Manic-Depressive vs. Bipolar...Why?

[Squid Vicious]

Elsewhere in the pit, Polycarp posted this:

bipolar syndrome (FKA manic-depressive syndrome, and good riddance to the foul name!).

I've heard this sentiment before, and I wonder what the stygma is with saying someone is manic-depressive. I have a colleague (and friend) who is treated for bipolar disorder, so I asked him. He replied, "It's just a bunch of P.C. crap.". Well, O.K., but WHY? "I don't know." was his response.

So, I put it to you guys. What's so bad about manic-depressive disorder that the name has changed to bipolar?

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"We've all heard that a million monkeys banging on a million typewriters will eventually reproduce the entire works of Shakespeare. Now, thanks to the Internet, we know this is not true."

Robert Wilensky

[Bricker]

I think there's a certain perjorative tone to "manic-depressive" that isn't there with "bi-polar disorder."

I think a lot of the perjorative sense, though, comes from time. I suspect at one time, "retarded mental development" was simply an accurate description. But "retarded" now is regarded as an insensitive insult, and "mentally challenged" seems to be the way to go.

- Rick

[Elmer J. Fudd]

Just as pejorative "retard" has become associated with the word "retarded", so has the pejorative "maniac" become associated with the word "manic".

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Elmer J. Fudd,
Millionaire.
I own a mansion and a yacht.

[Squid Vicious]

Well, I would agree with you except in my 35 years on this planet, I have never heard the term used perjoratively. I have heard retarded, schizzo, psycho, crippled, and so on used perjoratively; but never manic-depressive. It certainly isn't a school yard favorite in my neck of the woods. As a matter of fact there are far too many syllables for your average redneck to use.

When was it "oficially' changed, and by whom? And, of course, WHY?

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"We've all heard that a million monkeys banging on a million typewriters will eventually reproduce the entire works of Shakespeare. Now, thanks to the Internet, we know this is not true."

Robert Wilensky

[Elmer J. Fudd]

What I was trying to say is that the average joe (redneck or otherwise) doesn't know the difference between "maniac" and "manic". Somewhere along the line the psychiatric community decided to remove the chance of confusion by changing the name of the disorder.

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Elmer J. Fudd,
Millionaire.
I own a mansion and a yacht.

[Mr.Zambezi]

If you have ever had the misfortune to know one of these mentally ill folks, you wouldn;t really care too much about the name of the disorder. You would just wish you hadn't met them.

[Squid Vicious]

Hey Zambezi! Did you read my original post?

What a dork.

[Rysdad]

Originally posted by Mr.Zambezi:
If you have ever had the misfortune to know one of these mentally ill folks, you wouldn;t really care too much about the name of the disorder. You would just wish you hadn't met them.

Um, no.

My closest friend is bi-polar, and I'm damn glad we met.

[Mr.Zambezi]

No need for insults. I don't know what your friends are like, but the bipolar people I have known were downright dangerous.

It is a mental illness folks. You can argue all day about what stellar folks your companions are, but it is still a defect.

[Odieman]

The way I had it explained to me Bi-polar is a more accurate description of the disease. the name and definition was pretty much limited to the classic symptoms of the disease eg. swinfgs of moods from depression to mania and back again. Unfortunately not all people who have bi-polar disorder manifest these classic symptoms. A lot of them tend to spend more time at one extreme rather than switching from one pole to the other. I know someone who usually exhibited the symptoms of depression with only an occasional bout of mania. The name change was due in part so that they could include people who don't fit the classic profile, but they still don't have only epsisodes of mania, for example.
Keith

[Bricker]

Originally posted by Mr.Zambezi:
No need for insults. I don't know what your friends are like, but the bipolar people I have known were downright dangerous.

It is a mental illness folks. You can argue all day about what stellar folks your companions are, but it is still a defect.

So is close-mindedness, and I would aver it is a more dangerous defect, since bi-polar disorder may be chemically treated.

- Rick

[Mr.Zambezi]

I don't want to get into a flame war here, but it is a disorder. That is why they treat it. It is not preferable to have bipolar disorder. That is not to say that people who are bipolar can't possibly be good people. In fact they can be a lot of fun when manic.

Bricker et al., are you trying to argue that it is good to be bipolar?

[missdavis102]

(note to self: You're gonna be sorry you posted to this topic...)

