This article is devoted to the history of bipolar disorder. Bipolar disorder is one of the oldest illnesses – the first records of it appeared a long time ago. Its history goes back to the 1st century in Greece when Aretaeus of Cappadocia began exploring the disorder symptoms. He shared his observations with the medical society of that time, trying to prove that mania and depression are linked mind’s states, but his notations were met like fantasies and they didn’t gain the ground for many centuries after.
The history of bipolar disorder
The terms we know today – “mania” and “melancholia” – were created by the ancient Greeks and Romans. Today these are the names for manic and depressive stages of bipolar disorder. It was then when people discovered that lithium salts helped to calm manic patients and elevate the mood of those depressed. And nowaday lithium is a common widely used treatment for bipolar patients.
Aristotle was one of those people, who not only acknowledged melancholy as a condition but also believed that it is this condition that inspired all the great artists of that time.
The religious dogma of that time indicated loud and clear that people with “mental disorders” are possessed by demons and should be executed. Therefore, all the people from all over the world were executed if they had bipolar disorder or any other mental condition.
In the 17th century, the world has seen the book “The Anatomy of Melancholy” by Robert Burton, which was all about this state of mind and the ways of its treating with music and dancing. The book encompasses both – medical knowledge and a collection of commentaries about depression and its influence on society. It was the first book to describe the symptoms and the treatment for melancholy, which is nowadays known as clinic depression.
The very important step was made soon after by Theophilus Bonet. While mania and depression were considered to be separate diseases, he was studying the melancholy. He performed 3,000 autopsies and published all the collected info in his book called “Sepuchretum”. He was able to link melancholy with mania and he named it “manico-melancolicus”.
A few centuries later, in 1851 a French psychiatrist, Jean-Pierre Falret, published an article in which he described the condition called “la folie circulaire” – “circular insanity”. The article describes patients whose mood was circling from severe depression to manic excitement and back. What is more, Falret was able to connect the genetics to the bipolar disease. This is considered to be the first documented diagnosis of bipolar disorder.
The more – the merrier! Remember Sigmund Freud’s theory about society suppressing its desires and how it is connected to mental illnesses? A German psychiatrist, Emil Kraepelin, managed to break away from it by finding out the biological causes of mental conditions. He was one of those who truly studied and took mental disorders seriously. His “Manic Depressive Insanity and Paranoia” was published in 1921 and explained the difference between manic-depressive and praecox, known as schizophrenia. He classified mental conditions and it is used by professionals today.
In 1950s, Karl Leonhard, another German psychiatrist, contributed to the development of this classification system.
The term “bipolar” means “two poles” (manic and depressive stages). It has first appeared in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) in its third revision in 1980. It was then when people decided to go away from the term mania to avoid calling patients “maniacs.” Nowadays the DSM is considered the leading manual for mental health professionals.
According to the latest version of the DSM, there are four types of bipolar disorder with the following diagnostic criteria:
Bipolar Disorder I
- at least one manic episode and one or more major depression episode.
Bipolar Disorder II
- major depression;
- instead of mania, people experience hypomania: high energy, impulsiveness, and excitability, but less severe as full-blown mania.
- less severe mood swings;
- episodes shifting from hypomania to mild depression;
- more common in people who have their first episode at a younger age.
Rapid-Cycling Bipolar Disorder
- rapid changes in mood – with four or more episodes of major depression, mania, hypomania, or mixed symptoms within a year.
Of course, there is so much more to explore! Two excellent resources are:
- Bipolar Expeditions: Mania and Depression in American Culture by Elizabeth Martin.
- Mania: A Short History of Bipolar Disorder (Johns Hopkins Biographies of Disease) by David Healy.
These are wonderful books and provide a much fuller history of bipolar disorder than a single web page can offer.