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==Overview==
==Overview==
The idea of a relationship between mania and melancholia can be traced back to at least the [[2nd century AD]]. [[Soranus (Greek Physician)|Soranus]] of Ephesus (98-177 AD) described mania and melancholia as distinct diseases. [[Emil Kraepelin]] ([[1856]]-[[1926]]), a German [[psychiatrist]] categorized and studied the natural course of untreated bipolar patients long before [[mood stabilizer]]s were discovered. Describing these patients in 1902, he coined the term manic depressive [[psychosis]]. In 1949 , Cade discovered that [[lithium carbonate]] could be used as a successful treatment of manic depressive psychosis. Subclassification of bipolar disorder was first proposed by German psychiatrist [[Karl Leonhard]] in 1957; he was also the first to introduce the terms ''bipolar'' (for those with mania) and ''unipolar'' (for those with depressive episodes only).
==Historical Perspective==


Varying moods and energy levels have been a part of the human experience since time immemorial. The words "[[melancholia]]" (an old word for [[depression (mood)|depression]]) and "mania" have their [[etymologies]] in [[Ancient Greek]]. The word melancholia is derived from ''melas''/μελας, meaning "black", and ''chole''/χολη, meaning "bile" or "gall",<ref name="Liddell 1980">{{cite book|author = [[Henry George Liddell|Liddell, Henry George]] and [[Robert Scott (philologist)|Robert Scott]] | year = 1980 | title = [[A Greek-English Lexicon]] (Abridged Edition) | publisher = [[Oxford University Press]] | location = United Kingdom | id = ISBN 0-19-910207-4}}</ref> indicative of the term’s origins in pre-[[Hippocrates|Hippocratic]] [[humoral]] theories. Within the humoral theories, mania was viewed as arising from an excess of [[yellow bile]], or a mixture of black and yellow bile. The linguistic origins of mania, however, are not so clear-cut. Several etymologies are proposed by the [[Ancient Rome|Roman]] physician [[Caelius Aurelianus]], including the Greek word ''ania'', meaning to produce great mental anguish, and ''manos'', meaning relaxed or loose, which would contextually approximate to an excessive relaxing of the mind or soul (Angst and Marneros 2001). There are at least five other candidates, and part of the confusion surrounding the exact etymology of the word mania is its varied usage in the pre-Hippocratic [[poetry]] and [[mythology|mythologies]] (Angst and Marneros 2001).
* The connection between mania and melancholia dates back to the 2nd Century CE.
** Soranus of Ephesus (98-177 CE), a Greek physician, characterized mania and melancholia as separate illnesses.
* German [[psychiatrist]] [[Emil Kraepelin]] ([[1856]]-[[1926]]) examined and classified the natural course of patients with untreated bipolar disorder years prior to the discovery of [[mood stabilizer]]s.
** In 1902, Kraepelin created the term ''manic depressive psychosis'' to describe these patients.
* In 1957, Karl Leonhard, a German psychiatrist, coined the terms ''bipolar'' and ''unipolar'' to describe subclassifications of manic depressive psychosis (bipolar disorder).
** ''Bipolar'' was used to describe cases with manic episodes.
** ''Unipolar'' was used to describe cases characterized by the presence of depressive episodes and the lack of manic episodes.


The idea of a relationship between mania and melancholia can be traced back to at least the 2nd century AD.[http://www.k12academics.com/bipolar_history.htm] Soranus of Ephesus (98-177 AD) described mania and melancholia as distinct diseases with separate [[etiologies]] [http://assets.cambridge.org/97805218/35176/excerpt/9780521835176_excerpt.pdf]; however, he acknowledged that “many others consider melancholia a form of the disease of mania” (Cited in Mondimore 2005 p.49).
==Historical Perspective==
 
A clear understanding of bipolar disorder as a mental illness was recognized by early Chinese authors. The encyclopedist Gao Lian (c. 1583)  describes the malady in his ''Eight Treatises on the Nurturing of Life'' (Ts'un-sheng pa-chien) [http://www.nmh.gov.tw/nmh_web/english_version/exhibition/exhibition_s0703.cfm]
 
