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1 - Bipolar disorder in historical perspective

Published online by Cambridge University Press:  13 August 2009

Edward Shorter
Affiliation:
Department of Psychiatry, Faculty of Medicine, University of Toronto, Ontario, Canada
Gordon Parker
Affiliation:
University of New South Wales, Sydney
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Summary

Psychiatric disorders are like children laughing and playing gaily at the park, while behind a screen other children, dimly seen, cry out to us for help. We want to come to their aid but their shapes are like shadows. Nor can we locate them.

Bipolar disorder is like one of these children. We have it before us in the pharmaceutical advertising, the woman going up and down on the merry-go-round and helped with ‘mood stabilizers’. Meanwhile, behind the screen there are other forms. Maybe a historical analysis will help us to see them more clearly.

Physicians have always known the alternation of melancholia and mania. The consistency of description across the ages gives the diagnosis a certain face validity, and it would be as idle to ask who was the first to describe their alternation as to ask who first described mumps. Aretaeus of Cappadocia, around 150 years after the birth of Christ, wrote of the succession of the two illnesses. It is clear from the context (Jackson, 1986, pp. 39–41) that he was using the two terms to describe what we today would consider mania and melancholia. Yet Aretaeus did not consider the alternation of mania and melancholia to be a separate disease.

For these remote centuries I use ‘bipolar disorder’ to mean the succession of melancholia and mania. A word of clarification: in the twentieth century, after the writings of Kleist and Leonhard, ‘bipolar disorder’ implies that there is a separate unipolar depressive disease.

Type
Chapter
Information
Bipolar II Disorder
Modelling, Measuring and Managing
, pp. 5 - 14
Publisher: Cambridge University Press
Print publication year: 2008

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