Um, as a bi-polar person myself, I will cheerfully admit to being something of a danger. I find myself having to sit on my hands in an effort not to throttle people who make blanket comments about mental illness, especially comments using the word "defect".
However, I don't ascribe any moral or value judgement to the condition itself; it is no more good or bad than any other physical condition. Is it good to have diabetes? Not necessarily, but having it doesn't make the person bad (or good, for that matter). I wouldn't want to have diabetes, but I don't shun or say rude things about those who do. So you see, it's not the condition that might make me violent, it's the attitudes I sometimes confront in society.

A mental illness is no more a defect than any other sort of an illness. Sure, my brain does not happen to produce a stable amount of seratonin over time. So what? It's chemically correctable. My mom's body produces antibodies that attack her joints (rheumatoid arthritis), and there's pretty much nothing she can do about it; it just hurts, hurts, hurts. Which is worse?
And you, you have a bad personality. I'd certainly consider that to be a defect.
See what I've been driven to? I'm already sorry and I haven't even hit the button....

As to the OP, I concur that the term Manic-Depressive has negative connotations that are not necessarily in line with the reality of the condition, and that the term BiPolar gives more space for differentiation between degrees and symptoms (I'm type II, for example). "BiPolar" showed up in the 80's, I believe, and is now the more accepted term. As with most changes of this nature, it wasn't instantaneous: all the psychiatrists didn't just get together one day and say, "Hey guys, new term! It'll confuse the masses for awhile."

[Mr.Zambezi]

I don't really have a mission to prove this point. My first wife was bipolar/schizoaffective. She did many, many dreadfull things and I was told by her doc that this was typical. I am highly biased, but clearly do not have the credentials to make blanket statements about the disorder.

I appologize. I was out of line. I just can't get over the experience I had with my bipolar ex. I am relying on what mental health specialists told me at the time, but I certainly can't vouch for the accuracy of those statements.

[woodja]

Well, if they said she was bipolar and schizoaffective they weren't very knowledgeable, since you can't have both diagnoses at the same time, by definition. Your problem is either primarily mood related (BP) or primarily psychotic with mood features (schizoaffective).

[Mr.Zambezi]

Well then I am very misinformed. I will try to refrain from talking out of my ass in the future.

[OpalCat]

Well it's nice to know that everyone who has ever known me wishes they had never met me. UndeadDude, I'll grant you a divorce if you want to leave me. I'll just go curl up in the closet now so I don't inflict myself on anyone.

[OldBroad]

I think it is more than just pc. It is also an effort to de-fuse the often strong reaction to the original term. Although manic-depressive is certainly the best description, IMO, there is still a real stigma having to do with any sort of mental disorder. Witness the difficulty of getting insurance plans to open up payment for mental illness. They'll pay if your bones break or if your liver, kidney or heart fail; they'll pay if your brain blood supply isn't right, but not if your neuro-transmitters don't work right. Most insurance limits on mental health issues are laughable.

[TubaDiva]

Opal, that's not what's going on here, not at all.

Cut yourself a break here, and us too.

It's not an easy thing you're going through, and it's not easy for other people to see you going through it. This is true both for people that care about you and people that don't know you. It's just a damn hard thing, very scary for some, too. People tend to react negatively to things that scare them.

Mostly people just want you to get the stuff you need and to get better.

your humble TubaDiva

[Milossarian]

(Attempting to lighten the mood ....)

I thought 'bipolar disorder' was when Robert Edwin Peary and Roald Amundsen trashed their hotel room.

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"You should tell the truth, expose the lies and live in the moment." - Bill Hicks

[Anti Pro]

This is about using more specific terms to describe a condition. I know when my son, Billy started having seizures when he was three (he's 15 now). I asked 'is this epilepsy'? The doctor hastily said that it wasn't it's 'seizure disorder'. I then wanted further clarification and we ended up with, yeah, it IS epilepsy, but we don't like calling it that. My mother in law acted as though Billy had leprosy, she didn't want to hug, or touch him in anyway, while staying close to my older son, DJ. It hurt Billy terribly, because he didn't understand what predjudice and fear even was yet. Which is what this comes back to in the final analysis. Billy's brain misfires for some unknown reason, medication works, but the dosage has to be reworked ALOT.

I think of bipolar much the same way, except it has the additional stigma of 'mental illness' behind it. While Billy has suffered predjudice because of the condition, he hasn't been slapped around and told to 'pull himself out of it'.