The earliest written descriptions of a relationship between mania and melancholia are attributed to [[Aretaeus of Cappadocia]]. Aretaeus was an [[Eclectic medicine|eclectic]] medical philosopher who lived in Alexandria somewhere between 30 and 150 AD (Roccatagliata 1986; Akiskal 1996). Aretaeus is recognized as having authored most of the surviving texts referring to a unified concept of manic-depressive illness, viewing both melancholia and mania as having a common origin in ‘black bile’ (Akiskal 1996; Marneros 2001).
[[Image:Emil Kraepelin.png|left|thumb|[[Emil Kraepelin]] (1856–1926) refined the concept of [[psychosis]].]]
The contemporary psychiatric conceptualization of manic-depressive illness is typically traced back to the 1850s. Marneros (2001) describes the concepts emerging out of this period as the “rebirth of bipolarity in the modern era.” On January 31, 1854, [[Jules Baillarger]] described to the French Imperial [[Academy of Medicine]] a [[biphasic]] [[mental illness]] causing recurrent oscillations between mania and depression. Two weeks later, on February 14, 1854, [[Jean-Pierre Falret]] presented a description to the Academy on what was essentially the same disorder. This illness was designated ''folie circulaire'' (‘circular [[insanity]]’) by Falret, and ''folie à double forme'' (‘dual-form insanity’) by Baillarger (Sedler 1983).
 
[[Emil Kraepelin]] (1856-1926), a German [[psychiatrist]] categorized and studied the natural course of untreated bipolar patients long before [[mood stabilizer]]s were discovered. Describing these patients in 1902, he coined the term ''manic depressive [[psychosis]]''. He noted in his patient observations that intervals of acute illness, manic or depressive, were generally punctuated by relatively symptom-free intervals in which the patient was able to function normally.<ref>[[Emil Kraepelin|Kraepelin, Emil]] (1921) ''Manic-depressive Insanity and Paranoia'' ISBN 0-405-07441-7 </ref>


After World War II, Dr. [[John Cade]], an Australian [[psychiatrist]], was investigating the effects of various compounds on veteran patients with manic depressive psychosis. In 1949 , Cade discovered that [[lithium carbonate]] could be used as a successful treatment of manic depressive psychosis.<ref>{{cite journal  
* Humans have experienced cycles of varying moods and energy levels for thousands of years.
* The terms ''melancholia'' and ''mania'' originated in Ancient Greece.
** ''Melancholia'' originates from the Greek words ''melas'' and ''chole,'' meaning "black" and "bile" or "gall"<ref name="Liddell 1980">{{cite book|author = [[Henry George Liddell|Liddell, Henry George]] and [[Robert Scott (philologist)|Robert Scott]] | year = 1980 | title = [[A Greek-English Lexicon]] (Abridged Edition) | publisher = [[Oxford University Press]] | location = United Kingdom | id = ISBN 0-19-910207-4}}</ref> respectively.
** ''Mania'' originates from the Greek words ''ania'' and ''manos,'' meaning "to produce great mental anguish" and "relaxed or loose" respectively.
* Both mania and melancholia were thought to arise from imbalances in the body's humors.  Mania was thought to result from excess amounts of yellow bile, while melancholia was thought to result from excess black bile.
* The connection between mania and melancholia dates back to the 2nd Century CE.<sup>[http://www.k12academics.com/bipolar_history.htm]</sup>
** Soranus of Ephesus (98-177 CE), a Greek physician, characterized mania and melancholia as separate illnesses<sup>[http://assets.cambridge.org/97805218/35176/excerpt/9780521835176_excerpt.pdf]</sup> during a period where many viewed melancholia as a type of mania.
** Aretaeus of Cappadocia, a medical philosopher who lived between the years 30 and 150 CE, is credited with the earliest accounts of a connection between melancholia and mania.  Aretaeus wrote many texts that survive today in which he described manic-depressive disease that he believed originated in black bile.
* Early Chinese authors established clear classification of bipolar disorder as a mental illness.  For example, author and encyclopedist Gao Lian (c. 1583) described the disorder in ''Eight Treatises on the Nurturing of Life.''<sup>[http://www.nmh.gov.tw/nmh_web/english_version/exhibition/exhibition_s0703.cfm]</sup>
* The modern psychiatric understanding of manic-depressive illness is often traced to the 1850s.
** On January 31, 1854, French psychologist Jules Baillarger presented a description of a biphasic mental illness characterized by alternating periods of mania and depression to the French Imperial Academy of Medicine.  Baillarger termed the illness "folie à double forme" (dual-form insanity).
* German psychiatrist Emil Kraepelin (1856-1926) examined and classified the natural course of patients with untreated bipolar disorder years prior to the discovery of mood stabilizers.
** In 1902, Kraepelin created the term manic depressive psychosis to describe these patients.
** He observed that periods of acute illness (manic or depressive) were often preceded and followed by symptom-free periods in which patients were able to function normally.<ref>[[Emil Kraepelin|Kraepelin, Emil]] (1921) ''Manic-depressive Insanity and Paranoia'' ISBN 0-405-07441-7 </ref>
* Following the Second World War, Australian psychiatrist Dr. John Cade conducted research on the effectiveness of different compounds in treating veterans with manic-depressive illness.  Through his research, Dr. Cade found that lithium carbonate was effective at treating manic-depressive illness<ref>{{cite journal  
| title = Lithium salts in the treatment of psychotic excitement
| title = Lithium salts in the treatment of psychotic excitement
| author = Cade J. F. J.
| author = Cade J. F. J.
Line 26: Line 36:
| issue =  
| issue =  
| pages = 349–352
| pages = 349–352
| url = http://www.who.int/docstore/bulletin/pdf/2000/issue4/classics.pdf}}</ref> Because there was a fear that table salt substitutes could lead to toxicity or death, Cade's findings did not immediately lead to treatments. In the 1950s, U.S. hospitals began experimenting with lithium on their patients. By the mid-'60s, reports started appearing in the medical literature regarding lithium's effectiveness. The U.S. Food and Drug Administration did not approve of lithium's use until 1970.<ref>{{cite journal  
| url = http://www.who.int/docstore/bulletin/pdf/2000/issue4/classics.pdf}}</ref>.  Lithium was not widely used as a treatment immediately following Dr. Cade's discovery as many held fears of its toxicity. However, following the use of lithium in the treatment of manic-depressive disorder in some hospitals beginning in the 1950s and reports of the benefits of lithium treatment in medical journals in the 1960s, the Food and Drug Administration approved the use of lithium as a treatment for manic-depressive illness in 1970<ref>{{cite journal  
| title =Lithium treatment for bipolar disorder
| title =Lithium treatment for bipolar disorder
| author = P. B. Mitchell, D. Hadzi-Pavlovic
| author = P. B. Mitchell, D. Hadzi-Pavlovic
Line 34: Line 44:
| issue =4
| issue =4
| pages = 515-519
| pages = 515-519
| url = http://www.who.int/docstore/bulletin/pdf/2000/issue4/classics.pdf}}</ref>
| url = http://www.who.int/docstore/bulletin/pdf/2000/issue4/classics.pdf}}</ref>.
 
