Bipolar disorders

1. Mood lability and bipolarity

– Mood lability refers to brief, passing changes in mood. Unlike bipolar disorders, these fluctuations are short-lived and do not constitute a bipolar condition.

2. Characteristics of bipolar disorders

– Bipolar disorders involve episodes of very elevated mood (manic or hypomanic) and depressive episodes, which follow one another over several weeks or even months. The Diagnostic and Statistical Manual of Mental Disorders (DSM) offers precise criteria for identifying them.

3. Type I

– Manic episode:

○ Manic periods can last several days.

○ Some patients sleep very little, or not at all, for several days, while others experience excessive sleepiness.

○ Symptoms include uninterrupted speech, ideas flying about without logical continuity, distracted attention and a sense of omnipotence.

○ They launch numerous projects, sometimes risky ones, convinced they will succeed.

– After mania: a prolonged depressive episode often follows.

4. – Diagnostic difficulties:

in people who use drugs or stimulants, it can be difficult for the clinician to distinguish a genuine manic episode from a simple substance-related reaction.

5. Type II (hypomania)

– Hypomanic episodes are less intense than the manic phases of type I:

○ Energy increases and the need for sleep decreases (sometimes to only 2 hours a night).

○ Patients remain highly productive, creative and focused for several days.

– This ‘boost’ seems appealing, but it is most often followed by a long depression. This profile is frequently observed among artists.

6. Cyclothymia

– This involves rapid mood swings over just a few days: alternating a brief depressed state with a period of heightened activity, without a return to calm. These overly rapid changes prevent any balance.

7. Care and prevention

– Aim: to stabilise moods and prevent depressive episodes.

– Positive approach: talk things through, propose concrete solutions and encourage regular routines (sleep, activity, food).