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 Marcia Purse

Called Manic Depression or Bipolar Disorder Stigma Persists

By June 16, 2009

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Manic depression is another term for bipolar disorder. Manic depression, a phrase that describes the extremes of mood associated with bipolar disorder. A phrase with origins rooted in Ancient Greek where the coupling of the words was used as early as the first century to describe symptoms of mental illness and an official title of the disorder coined by Emil Kraepelin in 1902.

Over the last few days, I’ve been researching the etymology – the development and use of a word or phrase through history and across languages – of the axiom manic depression. (Yes, I know I’m a complete word nerd.)

What is particularly interesting about the term manic depression is that in the last decade the medical profession, psychiatry specifically, has made a concerted effort to shift the vernacular to the now official DSM diagnostic term of bipolar disorder. There are a number of reasons cited for this shift:

  • Bipolar disorder is more of a clinical term; less emotionally loaded.
  • Manic depression gives emphasis to the predominant emotional symptoms, but implies exclusion of the physical or cognitive symptoms. The term also excludes the cyclothymic or hypomanic (bipolar II disorder) versions of the disorder.
  • Manic depression has been greatly stigmatized. Consider popular phrases such manic Monday, Animanics, homicidal maniac, etc. And depression is now generally used as an everyday replacement for the word sad or tired.

The diagnostic and clinical applications are most often referenced by medical professionals. But those with the disorder talk more about how manic depression is bandied about as if it is no more serious than the common cold.

What is wonderfully ironic is that it took centuries for the expression manic depression to become politically incorrect. It’s taken less than a decade for the replacement title bipolar disorder to reach the same status. I did a search on Twitter looking for other members of the online bipolar disorder communities. Tweet after tweet came up with the phrase “bipolar weather” referencing a sudden change in the temperature or precipitation.

Raisinear posted in our Forums about this very thing venting about how a person referenced their bipolar landlord because he is unbalanced and unpredictable. Raisinear pointed out that bipolar disorder can also be used interchangeably with brilliant, creative, energetic or artist.

She asks, “Should I just walk away from this, knowing that nothing I say will get through to them or should I try to educate them about why equating "unpredictable and unbalanced" with bipolar is hurtful and, for lack of a better word, just plain wrong?”

What advice do you have for Raisinear? ~Kimberly

June 18, 2009 at 8:12 am
(1) Martin says:

Hello, I can only agree with you on this, and in a way, I get daily proof. I use Google’s email “alert” service to send me new articles based on the word “bipolar”. I get maybe a dozen links each day.

The breakdown of these links is always much the same … usually a couple of news stories involving violence where someone’s bipolar disorder is quoted, a couple of articles (often about celebrities) who have used the word bipolar non-medically, then the rest would be actual articles and blogs about bipolar.

I don’t know what it means, but I’ve definitely noticed a rapid increase in the use of the word bipolar, and perhaps also in the awareness of the condition, but how accurately I don’t know.

June 18, 2009 at 8:51 am
(2) Sarah says:

Martin is 100% right-on! I also see these alerts every day and have been struck by how they are dominated by dubious claims of “bipolar” from people looking to construct a criminal defence (on my Bipolar Lives website I explain the research that shows how a person with manic-depressive illness is far more likely to be a victim of a crime than to commit one), or celebrity rants where the word is used as a prejorative intended to be synonymous with anything they don’t like. I think the reality is that in popular culture “bipolar” is a slang term that is bandied around very freely – BUT that is why I have my website, and I do try to educate people in personal conversation. It is like anything though – you have to pick your battles and some folks just don’t want to have one less word in their vocabularly of abuse.

June 18, 2009 at 10:47 am
(3) John Thompson says:

It’s important to keep it in perspective. By calling someone out on their usage of the word, you are setting up yourself for your own definition. You mentally confirm your condition as distinct from their misuse. It also offers them the opportunity to define the correct use as what they see in you, as if your symptomatic behavior defines the condition universally.

It all adds up to defining yourself as “bipolar”. I’d let it lay.

June 18, 2009 at 12:34 pm
(4) cribwinner27 says:

Hi Raisenear,

I try to follow the advice someone gave me some time ago. She said if you want to get closer to a person (have further interaction), maybe you should say something. If not walk away. I can’t always do this but I try. Sometimes I just feel compelled to say something, especially if they are making a joke about it. At these times I don’t identify myself as bipolar because it could bring more ridicule which I don’t need.

June 19, 2009 at 8:12 am
(5) Ben says:

My wife has bipolar II with rapid cycling. She is unpredictable and unbalanced much of the time. What’s wrong with the truth?

June 23, 2009 at 10:30 am
(6) Traci says:

Unfortunately, where I live, manic depression and bipolar disorder are all the same to people. They think it is just a big problem that cannot be controlled. I have to keep it a secret because if I say it, I might as well say I am practicing voodoo and slaughtering animals and bathing in the blood.

June 23, 2009 at 11:04 am
(7) Scott says:

I agree with Ben. We ARE unpredictable. We ARE unbalanced. The heartache is that our symptoms 1) sometimes come and go as they please (making us appear capricious), and 2) can be indistinguishable from deadly sins (hypomania looks like promiscuity, depression like sloth). Educate, educate, educate. That’s all we can do.