* In 1952, the phrase "manic-depressive ''reaction''" was included in the first American Psychiatric Association Diagnostic Manual, demonstrating the belief that the disease was a result of a reaction of biogenetic factors to social/environmental factors.<ref>Goodwin & Jamison. p60-61</ref>
The term "manic-depressive ''reaction''" appeared in the first [[American Psychiatric Association]] Diagnostic Manual in 1952, influenced by the legacy of [[Adolf Meyer (psychiatrist)|Adolf Meyer]] who had introduced the paradigm illness as a reaction of biogenetic factors to psychological and social influences.<ref>Goodwin & Jamison. p60-61</ref> Subclassification of bipolar disorder was first proposed by German psychiatrist [[Karl Leonhard]] in 1957; he was also the first to introduce the terms ''bipolar'' (for those with mania) and ''unipolar'' (for those with depressive episodes only).<ref>Goodwin & Jamison. p62</ref>  
* In 1957, Karl Leonhard, a German psychiatrist, coined the terms ''bipolar'' and ''unipolar'' to describe subclassifications of manic depressive psychosis (bipolar disorder).<ref>Goodwin & Jamison. p62</ref>
 
**''Bipolar'' was used to describe cases with manic episodes.
In 1968, both the newly revised classification systems ICD-8 and DSM-II termed the condition "manic-depressive ''illness''" as biological thinking came to the fore.<ref>Goodwin & Jamison. p88</ref>
**''Unipolar'' was used to describe cases characterized by the presence of depressive episodes and the lack of manic episodes.
 
* In 1968, ICD-8 and DSM-II both called the condition "manic-depressive ''illness,"'' demonstrating the increasing biological thinking surrounding the condition.<ref>Goodwin & Jamison. p88</ref>
The current [[nosology]], [[bipolar disorder]], became popular only recently, and some individuals prefer the older term because it provides a better description of a continually changing, multidimensional illness.
* The current term for the condition, bipolar disorder, recently became popular, though some prefer the old nosology and claim that "manic-depressive illness" better described the multifaceted illness.


==References==
==References==

Latest revision as of 15:43, 30 July 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

  • The connection between mania and melancholia dates back to the 2nd Century CE.
    • Soranus of Ephesus (98-177 CE), a Greek physician, characterized mania and melancholia as separate illnesses.
  • German psychiatrist Emil Kraepelin (1856-1926) examined and classified the natural course of patients with untreated bipolar disorder years prior to the discovery of mood stabilizers.
    • In 1902, Kraepelin created the term manic depressive psychosis to describe these patients.
  • In 1957, Karl Leonhard, a German psychiatrist, coined the terms bipolar and unipolar to describe subclassifications of manic depressive psychosis (bipolar disorder).
    • Bipolar was used to describe cases with manic episodes.
    • Unipolar was used to describe cases characterized by the presence of depressive episodes and the lack of manic episodes.

