For the time being this post is going to be relatively shorter (still long now I’ve typed out 😂) than I intend. I’ll be returning at some point when I have more time.
Anyway, here is the history of Bipolar Affective Disorder or dis-ease, what it is and what it isn’t and a bit about the stuff in the title.
Bipolar is not a 20th century epidemic created by psychiatry. I hear time and time again, like many other mental health conditions that have been given a name, that it’s a mere ‘label’ created by psychiatry to pathologise what is distress, usually followed by the assertion that this particular distress is the same kind of distress and normal human emotion that anyone in the world experiences.
The “What is Normal Anyway”?
‘Normal’ is normal everyday ups and downs in normal mood. It’s a 4-6 on a scale of 0-10. That incorporates normal low mood and exceptionally good mood. Not clinical depression or mania.
‘Normal’ is what happens between bipolar episodes – that is if one is lucky enough to be completely symptom free during this time. But then with bipolar, you have 0-3 gradients of low mood and 7-10 – gradients of high mood on the scale. This is anywhere but in the range of normal human experiences. The average Joe Bloggs on the street.
Here is the 0-10 scale:
And accompanying that from Bipolar UK is this chart and diary to aid monitoring changes and triggers:
What is crucial to point out now though is:
Bipolar is not just about moods. That’s just silly. Diagnostic criteria doesn’t at all restrict to mood. I find it ironic that many people who reject bipolar as a real illness are the same people who criticise the diagnostic rule book (DSMIV in particular) and even cut and paste the criteria in their critiquess yet seem to ignore the crucial points.
It’s extremely physical.
It’s not just thoughts, feelings and behaviour and even those components are not, in the main, wilfull ones.
Its about energy, elevated mood states and often a decreased NEED for sleep in mania, in depression often excessive NEED for sleep or insomnia. This is key criteria in the DSMIV (America) and ICD11 (rest of world) diagnostic tools used by professionals during a semi- structured interview.
Here are some facts and figures:
Bipolar stats within the UK population (& similarly worldwide)
- 1-2% diagnosed and incidence rates increase from 8% – 27% if an immediate relative has it (or they have schizophrenia or depression)
- Affects 60 million people worldwide. There are approximately 7.6 billion in the world.
- Takes around 10 years for correct diagnosis (initial misdiagnosis around 3.5 times)
- 21% in long term employment
- It is one of the top causes of lost years of life and health in 15 – 44 year olds according to the World Health Organisation
- 20 times increased suicide risk compared to general population and is also the highest rate of any psychiatric illness
- 25% – 50% will attempt suicide
- 10% – 20% will die by suicide
- It has a huge impact on every area of your life
- It is badly affected by stigma and misunderstanding
- 50% relapse rate in first year of illness and 70% within 4th year period
- 60% will divorce/separation
- 60% will abuse drugs or alcohol
- 1 in 4 has a seasonal pattern (think of seasonal depression but bipolar instead)
- Often a person with bipolar will have other psychiatric comorbidities – for example:
- 0.85% ADHD in females in UK
- Between 5-20% chance to have both ADHD and Bipolar if you have one of them anyway.
- 50% – 80% inheritance rate for ADHD. Heavily runs in throughout the family tree
When I first received my diagnosis of bipolar I was curious to know it’s origins beyond how I came to develop it myself.
I cast my mind back to the first real learning day at university where we looked at the history of mental illness in general. I was in complete shock. It wasn’t that I believed at all that mental ill health was a product of modern times but 1) just how far back our historical knowledge goes and 2) how barbaric the treatment these poor individuals endured.
I’d heard of lobotomies in the 20th century, that was pretty much it and terrible enough and I’ve since learned that the man who performed the most, I believe, lobotomies in the UK, over 16k, was performing what he genuinely believed was the most human treatment at the time. He finds that hard to live with that now I hear.
I mention this as it illustrates how, in more modern times, treatment is still experimental yet the best known at the moment. Not intentionally (prescribing wise anyway) I believe harmful. However…
Much still needs to be discovered and will always be ongoing I suspect. HARMS MUST BE ACKNOWLEDGED.
In earlier times treatment consisted of not just hopeful therapeutic treatment but as previously mentioned barbaric treatment, for example, euthanasia was the norm. Ridicule was the norm in Victorian times with ladies in their fineries coming to spectate the mental unwell changed up by shackles in the street. There was an era of spinning contraptions. Think of a giant equivalent of a hamster wheel for the afflicted person to run in. It was thought such contraptions would drive out evil spirits. People were once driven out of towns and villages because the other ‘normals’ were frightened and so they were also frightened and left to fend for themselves alone.
Bipolar has been around forever. It’s just had different names. In fact, once upon a time it didn’t have a name, it just was.. and has been refined. Over and over, naturally.
Aretaeus of Cappadocia was the first person attempting to group together symptoms. This was in the 1st century in Greece. He was not a psychiatrist but a physician. Not only that but it was described earlier than that, I believe in 300-400BC.
To save me from writing out a version of the history, of which I wouldn’t be able to do it justice in a short amount of time here, there are a couple of history sites I urge you to read on if you’re interested. They give a more thorough understanding of bipolar:
On a final note, once you have read the above, you’ll hopefully see why the debate used about the names/classifications changing as a reason against them being a real issue is completely unfounded. Many medical diagnosis change over the course of history and will continue to do so as further discoveries are made:
Thank goodness for the most recent change to bipolar. Certainly slit more descriptive feet than manic depressives which sounds as if us with a diagnosis are maniacs!
I’d welcome, as usual, to hear any comments, comments or questions. See below for comments section or contact me through my contact page.
Best wishes and peace all, B x