You've probably heard the name bipolar disorder . But it's not just a mood swing. It's a medical condition that has a specific diagnosis and treatment. But do you know how the idea for the disease we call it today came about? There's a very interesting story behind it that goes back thousands of years. Let's talk a little about that story today.
Ideas from a very long time ago
This story begins in ancient Greece. Hippocrates, known to us as the "father of medicine," was the first to document this. He was the first to see that people have two extremes in their moods. One is extreme sadness and anxiety . Today we call this depression . The other is extreme energy and enthusiasm . Today we call this mania .
At that time, Hippocrates thought that these things were caused by changes in the fluids (bilie) in the body.
- Melancholia: He said that excessive sadness comes from an increase in "black bile ." "Melas" means black, and "chole" means bile.
- Mania: He thought that excessive energy came from an increase in "yellow bile."
Then, another Greek physician named Aretaeus of Cappadocia, who lived around the first century, took this idea a little further. He was the one who suggested that this extreme sadness and extreme energy could be two extremes of the same mood. He was also the first to suggest that both conditions were related to some problem in the brain . This was a major discovery for the time.
Simply put, doctors have been trying to understand the idea that these conditions are not just feelings of sadness or happiness, but are related to biological changes occurring in the body, especially the brain.
Are depression and mania two sides of the same coin?
For hundreds of years, doctors thought that depression and mania were two completely different illnesses. But in the mid-19th century, two French psychiatrists changed this idea.
- Jean-Pierre Falret: He was the first to say that this was the same disease, that it came in cycles. He called it "folie circulaire" (cyclic madness). His idea was that a person could have depression, then be normal for a while, and then develop mania. This cycle continues.
- Jules Baillarger: Another French doctor from the same period said that it was a cycle, but there was no normal time between depression and mania , and that as soon as one ended, the other began.
Meanwhile, a German physician named Emil Kraepelin, considered the "father of modern psychiatry," combined all these ideas and gave the condition a single name: "manic-depressive insanity." His idea was accepted almost worldwide at the time.
How DSM changed everything
In the 1950s, psychiatrists came together to create a common system, a rulebook, for diagnosing mental illnesses. It's called the Diagnostic and Statistical Manual of Mental Disorders (DSM) . It's like a guidebook that doctors use to accurately diagnose mental illness. This book is updated from time to time. The way bipolar disorder is diagnosed has changed along with it.
| DSM version (Version) | How Bipolar Disorder was introduced |
|---|---|
| DSM-I (1952) | Kraepelin's "manic-depressive insanity" was divided into three phases: manic, depressed, and "other." Cyclicality was included in the "other" phase. |
| DSM-II (1968) | The name was changed to "manic-depressive illness." Instead of "other," a new category was introduced called "cyclical," meaning people who have experienced both manic and depressive episodes at least once. |
| DSM-III (1980) | This was the turning point! The name "Bipolar Disorder" was first used here. It was also introduced as a separate illness, separate from generalized depression. The criteria we use today were based here. |
How we see Bipolar Disorder today
Today, doctors have divided bipolar disorder into four main types. This classification has made it possible to provide the patient with more appropriate and accurate treatment .
| Type of Bipolar Disorder | Simply put... |
|---|---|
| Bipolar I | Have experienced at least one full manic episode lasting at least 7 days. Depressive episodes may come and go. |
| Bipolar II | There are no full- blown manic episodes. Instead, there are alternating episodes of hypomanic and depressive episodes. |
| Cyclothymic Disorder | For at least two years, alternating between manic and depressive symptoms. However, these are not as severe as in Bipolar I or II. The period of time in a normal mood is less than 8 weeks. |
| Unspecified Bipolar Disorder | Cases where a person has significant mood swings but does not meet the criteria for any of the above categories. |
In terms of treatment, a major change occurred in the 1970s with the approval of the drug lithium . Today, there are many effective medications, such as mood stabilizers, some antiepileptic drugs, and antipsychotics.
The influence of culture and society
Bipolar Disorder is a condition that can affect people in any country and culture. According to the World Health Organization, about 45 million people worldwide suffer from this condition.
However, culture and society influence how people diagnose and receive treatment.
- Stigma: Even in our country, some people are ashamed and afraid to talk about mental illness or see a doctor. Because of this "stigma", many people do not seek proper treatment. This can delay the correct diagnosis of the disease.
- How symptoms are expressed: Some studies have shown that people in Asian countries tend to talk more about physical symptoms (e.g., body aches, headaches) than about mental health problems. This may also lead to a different diagnosis.
All major medical organizations, including the World Health Organization, emphasize that both medication and psychological/social support are essential to managing this condition.
Take-Home Message
- Bipolar Disorder is nothing new. Our understanding of it has evolved over time, from old ideas like "black bile" to the brain disease we know it to be today.
- This is not just a mood swing. It is a cyclical change between periods of mania, when you feel high energy, and periods of depression, when you feel very sad.
- Today, there are specific classifications such as Bipolar I and II, so the disease can be accurately diagnosed and treated.
- If you or someone you know has these symptoms, don't be ashamed or afraid. Talk to your doctor or nurse about it. Today, there are effective treatments that can help manage this condition very well.
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