You may have heard that Bipolar Disorder used to be known as Manic Depression. This was the case until 1980, with the advent of the DSM-III. The committee over at the APA who decides these things had three goals in mind when they changed the name:

1. Reduce stigma — The APA saw that the term “manic depression” had become highly stigmatizing.
2. Provide a more accurate and clinical description of the condition
3. Reflect the alternating periods of mania and depression that characterize the disorder — more on these in a minute.

I want to clarify that while the APA laid out the missions above, they did not consult the community members who live with the condition. Many people, some of them high profile (like Kay Redfield Jamison) still prefer the term manic depression still today. To change the name of a disorder without extensive community feedback feels like a violation of autonomy for those of us who live with a severe mental illness.

But let’s address the three goals laid out by the APA with the publication of the DSM-III…

1. Although it’s very likely true that the term “manic depression” had become highly stigmatized, it seems a bit odd to assume that the stigmatization of the disorder came from what we choose to call it, rather than stemming from the people who live with the condition. Case in point, today “bipolar” is highly stigmatized and used inappropriately for a number of reasons — to refer to indecisive weather patterns, people we don’t like, and a host of other things. It’s just as bad as manic depression ever was. Why? Well, maybe the problem wasn’t the term manic depression. The stigma was never attached to the term. The stigma is attached to those of us who live with the condition, regardless of what you choose to call it. No matter how many times you change the name of the disorder, that truth would never change.
2. Many of us in the bipolar disorder/manic depression sphere actually feel that “manic depression” is much more descriptive of our lived experiences. “Bipolar” exemplifies a particular phenotype, one which is at least somewhat common among bipolar folks (and considered by some to be an archetypal presentation) but to the exclusion of others with more uncommon manifestations of the disorder. If we are to take “bipolar disorder” at face value, I am left to assume that there are two “poles” (opposites) which people oscillate between. However, this ignores the very real and unfortunately common experience of mixed episodes — when the two opposing states of “bipolar” are somehow happening both at the same time. How can they be opposite, when in fact they coexist so frequently?
3. I don’t think most people who know little about “bipolar disorder” are thinking about its longitudinal dynamics. Many people still believe that bipolar disorder is about quick shifts in mood lasting only a few hours (although these types of episodes do happen in classic bipolar disorder, they are much more rare and occur in the context of other well-known symptoms) or that bipolar disorder is the same as “multiple personality disorder”.

As it turns out, I think manic depression is both more accurate (instead of positing that mania and depression are opposing forces, when in reality, they seem to be linked and can even occur simultaneously) and, in the end, probably less stigmatizing than “bipolar disorder”. This just highlights the importance of including community input (for example, from “bipolar” patients) when making decisions like this.

What do you think? Leave a comment and let us know!