bipolar: what’s in a name?

The oldest words attached to what we now call bipolar affective disorder, are melancholia and mania. The both have their origins in Rome and Greece, before Hippocrates came along and started swearing.

Melancholy’ derives from melas ‘black’ and chole ‘bile’, because Hippocrates thought that depression resulted from an excess of black bile. ‘Mania’ is related to menos ‘spirit, force, passion’; mainesthai ‘to rage, go mad’; and mantis ‘seer’, and ultimately derives from the Indo-European root men- ‘mind’ to which, interestingly, ‘man’ is also sometimes connected. (‘Depression’, the clinical term for melancholy, is much more recent in origin and derives from the Latin deprimere ‘press down’ or ‘sink down’.)
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From 300 to 500 AD, a theory claims that some people with bipolar disorder were euthanased. In the present day, Belgian law can grant permission for euthanasia to mentally ill patients (only residents of Belgium).

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400 BC – Hippocrates linked the black bile of melancholia with the yellow bile of mania.
98 – 177 AD, Soranus of Ephesus linked the two words.
30 – 150 AD, Aretaeus of Cappadocia wrote the earliest surviving texts about it.
1025, Avicenna, in Iran, defined it as a manic melancholic madness.
1583, Gao Lian in China, described it as a mental illness (hsin-ping) and identified the role of stress.
17th century, Richard Napier, Britain, wrote extensively about psychiatric mental referred to a disorder in which two mood states existed in a cycling pattern within one individual.
1686, Swiss Theophilus Bonet  described it as ‘manico-melancolicus’.
1854, Jules Baillarger, Switzerland,  called it folie à double forme (‘dual-form insanity’).
1854, Jean-Pierre Falret, Switzerland, called it folie circulaire (‘circular insanity’) by him.

“It is remarkable how Falret’s description of symptoms and hereditary factors are so similar to descriptions found in present-day books and journals.” – Erika Bukkfalvi Hillard

1896 – 1913, Emil Kraepelin, Germany who, using Kahlbaum’s concept of cyclothymia, coined the term manic depressive insanity.
1903, Carl Gustav Jung, Switzerland,  distinguished between manic depression with and without psychosis.
1952, the American Psychiatric Association defined it as ‘manic-depressive reaction’, as opposed to illness.
1957, Karl Leonhard, Germany, was the first to introduce the terms bipolar and unipolar.
1968, USA, both the ICD-8 and DSM-II reverted to ‘manic-depressive illness’ as biological thinking came to the fore.
1980, USA, the DSM adopted the term bipolar disorder.

2015, it is known as bipolar disorder (BD) or bipolar affective disorder (BAD). However, there is a fairly widespread wish to revert to manic depression, notably expressed by Kay Redfield Jamison. Sometimes the emoticons :): and :(: are used. Most non suffered think it simply means unpredictable and extremely fast mood swings. The level of stigma is still ludicrous in postmodern times.

Thesaurus.com currently lists synonyms for bipolar disorder as “bipolar affective disorder, bipolar illness, manic-depression, manic-depressive disorder and manic-depressive psychosis”.

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*pompous pose* It is my contention that the word bipolar doesn’t describe it accurately at all. I think we need the word spectrum – which negates bipolar, so we would need to rewrite the whole name. And the emphasis should be shifted from psychology to psychiatry, which, as the field includes an MD qualification, would put it firmly into the genetic and neurotoxic categories. Calling it a mental illness (although hsin ping does sound rather fun) doesn’t work; people simply assume that we’re doing it all on purpose.

Any ideas?

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