June 23, 2009 at 11:22 am
(8) George says:

The stigma of mental illness still exists and can be very damaging.

However, I feel strongly that the huge numbers of us who are more or less successfully treated for bipolar and more or less as “normal” or “stable” as the next guy/gal should speak out when we feel it relatively safe and appropriate to do so.

Reputable and upstanding people coming out of the closet, as it were, is the most powerful way to attack a stigma. Just ask the gays and lesbians.

June 23, 2009 at 11:36 am
(9) Kenn says:

Stigma interests me a great deal, as I’m also living with HIV.

I almost feel defensive in talking about my bipolar II condition, particularly around other recovering alcoholics who look skeptical when I tell them I was diagnosed before I stopped drinking. The implication is that now that I’m stopped, the bipolar should be less of a problem. Indeed it has been but I’ve been taking medications of one kind or another for it all along!

Someone else has had terrible experiences with psychiatrists and meds so she’s very worried about me and seems to be re-living her experience through me.

I guess I just have to pick and choose who I confide in. After giving up Seroquel because of elevated blood sugars old-fashioned lithium has kept me stable – and I don’t want to fight that!

June 23, 2009 at 12:56 pm
(10) Tami says:

I agree with you all, that it seems like anyone who has a mental disorder is labeled BP. We can see it in the TV shows and movies, as well. It makes me cringe to see some whacked-out person on TV that is killing people or throwing babies off the roof classified as BP.

The problem is, as many of you have mentioned – we all act differently. Firstly, if we weren’t BP we’d still have issues. Look at “normal” people who overreact, change their minds frequently, complain a lot and so forth. Then, add the “normal” issues we have to being BP and it causes major differences in the way people see and label us. Sometimes when I feel or react a certain way I do question whether I’d have done the same if I was not BP.

So, yes! Educate the public, that’s true, and most of us seem to understand we have a problem and seek treatment.

Hugs to all!

June 24, 2009 at 9:51 am
(11) Lori says:

If I hear this statement once, I hear it ten times…”I think all of us are a little Bipolar.” Those who say it have no idea how it belittles and downplays those of us who actually do have BP.

If that’s the case, then why do I have to have my meds just to make it through the day? Meds that are still being adjusted to help me.
If people can understand a thyroid problem, for example, why can’t they understand that mental disorders DO exist? Why can’t they comprehend that the brain can have problems, just like the heart or kidneys or liver or any other organ in the body?

June 25, 2009 at 2:12 am
(12) Cedric says:

Many people believe human disorders are caused by the brain. I have discovered the interbreeding of the various caucasion races with the different shape skulls & eye socket shape has caused incorrect formation of the muscles & cranial nerves around the eye, once the cranail nereve is in peril many disoders like dpression, add & bipolar disorder occur. I have done self testing and experinting to find out that when the cranial nereve is in peril the eye actually becomes retarded. The transfer of images to the brain are slowed down vastly. All the muscles in my body are stressed when the cranial nerve is in peril as well. My thoughts patterns are coherent when the cranial nerve is relaxed as well. an operation to correct his has not been tested yet. there is an ape group with a similiar problem that has a lot of sex to relieve the stress in the muscles similiar to me relieving myself way too much. I believed I have discovered the answer to bipolar disorder!

June 25, 2009 at 12:45 pm
(13) Diana says:

For the most part, the people (friends, family, co-workers) I have told about my disease have been pretty supportive. It is the healthcare providers which have caused me the most problems. Changing the name to “bipolar disorder” hasn’t made a difference to the discrimination that I have experienced. Just last year, I was not believed when I told the docs/nurses that the pain I was experiencing immediately after knee surgery was excruciating. Instead, the doctor sent for a psych eval. Later it was discovered that the epidural line had fallen out and no pain medication was actually been going into my body. As you can imagine it was a tough couple of days. Finally, a physical therapist realized the line was out when she was moving me around.

These are medical professionals, but they saw the bpd in my chart and believed that I wasn’t to be believed.

This is just one example of discrimination by healthcare providers. Because of the many surgeries/recovery that I’ve experienced, I could tell you many examples of such discrimination. Don’t worry I won’t bore you with another story.

Maybe education can change beliefs and misconceptions. But I’m not that hopeful it will change the medical professional’s mindset.

June 26, 2009 at 12:35 am
(14) mithi says:

I believe there will always be stigma attatched to mental illness in general.We also can not change the perspective of every one.We can make changes in the perspective of those around us,and we can do this through education.I work in a high paced work environment when I first started my job I had not even been diagnosed yet but I was still in the mental health system.
At the time i was diagnosed as border line personality disorder.I found all the info. I could find to give to my boss to help him understand what I was going through.I was very unstable at the time.
Now I have been diagnosed with bi-polar 1 rapid cycling and have to go through the eduction process all over. My boss still wants to try to understand.
I guess I am trying to say is we should give the “normies” a little bit of credit.
When there is stigma take it as a chance to educate.That may be all it takes to change someone attitude about bi-polar and mental illness as a whole.

