Roller coaster mood, what bipolar disorder is and why the diagnosis comes late

Roller coaster mood, what bipolar disorder is and why the diagnosis comes late

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A life swinging between moments of euphoria and apathy and sadness. This is how it goes for 120 thousand Italians, but bipolar disorder – because that is what it is – is confused with depression, and it takes on average 10 years – reports the Psychiatry Society – for a correct diagnosis. An early diagnosis, however, can allow patients to follow correct and effective therapy capable of preventing mood swings with a marked improvement in the quality of life.

What is that

First an inexplicable sadness, tiredness and apathy. Then follows a phase of apparent well-being, euphoria, courage and unscrupulousness. Down and up, then up and down again: living with bipolar disorder is like staying on a swing forever. But it is possible to go down, as long as you follow the right therapies, which are too often prescribed very late due to missed and incorrect diagnoses. Bipolar disorder, in fact, is too often confused with depression and the correct diagnosis can arrive ten years late. Meanwhile, sufferers’ lives can fall apart, literally.

For this reason, on the occasion of the World Day dedicated to bipolar disorder on 30 March, the Italian Society of Psychiatry (SIP) launches an appeal to doctors and specialists not to fall into the trap of hasty and incorrect diagnoses. And the SIP president, Emi Bondi, does it directly in the program ‘Coffee and Psychiatry’ in the episode broadcast tomorrow, the world day dedicated to bipolar disorder, on the YouTube channel of Psychiatry online Italy , in an interview with the magazine’s editor, Francesco Bollorino. The interview is also available from tomorrow on home page of the SIP website.

It’s not “normal” depression

“A poorly treated bipolar disorder, as if it were a ‘normal’ depression for example, can have important consequences on the lives of patients – explains Emi Bondi, president of SIP and director of the mental health department at the Papa Giovanni XXIII Hospital in Bergamo -. It is therefore a good idea to listen carefully to patients and take an accurate medical history with the help of family members to avoid prescribing inadequate therapies which can worsen the situation rather than improve it”.

Bipolar disorder is a rather widespread psychiatric pathology. It is estimated that between 1 and 2% of the Italian population suffer from it, around 120 thousand people. Worldwide, it is estimated that there are as many as 80 million. “Although we sometimes tend to make fun of people’s ‘bipolarity’, it is a serious illness, which falls under mental disorders, and is characterized by mood swings ranging from depressive episodes to hypomanic and manic episodes – continues Bondi – This means that phases of profound depression, anguish and sadness alternate with phases of extreme euphoria and exaltation which, at times, can lead to unscrupulous and dangerous behavior for oneself and others”.

A swing of emotions

This swing of emotions is often not correctly identified. “First of all, it is the patient himself who finds it difficult to recognize it: while the depressive episode is easily recognizable – explains the SIP president – because it is experienced with profound suffering, like a blockage of one’s abilities, the ‘recovery’ phase of the mood is experienced in a positive way because one’s abilities are enhanced and everything becomes easier and simpler. There may therefore be a lack of awareness and therefore acceptance in asking for help and treatment. But the euphoric phase can be even more dangerous because the patient can carry out actions that he later regrets and which can create a void around him.”

The alternation of these phases can push the patient to ask for help only in the depressive phase and the doctor limits himself to treating only this one, confusing bipolar disorder with “normal” depression. “But the therapeutic approach to depression and that to bipolar disorder are very different – continues Bondi -: while in depression the mood only goes down, so the therapy is based only on antidepressants to bring the mood back on track, use only these drugs in patients with bipolar disorder risk triggering the hypomanic and manic phase, increasing mood instability to the point of involutions that can compromise the health and, in general, the lives of patients. But if we intercept the pathology well and early , with the use of mood stabilizers it is possible to treat the patient very well who can live so peacefully.”

Appeal to general practitioners

The SIP therefore joins the World Health Organization and, on the day dedicated to bipolar disorder, invites general practitioners and specialists to pay extreme attention when making the diagnosis. “With a timely diagnosis, the current therapies available can allow patients to get off the roller coaster and have a good quality of life”, concludes Bondi.

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