Bipolar Disorder: Could an early diagnosis save lives?
Bipolar disorder is still often diagnosed late and suicide risks remain very high.
Bipolarity is now fashionable. Mood disorders, hypersensitivity, emotional outbursts… any manifestations of a mood change that may seem a little brutal are now made suspect. In the past, this would have been deemed as ‘whimsical’, but now it may mean one is bipolar. Blame it on a vague classification of psychiatric diseases and too broad an industry of drugs wishing to sell their products and moody ambient atmosphere that puts a strain on our nerves.
Of course, and fortunately for most of us, the term ‘bipolar’ is misused. Paradoxically, unless one is really sick, they are not detected immediately. It takes an average of 10 years between the first symptoms of bipolar disorder before a diagnosis is made. A shift that has tragic consequences: 1 of 2 of those with the disorder will at least attempt suicide and 15% will die from it. In an attempt to save lives and prevent complications related to the disease, the French National Authority for Health (HAS) has published a series of recommendations which should lead to better care.
LEARNING TO RECOGNISE BIPOLAR DISORDER
This psychiatric illness – previously called manic depressive psychosis – is ranked as one of the ten most disabling diseases by the World Health Organisation.
According to the HAS: “Bipolar disorder alternates manic or hypomanic episodes (agitation, mood elevation, grandeur ideas) and depressive episodes with remission times. This disease leads to the patient and remains chronically vulnerable if diagnosed too late. In addition to promoting the risks associated with the disease such as suicide, hospitalisation or comorbidity, delayed diagnosis may also have disastrous consequences for the social, professional and family lives of patients. “
The pathology declares that sufferers are mostly between 15 and 19 years old, although it can also occur later in life. Screening is complicated by the more frequent depressive episodes than manic episodes. These can be easily overlooked. The disease is often confused with depression but also with other disorders that may be associated with anxiety, addictions and behavioral disorders. However, treatment and monitoring are not at all the same in case of bipolar disorder.
NEW RECOMMENDATIONS FOR DOCTORS
The HAS has invited doctors in France to be vigilant and to always think about the possibility of bipolar disorder in the face of depression. It encourages them to seek systematically possible undetected manic episodes, and to pay special attention to family background (there is a hereditary component), with depressions that occur before the age of 25 or that are repeated (more three depressive episodes). Adolescents should be monitored closely to identify a withdrawal, or a dropout-risk behavior. Bipolar disorder should always be considered if suicide is attempted in an adolescent or young adult. Finally, if the doctor suspects bipolar disorder, “they must refer the patient to a psychiatrist to confirm the diagnosis, prescribe appropriate treatment and set up a joint monitoring.”
Source: Press release of the French National Health Authority, October 6, 2015
