Understanding Manic Depression

Manic depression is an older term for what is now referred to as bipolar disorder. Bipolar disorder, which is the official terminology used in the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-5), is a reference to a person's swings from the manic pole of the disorder to the depressive pole.

The change from "manic depression" to "bipolar disorder" was made in 1980. It was done to include symptoms such as hypomania and exclude some others while attempting to reduce the stigma associated with the disorder.

What Is Bipolar Disorder?

Bipolar disorder is actually a group of mood disorders characterized by cyclical disturbances in mood, thoughts, and behavior. These disorders consist of alternating periods of elevated, expansive, or irritable moods, called manic episodes. They also include periods of feeling worthless, a lack of concentration, and fatigue called depressive episodes. The disorders differ in the severity of these two phases.

Bipolar I

Bipolar I disorder is the diagnosis for people who have had at least one episode of mania or mixed episodes (exhibiting symptoms of both depression and mania during the same period of time).

Updates to the DSM specify that a person with mania must present with an elated or irritable mood or both, in addition to increased energy or activity. Also, the "excessive involvement in activities" that are a marker for manic episodes no longer needs to be pleasurable, as in previous versions of the diagnostic criteria.

Bipolar II

Bipolar II disorder is the diagnosis for people who have had both hypomania (a milder form of mania) and major depressive episodes. The old description of "manic depression" did not include hypomania or the consequences that may occur with less than a full manic episode.

Cyclothymia

Cyclothymia is the diagnosis for people who have had chronic fluctuations between hypomania and milder, subclinical depression for at least two years. In addition, the DSM-5 criteria clarify that hypomanic or depressive symptoms must be present for at least half of the time during the required two-year period.

Bipolar Disorder vs. Manic Depression

A critical point in distinguishing bipolar disorder from major depressive disorder is whether the person has had a manic episode. For someone to be diagnosed with bipolar disorder, they must have had a manic episode lasting for at least one week or a hypomanic episode lasting for at least four days.

Why Did Manic Depression Become Bipolar Disorder?

In the past, "manic depression" was generally used to denote a wide array of mental illnesses. It was also a term that quickly became stigmatized. As classification systems became more sophisticated, the new term bipolar disorder allowed for more clarity in diagnosis, which has also provided a clinical term that is less emotionally loaded.

What Does Manic Mean?

Manic refers to a state of mind that involves excitement, euphoria, and high energy levels that last for an extended period. When a person has a manic episode, they experience an extreme shift in mood.

In order to be diagnosed with bipolar disorder, episodes of mania or hypomania (a less severe form of mania) must be present. These manic episodes can have a serious impact on a person's life and ability to function in different settings including home, school, or work.

Symptoms of Mania

The experience of what is known as mania is one part of the symptoms associated with bipolar disorder. It comes with its own set of symptoms, which include:

• Grandiosity
• Decreased need for sleep
• Pressured speech
• Racing thoughts
• Distractibility
• Excessive energy
• A tendency to engage in behavior that could have serious consequences, such as spending recklessly or unprotected sex

Symptoms of Major Depression

Major depression, on the other hand, is an experience that lives on the other end of the bipolar spectrum. It can also be experienced by people who are not diagnosed with bipolar. Symptoms of major depression include:

• Decreased energy
• Despair
• Hallucinations and/or delusions
• Irritability
• Uncontrollable crying
• Severe withdrawal from normal activities
• Thoughts of, or attempts at, suicide
• Weight loss or gain
  

Bipolar Disorder vs. Major Depression

You may have heard of people who were first diagnosed with depression but later diagnosed with bipolar disorder, and this can be confusing. How can you tell the difference? Keep in mind that the hallmark of bipolar disorder is the presence of episodes of mania or hypomania. These are not present in major depression.

Another common question that's asked is "Can depression turn into bipolar disorder?" The answer to that question is no, depression doesn't transition into bipolar disorder later on.

However, it is possible for someone to be diagnosed while they are in the depressive phase, which may result in a diagnosis of depression. At the time, they may not recall or be asked about symptoms of mania or hypomania that would lead to a bipolar diagnosis. Later on, with more careful questioning, or with the occurrence of a manic or hypomanic episode, the diagnosis of bipolar may become clear.

Causes of Manic Depression/Bipolar Disorder

The exact causes of bipolar disorder are not known. A number of different factors likely play a role, including:

• Genetics: Research suggests that bipolar disorder tends to be influenced by genetics. Studies have found having a family member with bipolar disorder increases the likelihood of a person also developing the condition.
• Brain function: Differences in brain chemistry and structure may also play a role. Imbalances in neurotransmitters such as serotonin, dopamine, and norepinephrine increase the risk of having the condition.
• Environmental factors: Certain environmental factors, including stress, can contribute to mood episodes in bipolar disorder, although why this happens is not known. Other environmental triggers may include sleep problems, injury, and substance use.

Diagnosis

The symptoms of bipolar disorder can be quite complex and vary for each person. A doctor, psychiatrist, or psychologist will ask you questions to get a clearer picture of your symptoms and overall mental health. These questions often focus on the type of symptoms you are experiencing, how long you have had these symptoms, and whether you have any family history of related mental conditions.

Your doctor or psychiatrist will also rule out other medical and mental health conditions that may be causing your symptoms, such as hypothyroidism, alcohol or substance use, borderline personality disorder, attention deficit hyperactivity disorder (ADHD), panic disorder, schizophrenia, and other depressive disorders.

It's an ongoing process, but one that many are hopeful will further improve the guidelines that psychiatrists use to help those dealing with the condition.

Coping With Manic Depression/Bipolar Disorder

Bipolar disorder can create challenges in your life, but there are steps that you can take that can help you cope and manage your condition effectively. In addition to seeking help from a healthcare professional and adhering to your treatment, steps that can help:

• Track your mood: Keep a journal where you track your mood and factors that tend to impact how you feel. This might include sleep habits, medication, stressful events, or other triggers.
• Practice good sleep habits: Getting adequate rest is important for mental health, particularly if you have bipolar disorder. Create a restful sleep environment and strive to got to sleep and wake up at the same time each day.
• Manage stress: Because stress can often trigger mood episodes, keeping stress levels low is important. In addition to making modifications to your life that can help reduce your stress levels, practicing relaxation techniques may also be beneficial.
• Get regular exercise: Research has found that exercise can be beneficial for some individuals with bipolar disorder. However, some people may experience worsening of manic symptoms, so using caution, going slow, and referring to your doctor if you have any concerns is important.

A Word From Verywell

Bipolar disorder is a complex mental health condition that can be difficult to understand. It can take a toll on the person dealing with it, as well as their family and friends. The good news is that treatment is available, so if you have concerns, speak to your doctor or seek out the help of a psychiatrist.

It's also good to remember that you're not alone. The stigma surrounding the disorder has been reduced in recent years, and many people—including a number of celebrities—are talking openly about their journey.