The History of Bipolar Disorder

While Bipolar disorder most likely dates back as far as when our ancestors first came into existence, the earliest documentation we have on bipolar disorder goes back to 300- 400 BC the ancient Greek philosopher Aristotle had thanked melancholia for the gifts of artists, poets, and writers, the creative minds of his time. Whereas Greek physician Hippocrates believed that the state of depression (melancholy, melancholia) resulted from an excess of black bile in the body. The ancient physicians practiced medicine and diagnosis based on the four temperaments as part of the ancient medical concept of humorism, that four bodily fluids ( blood, yellow bile, black bile, and green phlegm) affect human personality traits. Moods, emotions, and behaviors. (This appears to be the earliest documented discovery of bipolar disorder.) In ancient times, it was documented that bipolar sufferers were treated inhumanely and sometimes sent to their premature deaths due to extreme treatments/punishments.In the earliest days of documentation, these people were viewed as 'crazy,' possessed by the devil or demons, Dr. Gardenswartz says.

The people ought to know that the brain is the sole origin of pleasures and joys, laughter and jests, sadness and worry as well as dysphoria, and differentiate between feeling ashamed, good, bad, happy Through the brain we become insane, enraged, we develop anxiety and fears, which can come in the night or during the day, we suffer from sleeplessness, we make mistakes and have unfounded worries, we lose the ability to recognize reality, we become apathetic and we cannot participate in social life We suffer all those mentioned above through the brain when it is ill Hippocrates (460-337 BC)

Centuries would come and no new research or advances on bipolar disorder or mental illness would be conducted. It wasn't until the 18th and 19th century when developments in science and medicine were fast underway. Studies conducted allowed researchers, physicians, and early psychiatrist the opportunity to truly learn and grow an understanding of the disorder. It is at this time in 1854 when two French Psychiatrists Jean-Pierre Falret and Jules Baillarger began their individual research on bipolar disorder. Both men presented their research and reports on the disorder to the Academy of Medicine in Paris. Baillarger called his diagnosis to the disorder dual-form insanity and Falret called the disorder circular insanity, this is believed to be the first recorded diagnosis of bipolar disorder. Falfret was the first to identify that bipolar disorder is genetically linked. In his research, he followed 6 individual with bipolar symptoms and their families. He found that other family members showed symptoms as well.

In 1902 a German psychiatrist by the name of Emil Kraepelin, who is considered the founder of the field of pharmacopsychology what is known today as psychopharmacology. Kraepelin is best recognized for his work in classifying mental disorders and for bringing together and analyzing the influence of biology on mental disorders, including bipolar disorder. Up until this time, most psychiatrists classified the symptoms of bipolar illness as a diagnosis for schizophrenia. It was through Dr. Kraepelin's studies and diagnosis that a new term for the disorder was established Manic-depressive Psychosis. along with Manic-depression the term Kraepelin used to describe mental illnesses centered in emotional or mood problems.

By the 1950s, German psychiatrist Karl Leonhard and his colleagues developed the classification system that led to the term bipolar, differentiating between unipolar and bipolar depression. According to Robert L. Spitzer, MD, professor of psychiatry at Columbia University. The term bipolar logically emphasizes the two poles, Specifically, it is known that people with unipolar depression experience drops in mood, and people with bipolar depression usually experience both depressed and elevated moods in a cyclical manner.

By 1952 the DSM American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) for classifying mental illnesses was available and was a big help in diagnosing many mental illnesses. The breakthroughs would come in the late 1970's and early 1980's when a lot more funding became available for research and studies into behavioral health. It was during this time in 1980 when Dr. Spitzer and his team wrote the third version and a major revision to the DSM. The 3rd version is considered a bible and a scientific instrument of enormous power by specialists and others in the professions, having done away with a one-size-fits-all classification system. Since then a fourth revision has been published in 2000 and a fifth in 2013. Along with the DSM, another relevant major system of classification is the International Classification of Diseases (10th revision, ICD-10, and the revised 11th revision, ICD-11) published by the World Health Organization. Both manuals have deliberately merged their diagnoses to some extent, but there are some differences. An example is that ICD-10 does not include narcissistic personality disorder as a distinct category, while DSM-5 does not include enduring personality change after a tragic or stressful experience or after a psychiatric illness.

While times have changed as did the names of mental disorders. so did the range of medical treatments for those with bipolar disorder. A new revision to the DSM is in the talks as of 2014 the revision would include removing a current concept of childhood bipolar disorder to the bipolar field and create a new disorder category called: Temper Dysregulation Disorder with Dysphoria (TDD).

During the 1940's strong sedatives and barbiturates were prescribed especially to the grief-struck war veterans coming back from the war. prior to the 1950s and into the late 1950's; patients who showed signs of mental illness, delay or bipolar disorder were also institutionalized to separate them from others. Hot baths were used in the ancient times and continued to be used through the ages, presumed to calm the person down. Bleeding a patient was also a treatment used, thought to help cleanse the body of toxins and useful for balancing the patient's system with the hopes the patient mind find mental relief. Electroconvulsive shock therapy and prefrontal lobotomies emerged as two more radical treatment options until new methods evolved and were accepted. Psychotropic medicine was developed and in its early stages, it was prescribed to young children as old 2 years old who seemed to fit a mood disorder like bipolar disorder. Dangerous consequences permanent irreversible damage and death came along with these treatments and were found to be inhumane and have since been banned for medical practice. Since the discovery and arrival lithium, the choices in medications (including antipsychotics, mood stabilizers, and antidepressants) combined with supportive, cognitive behavioral and insight-oriented counseling and care, have provided new tools to confront and manage bipolar disorder. We have come along way and Our understanding of bipolar disorder has certainly evolved since ancient times. Great advances in education and treatment have been and are being made in just the past century alone. In the next several decades, Dr's believe we will see an increased differentiation of symptoms and of treatments, and possibly, the ability to prevent and detect the onset of the disorder. Still, there's a lot of work to be done because many people today aren't getting the treatment they need to lead better quality lives. Thankfully, continuous research is ongoing to help us better understand even more about this confusing chronic condition. The more we learn about bipolar disorder, the more people may be able to receive the care they need.

Research:

https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

From Mania to Bipolar DisorderBipolar DisorderClinical and Neurobiological Foundations

https://davidhealy.org/wp-content/uploads/2012/05/2010-Healy-Mania-ch1.pdf

A Short History of Bipolar DisorderPsychology Today

https://www.psychologytoday.com/blog/hide-and-seek/201206/short-history-bipolar-disorder

Demily C, Jacquet P, Marie-Cardine M. How to differentiate schizophrenia from bipolar disorder using cognitive assessment? Encephale. 2009;35:139“45.

Vitiello B. Psychopharmacology for young children: clinical needs and research opportunities. Pediatrics. 2001;108(4):983“89. [PubMed]

American Psychiatric Association (2013). ""Personality Disorders"". Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). pp. 645“84. doi:10.1176/appi.books.9780890425596.156852. ISBN 978-0-89042-555-8. PMC 4471981.

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