Previous editions of the Diagnostic and Statistical Manual of Mental Disorders additionally recognized the catchall category of “Bipolar Disorder NOS (not otherwise specified)” for manic-depressive illness that did not fit into the other categories (American Psychiatric Association, 2000). Bipolar affective disorders are classified as Type I (one or more manic episodes, with or without depression or hypomania), Type II (one or more depressive episodes with at least one episode of hypomania), and Cyclothymic (hypomania alternating with non-major depression) disorders. Patients may also have hypomania (less severe mood elevation or agitation) and depression that is less severe than the “major” variety. The new nomenclature derives from the fundamental characteristic of these illnesses, that patients have periods of mania (elevated or agitated mood) in alternation with major depression, as well as the great variability in clinical features and course that has been recognized. What by the 1950s was called Manic-Depressive Illness has now been elaborated into a spectrum of Bipolar Disorder. At the turn of the 20 th Century, Emil Kraepelin distinguished this illness from schizophrenia (dementia praecox) and termed it “manic-depressive psychosis” (Burton, 2012). Jules Baillarger identified folie á double forme (dual-form insanity) in the 19 th Century, and Jean-Pierre Falret observed the clustering in affected families of alternating mania and depression (folie circulaire). The alternation of mania and melancholy was described in the 1 st Century AD by Aretaeus of Cappadocia, who also described migraine.
“Depression” was coined later by Roman physicians, from the Latin depremire (to press down). “Mania” may derive from mainesthai (to rage).
“Melancholy” was named for the “black (melas) bile (chole)” that Hippocrates thought was responsible for low mood.
DSM-5 Category: Bipolar and Related Disorders IntroductionĮxtremes of mood have been recognized since Greek antiquity.
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