Historical Perspective

  • Humans have experienced cycles of varying moods and energy levels for thousands of years.
  • The terms melancholia and mania originated in Ancient Greece.
    • Melancholia originates from the Greek words melas and chole, meaning "black" and "bile" or "gall"[1] respectively.
    • Mania originates from the Greek words ania and manos, meaning "to produce great mental anguish" and "relaxed or loose" respectively.
  • Both mania and melancholia were thought to arise from imbalances in the body's humors. Mania was thought to result from excess amounts of yellow bile, while melancholia was thought to result from excess black bile.
  • The connection between mania and melancholia dates back to the 2nd Century CE.[2]
    • Soranus of Ephesus (98-177 CE), a Greek physician, characterized mania and melancholia as separate illnesses[3] during a period where many viewed melancholia as a type of mania.
    • Aretaeus of Cappadocia, a medical philosopher who lived between the years 30 and 150 CE, is credited with the earliest accounts of a connection between melancholia and mania. Aretaeus wrote many texts that survive today in which he described manic-depressive disease that he believed originated in black bile.
  • Early Chinese authors established clear classification of bipolar disorder as a mental illness. For example, author and encyclopedist Gao Lian (c. 1583) described the disorder in Eight Treatises on the Nurturing of Life.[4]
  • The modern psychiatric understanding of manic-depressive illness is often traced to the 1850s.
    • On January 31, 1854, French psychologist Jules Baillarger presented a description of a biphasic mental illness characterized by alternating periods of mania and depression to the French Imperial Academy of Medicine. Baillarger termed the illness "folie à double forme" (dual-form insanity).
  • German psychiatrist Emil Kraepelin (1856-1926) examined and classified the natural course of patients with untreated bipolar disorder years prior to the discovery of mood stabilizers.
    • In 1902, Kraepelin created the term manic depressive psychosis to describe these patients.
    • He observed that periods of acute illness (manic or depressive) were often preceded and followed by symptom-free periods in which patients were able to function normally.[2]
  • Following the Second World War, Australian psychiatrist Dr. John Cade conducted research on the effectiveness of different compounds in treating veterans with manic-depressive illness. Through his research, Dr. Cade found that lithium carbonate was effective at treating manic-depressive illness[3]. Lithium was not widely used as a treatment immediately following Dr. Cade's discovery as many held fears of its toxicity. However, following the use of lithium in the treatment of manic-depressive disorder in some hospitals beginning in the 1950s and reports of the benefits of lithium treatment in medical journals in the 1960s, the Food and Drug Administration approved the use of lithium as a treatment for manic-depressive illness in 1970[4].
  • In 1952, the phrase "manic-depressive reaction" was included in the first American Psychiatric Association Diagnostic Manual, demonstrating the belief that the disease was a result of a reaction of biogenetic factors to social/environmental factors.[5]
  • In 1957, Karl Leonhard, a German psychiatrist, coined the terms bipolar and unipolar to describe subclassifications of manic depressive psychosis (bipolar disorder).[6]
    • Bipolar was used to describe cases with manic episodes.
    • Unipolar was used to describe cases characterized by the presence of depressive episodes and the lack of manic episodes.
  • In 1968, ICD-8 and DSM-II both called the condition "manic-depressive illness," demonstrating the increasing biological thinking surrounding the condition.[7]
  • The current term for the condition, bipolar disorder, recently became popular, though some prefer the old nosology and claim that "manic-depressive illness" better described the multifaceted illness.

References

  1. Liddell, Henry George and Robert Scott (1980). A Greek-English Lexicon (Abridged Edition). United Kingdom: Oxford University Press. ISBN 0-19-910207-4.
  2. Kraepelin, Emil (1921) Manic-depressive Insanity and Paranoia ISBN 0-405-07441-7
  3. Cade J. F. J. (1949). "Lithium salts in the treatment of psychotic excitement" (PDF). Medical Journal of Australia. 2: 349–352.
  4. P. B. Mitchell, D. Hadzi-Pavlovic (2000). "Lithium treatment for bipolar disorder" (PDF). Bulletin of the World Health Organization. 78 (4): 515–519.
  5. Goodwin & Jamison. p60-61
  6. Goodwin & Jamison. p62
  7. Goodwin & Jamison. p88

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