The brain is a fantastically wonderful thing, but it is also mysterious. There is no history in either of our families, though in the 'good old days' they wouldn't have admitted it anyway! But, Billy is still a person of multiple talents, he isn't the EPILEPSY, he just has it. Most all of these conditions are treatable, it's the 'attitude' that comes along with it that can be more of a obstacle to overcome than the condition itself. And I don't mean the attitude of the person, I mean the rest of us. I didn't care about calling Billy's condition epilepsy....I finally had a NAME to go with what was happening to my beloved little boy. There is some comfort in just knowing what the IT is. And remembering, you're not the IT, the job then becomes convincing others, and diminishing the fears these names evoke.

I liken it to, Billy knows what he has, what he has to take for the seizures not to happen, and how straightforward I am about talking with him, he also has experienced ignorance, a condition NOT known to have a treatment to go along with it.
-----
Judy


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"Consider it a challenge.."

[woodja]

I think at least part of the renaming has do with changes in diagnostic criteria and the current model or conception of the illness. I believe it was changed in the DSMIII, and there were slightly different criteria for being diagnosed with bipolar disorder than previously for manic-depression. The diagnostic classifications are meant to, a)allow agreement on what spectrum of symptoms constitute a certain illness and b)reflect the current conception of what exactly is going, physically and mentally. Also, in some the mania is relatively mild, not much worse than a normal highly energetic person, while the depression is very deep. Or the reverse can be true, or a myriad of other courses of illness.
Bipolar disorder type one (BPDI) is closest to the classic manic-depression diagnosis but accounts for a wide variety of non-classic variations, like hypomanic episodes and mixed episodes. Bipolar disorder type two (BPDII) has different criteria. http://www.mentalhealth.com/dis/p20-md02.html has some good information on this.

[Cartooniverse]

Seems to me that this thread is unravelling into two topics. The history of mentally ill people being mistreated is the stuff of a thousand Doctoral Theses ( sp? ).
The clinical approaches to the treatment is another issue entirely. It's nice to see that people are able to separate the two, because the societal aspects, opposed to the clinical ones, are a different animal entirely.

Cartooniverse



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If you want to kiss the sky, you'd better learn how to kneel.

[AHunter3]

The psychiatric profession's inability to isolate and define its terms, combined with the large gap between the efficacy of available treatments and the efficacy that they'd like to claim for themselves has led on more than one occasion to New Name Syndrome.

Certainly, among those diagnosed as manic dep or bipolar are people who are very glad to have the medications that are available, and there are even a few who will praise the electroshock machine for saving their lives.

Quite aside from these, politically and morally, are those (diagnosed or not) that other people would be very glad to see medicated, whether "for their own good" or because "they're driving me crazy", or a combo of the two.

Not everyone in the latter category objects to their mental and emotional state, volatile though it may be; and even among those who do are many who have tried the available treatments and prefer the condition to the therapy.

The author Kate Millett, for example, does not regard herself as having a "disease", and is among those of us who are not comfortable with statements like "they are not bad people, they are sick and they need your enlightened attitude and they need their meds".

In my case, a later diagnosis of paranoid schizophrenic sort of tended to overshadow the manic dep (attitudes towards schizzies are usually even more extreme), but my attitude towards the mental health system never changed. Personally, I strongly prefer terms like "nuts", "crazy", or "lunatic" to terms like "mental illness", "decompensated", or "disorder", because the latter terms imply a state of scientific understanding and possible treatment that the psychiatric profession does not in fact possess.

Be that as it may, to those of you who happily make use of lithium carbonate, MAO inhibitors, or whatever and who prefer to be viewed as having a treatable condition rather than as a looney, no offense intended and my best to you.

(As long as you support my right to remain untreated for each and any condition that the psychiatric profession may deem me to have).



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Designated Optional Signature at Bottom of Post

[woodja]

AHunter3
Fair enough, assuming you are not a danger to yourself or others due to your unwillingness to undergo pharacotherapy, which I agree is wanting. I specify the danger aspect because there are some who cannot control their illness without chemical intervention and are a danger. I think it's reasonable to insist on medication in these cases for the same reason I think it's reasonable to forbid epileptics to drive: it's not fair to the innocent bystanders.
As far as naming goes, I agree it doesn't matter much to most people but it's important for doctors to agree on names because treatments are based on the symptom clusters those names describe, and even though the correct treatments aren't to great, they're usually better than the wrong ones, or none at all. Then to, there are a lot of observable organic differences in people with these various disorders, so to say there is no understanding in the scientific and medical community is not quite true. We just don't know enough yet to help as much as we'd like. I do genetics research on schizophrenia and bipolar disorder at the University of Pittsburgh, and I can tell you there are a lot of people trying to make it better.
all the best

