Washington (AFP)

American rapper Kanye West, who made confused remarks during a meeting for his White House candidacy, has publicly said he has bipolar disorder. What is bipolar disease?

Kanye West revealed his own diagnosis in 2018 on his album "Ye", and he said last year that the illness caused him to experience episodes of paranoid delusions. He declared himself a candidate for the US presidential election in November, and held a first confused public meeting on Sunday mixing words on arms, faith, slavery and abortion, during which he burst into tears.

Bipolar disorder is characterized by alternating manic phases, when patients are in a state of high psychic arousal and feeling elated, thinking and speaking fast, and depressive phases.

"They can almost forget any inhibition, to the point of, for example, spending all their savings in a day," Andrew Nierenberg, professor of psychiatry at Harvard, told AFP. "They can make big mistakes in judgment that they wouldn't ordinarily do, at the sexual, relationship or professional levels."

In the depressive phase, on the other hand, bipolar people no longer find pleasure in their usual activities and are in a state of suffering.

Up to 3% of the population could have the disease, making it more common than schizophrenia, but rarer than depression.

There is a wide variety of symptoms among patients, says Timothy Sullivan, chief of the psychiatry department at Staten Island University Hospital. Some are more depressed than manic, for others it is the other way around.

This partly explains why diagnoses arrive late, often after six years or more, especially in people with depression.

- Risk factors -

Bipolarity is "one of the mental illnesses most likely to be inherited," says Katherine Burdick, a psychologist at Harvard and Brigham and Women's Hospital.

When one of the parents is diagnosed, the risk is between 10 and 20%, she says.

Scientists are looking for the genes responsible and trying to understand how they can affect the part of the brain that deals with emotions.

Others are interested in possible environmental factors. Many patients, but not all, "have experienced childhood trauma, abuse and neglect," says Katherine Burdick.

Drug addiction is another risk factor.

- Treatments -

Standard treatment consists of drugs that regulate mood, the best being lithium, which has been used since the 1940s.

Recently, experts have been interested in the role played by the interruption of the "social rhythms" of people. For example, the death of a pet can trigger a manic-depressive cycle, but scientists have found that it is not just the bereavement that affects the sick.

“Not only did the person suffer psychologically from the loss, they previously walked the dog, played sports with it, the dog made them get up early and provided them with social interactions,” says Timothy Sullivan.

The greater susceptibility of people with bipolar disorder to social disruption may make them more vulnerable during the pandemic and lockdown. This is the case of a former patient of Dr. Sullivan, who contacted him during the pandemic after 10 years of stability.

- Creative link? -

Artists are over-represented among people with bipolar disorder, a topic described in the book "Touched with Fire". The painter Vincent Van Gogh may have had the disease.

"Creative people are distinguished by a very special way of thinking, which involves intense emotional experiences," says Timothy Sullivan. "It is possible that this sensitivity involves the regulatory systems of the brain, which makes them more vulnerable to mood disorders."

Some patients see their disorder as an asset, even if it can cost loved ones.

In one experiment, researchers asked patients with various illnesses if they would like to be able to make theirs go away with the push of a button, says Katherine Burdick.

Result: "the only group of patients who in the majority do not press the button is the group of bipolar patients".

Kanye West has also spoken of it as his "superpower".

© 2020 AFP