Bipolar disorder


Bipolar disorder, formerly manic-depressive psychosis, is classically defined as a succession of depressive episodes and pathological exaltations of the manic type. This disorder is seen today as a heterogeneous, multifactorial pathology, which gradually develops over time to become associated with many other psychiatric and somatic pathologies and represents a severe disability if adapted and personalised therapeutic strategies are not deployed early. Bipolar disorder represents a major public health issue because of its high frequency which is 1 to 4% of the population : in Switzerland 80,000 people are diagnosed bipolar. Moreover, these disorders begin in young adults between the ages of 15 and 25, persist throughout life and are responsible for a 10-year reduction in life expectancy. Depressive episodes frequently lead to suicide attempts, risky behaviour (sexuality, addictions, extreme spending), with which other disorders are often associated (diabetes, cardiovascular diseases, etc.). Placed 6th in the world for disabilities by the WHO, bipolar disorders represent a high cost in medical and economic terms, considered higher than that of coronary heart disease for example. In everyday life, bipolarity can become a very restrictive disease, if its progression is not slowed by appropriate treatments,: it affects cognition – by disrupting memory, attention, executive functions and sleep. It is characterised by difficulties emotional management and irritable behaviour and can also be associated with anxiety disorders. Delayed diagnosis (10 years on average) is a reality that greatly penalises patients: it is estimated that up to 40% of people with depression may actually suffer from bipolar disorder without being diagnosed as such.

Treatments - the promise of research:


Today, the improvement in prognosis of bipolar disorder lies in the development of diagnostic markers that will improve diagnostic accuracy and early diagnosis. In fact, the improvement of prognosis is based on the earliest possible management based on the identification of people affected from the very beginning of their disease, and on the implementation of personalised therapeutic strategies which must combine drug treatment, psycho-social therapy and lifestyle advice.

Bipolar disorder is a complex inherited disorder with both genetic and environmental underlying causes. While genetics accounts for 60% of the origin of the disorders, they are triggered only in interaction with one or more environmental factors. In the near future, through support for innovation in diagnosis, a better understanding of the causes of illness and treatment will help improve the prognosis for bipolar disorder. We have markers that will soon be used for better diagnosis, such as genetic, epigenetic and inflammatory markers, circadian rhythm markers, or brain imaging markers.

The exploration of the various aetiological avenues are within our reach to better understand this disease, such as the exploration of interactions between the genetic terrain and environmental risk factors (stress, infections), or the study of circadian rhythm dysfunction or brain connectivity anomalies. These are all avenues towards a better understanding of the causes of bipolar disorder and open up new therapeutic lines of research for its improved treatment and prevention.

Testimonies:


Testimony of Marie-Aude

Film made for the Mental Disorder exhibition at the Cité des sciences et de l'industrie / 4 min (in French)

Testimonies of Barbara and Gilles

"Bipolar disorder is still largely unknown to the general public" / RTS Info / 4 min (in French)