[Jeannie]

Hi. Okay, maybe no one wants to hear opinions on the original topic anymore, BUT in my very humble opinion, I think that pblic opinion has a lot to do with why the names of disorders and/or conditions are changed from time to time. I work with adults with developmental disabilities (I know, it has nothing to do with mental illness, but I do have a point...I think). The people I work with generally refer to themselves as "mentally retarded." They prefer that because it is the simplest and most accurate way to describe their situation. In fact, that is the diagnosis that most of them have. However, we staff members are frowned at when we use those words. People tend to think of "retarded" as a dirty word because some small minded people have made it an insult by using it out of context to be mean. So then they used "mentally handicapped" for a while, until someone decided that "handicapped" was a word with bad connotations. So now, we use "developmentally disabled." Some of my co-workers are starting to have a problem with that one, too, and prefer to use the initials "D.D." I figure that they'll use that until someone decides that term has become a stigma and they'll come up with something else. Just my opinion....

[foolsguinea]

What a lot of you are describing is what was called in the original post "a bunch of P.C. crap." People who object to a term having negative connotations try to cheat by using a NEW NAME. Also, I find the description of health professionals as pretending to know more than they do wildly plausible. But maybe "bipolar" has caught on as a term in part because it's a shorter word?
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"The universe is female, eluding the science of men...." Steve Kilbey/The Church, "Essence"

[Doctordec]

Just the evolution of language in America. Plenty of words were made more P.C. before anybody knew what P.C. was. Some examples...
Harelip became Cleft Palate, Pinhead became Microcephalic (I think), Gimp became Physically Challenged, Retard became Developmentally Disabled, Queer became Homosexual, Mick became Irish-American, etc.
Anytime a label grows offensive, it will change, as often as needed.

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"Hope is not a method"

[Cooper]

If you have ever had the misfortune to know one of these mentally ill folks, you wouldn;t really care too much about the name of the disorder. You would just wish you hadn't met them.

Some people respond very well to treatment, so well that you wouldn't ever know they were bipolar unless they chose to tell you. My father for instance. I'm sorry your wife couldn't be helped, but this is an extremly ignorant statement, and has no bearing on the question.

[Nekosoft's Girlfriend]

I was diagnosed as being bi-polar a few years ago, and after spending a lot of time and money at therapists, I am going to say that Odieman and woodja have the answers I best agree with. Basically the medical definition for "manic-depressive" is much more specific than the new definition for "bi-polar." This way doctors can diagnose more people as being bi-polar.

My thought on this is the same as ADD/ADDH. When I was a kid, kids were "hyperactive" or just "bad kids." Now they can't help but be disruptive in class because they have "ADD." In the same way, I was considered unstable, or crazy when I was younger, but now they can diagnose me as bi-polar.

Basically I think that American people don't like to blame themselves for their problems, so they like to have excuses. "Oh, officer, I'm sorry I hit that guy, but I must be in one of my manic states, you see, I'm Bi-polar!"

It's also a great money making idea for the Pharmacies!

[Harmonious Discord]

Someone hears your Manic-Depressive and they think your always a suffering from depression. They hear Bi-Polar, and they get a better idea of your mode swings. You can get super happy too.

From the last few days posts, can you tell my mood?

OpalCat:
I would like to know how you are cooping about now. Start a new thread. I think a few people would like to hear an update.


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I'm only your wildest fear, from the corners of your darkest thoughts.

[Harmonious Discord]

OpalCat:

I usually talk about my problems so others see that they're not alone, and the can get help. I'm who I am, and that's that.

Diagnose of a problem is the first step to your feeling better. Things will get better. It's an on going sometimes slow battle, but you will find things getting better as you and the doctors work at it.

[Boris B]

I think Phobia is right. Laymen have heard "depression" but they haven't always heard "manic". If you read Douglas Adams' Hitchhikers' Guide to the Galaxy books, it's pretty clear that he thinks "manic" means "very", since people often refer to (the clearly unipolar) Marvin the Paranoid Android as a "manically depressed robot". Which raises another point, both Adams and Ozzie Osbourne (in "Paranoid") seem to treat paranoid as meaning "depressed".

So the point is, you need to refine psychiatric terms a lot to keep from confusing the masses. (Not that Ozzie and Douglas are anything short of brilliant, but they're not really experts.)

By the way, Milossarian, I love your joke and will tell it incessantly at cocktail parties for the erudite.

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Any similarity in the above text to an English word or phrase is purely coincidental.