The History of Bipolar Disorder

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A quick housekeeping note: I was recently awarded the nineteenth spot on Feedspot’s Top 100 Bipolar Disorder Blog list. The blogs were ranked by a editorial panel based on Google search rankings, popularity on social media websites, and quality and consistency of posts.

Thank you. We now return to your regularly scheduled post, The History of Bipolar Disorder.


 

The history of bipolar disorder is a fascinating study of a mental illness that goes back to the second century. The ancient Greeks and Romans found that lithium salts in baths eased the symptoms of what they termed “melancholia” and mania. Aretaeus of Cappadocia demonstrated a link between the two mood states, a finding that would go unrecognized for several hundred years. Many mentally ill people were executed at this time based on fears about demon possession.

Early Chinese authors recognized bipolar disorder as a mental illness. In his Eight Treatises on the Nurturing of Life, Gao Lian (c. 1583) outlines the disorder. Avicenna, a Persian physician, established the disease in 1025, separating it out from other forms of madness, like rabies.

bipolar
Credit to flickr.com user Jessi RM. Used with permission under a Creative Commons license.

In 1854, French psychiatrist Jules Baillarger coined the term “dual-form insanity,” describing the oscillating symptoms of depression and mania. Two weeks later, Jean-Pierre Falret called the same disorder “circular insanity” while detailing that the disease clustered in families, proving a genetic link.

Emil Kraepelin was the next psychiatrist to address the illness, in the early 1900s. He coined the term “manic-depressive psychosis” to differentiate it from schizophrenia and to describe the relatively symptom-free intervals in the course of the untreated disorder. Carl Jung made a distinction in 1903 between bipolar I and bipolar II, focusing on psychotic states vs. that of hypomania.

John Cade, an Australian psychiatrist, then discovered the calming effect of lithium on patients with manic-depressive illness in 1949. But it took until 1970 for the U.S. Food and Drug Administration to approve of lithium’s use.

In 1952, the idea that the disorder ran in families was revisited in an article published in the Journal of Nervous and Mental Disorder, termed “manic-depressive reaction.” Then, Karl Leonhard introduced the terms bipolar (with mania) and unipolar (with depressive episodes only) in 1957.

People with bipolar disorder at this time and throughout much of the 1960s were institutionalized due to manic-depression not being recognized as an illness. That changed in the early 1970s, and in 1979 the National Association of Mental Health (NAMI) was founded.

The term “bipolar disorder” didn’t appear in the Diagnostic and Statistical Manual of Mental Disorders, third edition (DSM-III) until 1980, but it has quickly been accepted as less stigmatizing than “manic-depressive illness.” The history of the condition is a captivating look into the evolution of how we as a society treat mental illnesses.

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