The Discovery of Manic Depression

Bipolar disorder, also known as manic depression, has come a long way in terms of identification, definition and diagnosis. The first instance of manic depression may be impossible to identify, but historical accounts of manic depressive behavior have been recorded for many centuries. Many theories abounded as interest grew regarding this mental disorder, and the resulting interpretations of several scientists ultimately led to the present-day understanding of manic depression.

Historical Perspectives

• Very early history (i.e. in the B.C. centuries) features a number of popular customs founded upon belief in the supernatural. One such custom was the attribution of mental illness to magical sources: any disruption or madness of the mind was believed to have supernatural origins. During the four to fifth centuries B.C., Greek physician Hippocrates rejected this customary attribution and instead suggested that mental illness had biological origins. In the case of manic depression, Hippocrates believed patient cases were caused by a biological disequilibrium of the four humors: blood, black bile, yellow bile and phlegm. Melancholia, or depression, was a result of excessive amounts of black bile while mania was the result of excessive yellow bile.

Earliest Recorded Observation

• The earliest known record regarding the recognition of manic depression, at least in the medical sense, is found to have occurred in the Second Century A.D. A man by the name of Aretaeus (of Cappadocia--a city located in Ancient Turkey) observed a group of patients seen dancing, singing, and laughing, but later appearing monotonous, torpid, and regretful. Aretaeus identified these symptoms as that of mania and depression and in his book, "On Etiology and Symptomatology of Chronic Illnesses," he described how such symptoms could be found occurring in the same person and, therefore, must be associated.

Manico-Melancolicus

• In 1621 Robert Burton, an Anglican clergyman and English scholar, published a review of the medical and psychological insight of the last 2000 years. Titled "The Anatomy of Melancholia," Burton's book focused specifically on the depressive aspect of this mental illness: melancholia. Through his literature, Burton identified and defined depression--melancholia--as its own mental illness: an identification that was later used by Theophile Bonet in 1686 to link melancholia and mania under a single disorder he called "manico-melancolicus."

Circular Insanity

• In the mid 1800s French psychiatrist Jean-Pierre Falret observed that manic and melancholic incidences occurred episodically and were separated by symptom-free periods. Falret called this circular insanity. He then chronicled the distinct differences between the melancholia, or depression, episodes and that of the mania, or heightened moods. The work of Falret led to the recognition of "manic-depressive psychosis" as a psychiatric disorder in 1875.

Manic Depression

• German psychiatrist Emil Kraepelin is one of the most recognized contributors to the evolution of manic depression. This is because Kraepelin used an alternative approach to studying the disorder. Believing that mental illnesses had biological roots, Kraepelin chose not to classify such illnesses upon basic symptom similarities--the method his predecessors had all followed. An observed symptom did not necessarily come from one distinct mental disorder, but could actually be found occurring in any number of disorders, he theorized. So instead he grouped mental diseases together based on the shared patterns of symptoms he observed. This methodology, employed by his exhausting amounts of research, lead to the adoption of "manic-depressive" as the prevailing term used to identify depressive and manic mental states.