It’s about time I touched on the difference between Bipolar Disorder and Manic-Depression. I’ve talked to a number of older folks who were diagnosed as Manic-Depressive but insisted they are not Bipolar. I’ve talked to a therapist and two doctors that have insisted Manic-Depression was the same as being Bipolar. Misinformation runs deep and opinions abound.
Let’s begin with a little history lesson. The first recorded identification and separation of the Disorder occurred in 1025 by a Persian physician and philosopher by name of Ibn Sīnā (Avicenna). Avicenna wrote a five tome encyclopedia of current medical knowledge called The Canon of Medicine that separated a manic-depressive psychosis from things like schizophrenia and pure mania.
The modern understanding of the illness came around 1850 when two opposing French psychiatrists, Jean-Pierre Falret and Jules Baillarger, both presented their identification and understanding of the Disorder. One called it “dual-form insanity” while the other referred to it as “circular insanity”. The two psychiatrists would go on to bitterly feud over who was the first to conceptualize the Disorder and bring it into modern thinking.
The concepts were further honed by German psychiatrist Emil Kraepelin who studied patients with the mental illness and coined the term “manic depressive psychosis” to describe the behavior.
It was none other than Dr. Carl Jung who would go on to refine the illness further. In 1903, he introduced the idea of hypomanic states. Hypomanic states were severe enough to cause significant disruption to the patient’s life but were not severe enough to warrant the term “psychosis”.
The first American Psychology Association Diagnostic Manual published in 1952 included “manic-depressive reaction”. The second amended that to “manic-depressive illness”. A number of revelations and research about the mood disorder saw the name changed again to “Bipolar Disorder” with the third edition of the DSM in 1980.
Manic-Depression evolved from a single, all inclusive name to a more refined categorization of names with classifications. Today, we have Type 1, Type 2, Cyclothemic, and Uncategorized Bipolar Disorders. Each represents specific nuances about the way patients experience the Disorder.
The term Manic-Depression no longer exists in the way it was once thought of. At best, it can describe a Type 1 Bipolar, because Type 1s actually experience mania and depression. Type 2s do not escalate to that kind of extent. Cyclothemics and Uncategorized Bipolar Disorders can vary depending on the person. A quick thumb through the new editions of the DSM will show that Manic-Depression is no longer present in the category of Mood Disorders.
I have noticed several claims as to why this change was put forward. They range from the fact that Manic-Depression just didn’t cover the entirety of the illness to trying to remove associated stigma with the term manic (maniac) to patients getting it confused with Major Depression. Personally, I think it was just the natural evolution of the acquisition of new information. The terminology didn’t reflect the reality of the Disorder so it needed to be changed to represent our new information.
So there you go, an extremely cliff notes version of the history of the naming convention of Bipolar Disorder. It’s important that we all stay knowledgeable about our mental illness so we can communicate effectively with doctors and therapists.
Fascinating to know the first written acknowledgment of the Disorder was in 1025, especially given the number of people who insist it is a modern invention to sell psych medication.
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