Manic Depression and its Evolution to Bipolar.

manic depressionManic depression was the name previously given to the mood disorder, bipolar. Back in the late 1800’s the work of Jean-Pierre Falret, a French psychiatrist, led to the term Manic-depressive psychosis becoming the initial name for this mental illness. He identified the “folie circulaire”, the circular insanity of manic and melancholic episodes, interspersed with periods of balanced emotions. It’s interesting how the word psychosis has been dropped. Variations on the bipolar spectrum are now taken into account.

German psychiatrist, Emil Kraepelin,  was the next to officially define and classify psychosis. In 1902 he differentiated two main types of psychosis – mood and thought. Consequently, ‘manic depression’ he used to describe mental illnesses that centred around emotion and mood. ‘Schizophrenia’ (then called manic depression‘Dementia praecox’ meaning premature madness), he classified as mental illnesses to do with thought or problematic cognitive function.

History saw another important step in the evolutionary ladder to the distinction of manic depression. In the early 1950’s. German psychiatrist Karl Leonhard first introduced the term bipolar. He did this to differentiate unipolar depression (major depressive disorder) and bipolar depression.

1980 heralded the year the term manic depression was officially changed in the classification system to bipolar disorder. This came about with the third publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM).

So Why Change the Name Entirely?

  • The main reason seems to stem from the stigma attached to the word ‘manic’. Especially relevant, it denotes crazy, out of control connotations which psychiatrists wanted to steer away from.
  • Bipolar sounds like more of a clinical term and less of an ’emotional’ term. As such, it was another way psychiatrists thought would help reduce stigma.

Well that was the theory anyway. Having a daughter who is bipolar, that term is just as emotionally charged these days, at least in the teenage world. The term is used flippantly to describe a change in emotions or a change of mind. It is used just as flippantly as a derogatory name given to someone who has had a change in emotions or thoughts.

  • With the classifications becoming more defined, bipolar would include and exclude mania dependent on the type of bipolar. Manic depressive stereotype excludes by definition those types of mood disorders without manic episodes.

There are four types of Bipolar disorder recognised in the DSM-5. They are:

  • Bipolar I disorder. This type has manic or mixed episodes lasting at least a week. Manic symptoms need to be severe enough to require hospitalisation. Depressive episodes are often present as well.
  • Bipolar II disorder. Hypomanic, or depressive episodes are present, however no manic episodes.
  • Cyclothymic disorder or Cyclothymia. This a milder form of bipolar with both hypomanic and milder depressive episodes for at least two years.
  • Bipolar Disorder not otherwise specified (BP-NOS). There are symptoms of bipolar present but the criteria for any of the above three types are not met. This type is diagnosed when the symptoms are not normal behaviour for the person.

manic depression

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