June 27, 2009 at 6:32 pm
(15) Linus2 says:

I’m sorry, but I couldn’t disagree more regarding your opinion on stigma. I was pushed out of my church by old biddies, driven out f town by friends who didn’t care or want my friendship any longer. They were AFRAID. Ignorance causes anxiety. You are wrong. Come out of a mental institution and see what happens to you. You were in anonymous situations I think and the people do not know you. You should ask others, think about it and rewrite the column. You should also have an email people can contact you with.

July 4, 2009 at 11:48 pm
(16) better off says:

My husband left me when i was diagnosed with BP II, and told my daughter that i was ‘insane’ so she would have to leave with him. the pain was indescribable. but now with him gone (I remain in contact with my daughter)i am doing much better! in fact, many have remarked that i am flourishing. i stay on my meds because i am afraid of going back to where i was. But yes the stigma is there and my ex is using it when he speaks of the divorce, referring to me as insane.

August 15, 2009 at 12:32 am
(17) susanilj says:

Wow. What a bunch of articulate people in this forum.Adding my 2 cts.–I found out long ago, I don’t even tell my ‘other’ drs. what I have-they too have their own ignorances.If asked why I’m taking particular meds.-I say because I’m sick.Some of them are so ill informed-they don’t even go further.-then they get back to treating the prob. I came there for.
As far as my telling someone I have bp-nooo thanks, I know for a fact we are stigmatized, laughed at, called insane,whispered about,left for dead, blah, blah,blah.-and YES–people are AFRAID! OH! it’s catching !
One could imagine how painful a broken limb is,or plug their ears to imagine being deaf–but there is no way one could “imagine” what bp feels like.
One day you’re o.k. and the next day, or even an hr later you are crying, or too happy-yes we, know that feeling,or can’t seem to move out of the chair we’re in. The ruminating,the fears,the shame-if you feel that..the inability to control a mood-who could EVER understand that-if they hadn’t experienced those symptoms?It defies description.
Don’t waste your breath trying to explain it to others-for when normal moods surface, they will be interpreted as another bp attack too.
It’ll always be used as an attack word,why give them the ammo?
Before I was diagnosed, I saw many peoples ills-just by observation, and felt a quiet pity,thinking what a sad bunch we all are.And as I told my p-doc, we are all an accident away from having a mental disorder,a base ball to the head could do it.
So,to all you non-bp’rs..practice the sentence, ‘there by the grace of God go I’-and hope he hears you.

September 10, 2009 at 8:40 pm
(18) john P. says:

I have heard about this. A good site to look at is manicdepressioninfo.com

November 24, 2010 at 12:04 am
(19) john f says:

After I was hospitalized in 1989, I felt like a real zombie on stelazine. but completed a masters degree.
i tried to deny to myself that I had this problem.
for years, i tried to run from state to state and job to job. i was unaware of how sick i really was and was unwilling to face it. now 20 years later, after making an extreme ass out of myself as i finally gave into disability, with the help of others I learned to hate myself for it and set out to destroy myself. somehow i ended up on triliptal and feel i have another chance at life. i feel i owe it to those others with this problem not to stay quiet. but i have found it best to hideout and never tell anyone but a chosen few. bottom line. even the most open minds will have trouble believing this or accepting this. the subjective experience for me has been a meaningless life and time lost. all my best years and best relations down the drain or somewhat fragmented that i deem them as somewhat meaningless.
good luck to all with bipolar. john

December 28, 2010 at 8:16 pm
(20) bpdietitiab says:

I can’t really figure out what happened today. I went into our urgent care health centre in our small town. I also work there. I was sick with bronchitis and my son too. Another patient who I know from the daycare was there. In front of her, I am asked about meds, so while trying to remember, she says lorazapam (ativan) and I was offended the way she said it. The I told her the mood stabilizer drug I just started and I am not sure but I think that she looked at me sideways. Then I said that I was hypomanic the previous week and she cut me off. I tried to explain that I was working hard, got run down, but the assessment was OVER.

Another child arrives with similiar symptoms in the gurney besides us. Her son gets a similiar examination but then he gets tylenol and does’t have the coughing that my son had. After about an hour, fatigue hits and then I remember the nausea, I’ve had each night. Next time the nurse passes, I tell her and she says to tell the doctor, she is too busy. Remember, I report to the same rounds she does and work with the same doctors.

I became tearful and left without treatment. I know that the physical illness is also related to having just weaned off antidepressants. But does being bipolar mean I can’t receive as good care as the woman from the daycare or the other child?

August 12, 2012 at 3:31 am
(21) Jams says:

Being bi-polar simply sucks. No one else “gets” it and the stigma still rages. I tell no one. Screw that. My hands are full enough just getting through each day.

March 10, 2013 at 7:14 pm
(22) Learn to learn says:

When you want a new term for something you should create one ie Internet. You don’t steal one from other fields of knowledge. The term bipolar comes from physics. And btw you’re not bipolar, you have a bipolar disorder, it would be like saying I’m schizophrenia.

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