Kraeplin, father of modern psychiatry, separated the patients into three groups, schizophrenia, dementia and manic-depressive illness. This last name was finally replaced, in 1980, by the bipolar disorder that we know today.