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Mieux comprendre les personnes bipolaires

Posted on December 15, 2016 at 8:10 AM

Mieux comprendre les personnes bipolaires


Autrefois appelé psychose maniaco-dépressive, le trouble bipolaire fait partie des troubles de l’humeur auxquels appartient également la dépression récurrente (ou trouble unipolaire). C’est une maladie qui dans sa forme la plus typique comporte deux phases : la phase maniaque et la phase dépressive. Entre les deux pôles, la personne qui souffre de maladie bipolaire, retrouve un état normal que l’on appelle « euthymie » ou « normothymie ».



La phase maniaque se définit comme un épisode d’excitation pathologique : le sujet qui en souffre est hyperactif et euphorique, inhabituellement volubile et fait de multiples projets. Il peut présenter divers troubles comportementaux, perdre toute inhibition ou engager des dépenses inconsidérées.

 

La phase dépressive est en quelque sorte le miroir de la phase maniaque : le sujet présente des signes de grande tristesse, il est ralenti et n’a goût à rien, parfois il veut mourir ; les formes les plus sévères sont qualifiées de «mélancoliques». Le danger principal de cette maladie est le risque de suicide.

Sous-diagnostiqué en France

 

En France, le trouble bipolaire est sous-diagnostiqué. Il faut en moyenne 10 à 12 ans et quatre à cinq médecins différents avant qu’il ne soit nommé. De même, on estime que 40 % des dépressifs sont en réalité des bipolaires qui s'ignorent.

 

Aujourd'hui, on préfère le terme de trouble bipolaire à celui de psychose maniaco-dépressive. D'une part, parce que les formes cliniques sont en fait très diverses, alors que le terme de psychose maniaco-dépressive laisse penser que seules les formes où alternent des épisodes maniaques et des épisodes dépressifs sont prises en compte. D'autre part, parce que le terme de psychose renvoie à certaines théories explicatives mais correspond mal à l’observation purement descriptive de la maladie : entre les accès, le patient dans la plupart des cas a une vie psychique et sociale tout à fait normale, ce qui est inhabituel dans les cas de maladies psychotiques chroniques.

Il arrive à tout le monde de vivre des périodes de bonheur, de tristesse, d'excitation et d'être confronté à certaines difficultés. Cependant, dans le cas des troubles bipolaires, ces changements sont hors de proportion. Ils atteignent une intensité telle que la personne ne réalise pas qu'elle dépasse les bornes, ou encore, la personne souffre tellement de sa dépression qu'elle en est paralysée et est hantée par des idées suicidaires. Cet état amène des problèmes avec la famille, au travail, des problèmes financiers, parfois judiciaires. La maladie peut conduire à l'hospitalisation.

Différence entre manie et hypomanie

 

La manie se définit par la présence, pendant un minimum d'une semaine, d'une altération significative du fonctionnement pouvant conduire à l'hospitalisation ou à l'apparition de symptômes psychotiques (hallucinations, délires, paranoïa). Dans l'hypomanie, la durée des symptômes peut être plus courte, soit d'environ quatre jours. Ces symptômes n'entraînent pas de diminution significative du fonctionnement; bien au contraire, les personnes en phase d'hypomanie sont souvent plus fonctionnelles qu'à l'habitude (augmentation de l'énergie, meilleure concentration, plus grande sociabilité). Cette phase de la maladie peut même paraître attrayante aux yeux de la personne qui en souffre, mais elle peut aussi décourager certaines gens à vouloir recevoir ou poursuivre un traitement pour ces troubles.




Les symptômes de la bipolarité


 

En phase dépressive :

Sentiment de tristesse, humeur dépressive pratiquement toute la journée, presque tous les jours et pendant au moins deux semaines

Perte d'énergie et fatigue

Perte de l'intérêt et du plaisir

Troubles du sommeil (insomnie ou hypersomnie)

Troubles de l'appétit avec perte ou gain de poids

Agitation ou ralentissement psychomoteur

Baisse de concentration ou de l'aptitude à penser, ou indécision

Sentiments de culpabilité

Soudain retrait social ou comportements agressifs subits

Pensées de mort récurrentes (60 % des cas); idées suicidaires récurrentes (15 % des cas)

En phase de manie :

Estime de soi augmentée ou idées de grandeur

Énergie débordante et bonheur intense ou irritabilité excessive

Réduction du besoin de sommeil

Débit de la parole accéléré ou besoin de parler sans arrêt

Pensées rapides ou sensation d'un trop plein d'idées

Distractivité : incapacité à fixer son attention

Recrudescence de l'activité aux plans social, professionnel ou scolaire

Agitation psychomotrice, augmentation de l'énergie

Plaisirs augmentés de façon excessive et à haut risque de conséquences négatives : achats, sexualité, investissements financiers


NB: Les personnes affectées peuvent également faire l'expérience d'idées délirantes (des croyances fermes, mais impossibles)

et d'hallucinations. Les périodes de manie peuvent varier en intensité.

 



 

 






Categories: Psychologie et introspection, Questions / Réponses

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