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Humans have always suffered varying moods and energy levels. The words “melancholia” for depression and “mania” for excessive relaxing of the mind born from great mental anguish, come to us from ancient Greek. The first written record of the two as separate conditions, but also acknowledging the idea of an interrelationship of mania and melancholia, is in the 2nd century AD, between the years 97-177. The Chinese authors of the “Eight Treatises on the Nurturing Life” (“Ts’un-sheng pa-chien”) in 1583 describe bipolar disorder as a mental illness. Between the years 30-150 AD, we find the earliest written descriptions of a relationship between mania and melancholia being two stems of one condition. Persian physician Avicenna wrote in “The Cannon of Medicine” in 1025 that bipolar disorder is a manic depressive psychosis that is clearly different than other forms of madness such as mania, rabies and schizophrenia.

The basis for the modern definitions for manic-depressive illnesses, including bipolar, are traced to the Jules Baillarger’s 1854 description to the French Imperial Academy of Medicine of a biphasic mental illness of recurrent oscillations between mania and depression that he termed folie à double forme (dual-form insanity). Within two weeks of Baillarger’s description, Jean- Pierre Falret described to the Academy the same disorder that he referred to as folie circilaire (circular insanity). These concepts were further developed by the German psychiatrist Emil Kraepelin in the 18th century, coining the phrase manic depressive psychosis, noting that periods of acute illness, manic or depressive, were generally spaced between intervals of no symptoms where the patient was able to function normally. Kraepelin also emphasized a psychological factor for the disorder.

Australian psychiatrist John Cade discovered that lithium carbonate could be used to successfully treat manic depressive psychosis in 1949. U.S. hospitals began experimenting with lithium on patients throughout the ‘50s, although the U.S. Food and Drug Administration did not approve lithium’s use until 1970.

The term “manic-depressive reaction” first appeared in the 1952 edition of the American Psychiatric Association Diagnostic Manual. Sub-classification of bipolar disorder was introduced by German psychiatrist Karl Leonhard in 1957, and he was the first to introduce the term “bipolar” for those with mania, and “unipolar” for those with only depressive episodes. The term was changed to “manic-depressive illness” in 1968 as biological factors became more prevalent within psychiatry. Historically, the cause of bipolar has been argued to be psychological or biological. In the 20th century, a genetic basis for the illness dominated. Throughout the ‘90s there has been a renewed interest and research into psychological processes in bipolar. To date, more studies are needed to find probable causes and ways to treat bipolar

In 1980, the term bipolar disorder replaced manic-depressive illness in the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-III). It was also during the ‘80s that research began trying to distinguish between adult and childhood bipolar disorder.

Controversy of Childhood Bipolar

Initially, psychiatrists would be professionally ridiculed for suggesting bipolar in children because there were no plausible theories that it existed in children.

A prominent Harvard University child psychiatrist, Dr. Joseph Biederman, changed all that in the mid- ‘90s. He postulated that chronic irritability in children, often those already diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), was a childhood version of bipolar mania. Then in 1999, the book “The Bipolar Child” by Dr. Demitri Papolos, stated that bipolar disorder among children was on the rise. He attributed this to increasing stress and media exposure to children and “genetic anticipation,” the idea that diseases appear at younger ages as they are passed down the generations.