3 Reasons I Take Issue with “Bipolar Disorder”

Last Updated: 23 Nov 2020

As we learn more about our cognitive disorder, the brain/mind, and mood, it’s natural that the names of various diagnoses will evolve, or change. But I am not convinced that “bipolar disorder” is a good representation of what I (and others with this diagnosis) experience. Here’s why.

manic depression versus bipolar disorder name problematic mood spectrum

In 1980, the DSM-III changed the name of our cognitive disorder from “manic depression” to “bipolar disorder” (with types 1, 2, and “not otherwise specified,” NOS). Later editions of the Diagnostic and Statistical Manual of Mental Disorders, DSM, have attempted to add greater specificity, literally with “specifiers” by the fifth edition.

The Problem with “Bipolar”

Although I do appreciate the effort to bring clarity, I think the word “bi-polar” sounds like a reference to two ends of one pole, suggesting that you’re either here or you’re there. Sort of like a sliding scale.

That just doesn’t ring true for me; I usually experience symptoms from both ends of said “pole” at the same time! Depression can come with delusions of grandeur; hypo/mania can come with suicidal ideation.

If I had to sum up my feelings in a given day as either “high” or “low,” I could do that—but it would be a poor representation of my experience. And I think that might be true for many of us.

Consider the following understanding of mood and emotion, as defined by the authors of “Historical Underpinnings of Bipolar Disorder Diagnostic Criteria”:

“In a broad sense, mood can be described as a spectrum, describing how the various expressions of human happiness and sadness may be experienced. The outermost ends of this spectrum highlight two states which are linked to mental illness and are experienced in bipolar disorder: the lowest low, melancholia, and the highest high, mania. These mood states can also exist at the same time and overlap with the expression of emotions of conflicting affective states, such as irritability with elation.”

“Bipolar disorder” doesn’t suggest a spectrum of mood. The word bipolar defines our experience as either/or, black/white, manic/depressed. Yet there is much more that we experience “between” the “poles”—including stability.

As you can see, I really struggle with the either/or mentality.

The authors also touched on this problem, in a section called “A Bipolar Spectrum,” which explains how categorizing mood à la the DSM-III is too restrictive because it “assumes that there are clear boundaries between disorders and that the extremes of mood exist in polarity. This is in contrast to the … understanding in which all mood dysfunction exists in a spectrum, and the existence of mixed episodes is evidence which supports these ideas (e.g., if mood was truly of a polar fashion, symptoms of mania and depression could not exist together in time).”

I take issue with a few other reasons cited for this change, from “manic depression” to “bipolar disorder,” too:

A Rose by Any Other Name …

Reason #1: Because the term “manic” has been stigmatized beyond repair.

Seriously? I mean, they list the song “Manic Monday” by The Bangles as proof of this. I wish I could go back in time and show them this pic of a “bipolar” donut so they would see that one can’t run from stigma.

Reason #2: Because “manic depression” seems to exclude the physical and cognitive symptoms also present.

Strongly disagree here. Anyone who thinks the terms manic and depression exclude physical and cognitive symptoms has probably never experienced mania or depression.

Furthermore, how exactly is the word bipolar any better at explaining the physical and cognitive symptoms?

Reason #3: “Bipolar” is a more clinical term, and thus less emotionally loaded.

Oh, now they’re jumping to conclusions about my emotional reactions? No way, José! See #1—the stigma will follow us. We can’t hide from it or wrap it up in euphemistic “clinical terms” to make it more palatable.

And, frankly, I’m insulted that they thought (recognized) that the name “manic depression” was “too emotional” to stomach—and then tried to “dumb it down” for us! Let’s just keep it real, docs; this cognitive disorder ain’t easy to manage, and I think everyone needs to know this.


Call It What You Want…

Just for fun, I’ve been brainstorming other names for our disorder:

  • Cognitive Regulation Disorder
  • Atypical Cognitive Functioning
  • Cognitive Processing Disorder
  • Atypical Neurotransmitter Response
  • Tangled Brain Web

…OK, that last one’s just a joke.

Thank you for listening to my rant! I’d love to know your thoughts—Do you think the language switch from “manic depression” to “bipolar disorder’” was a good move? Can you think of a better name?

Changes,” by David Bowie
Manic Monday,” by The Bangles
Across the Universe,” by The Beatles
Across the Universe,” (covered) by Fiona Apple
Manic Depression,” by Jimi Hendrix
*I often get mentally bombarded with a certain song or musical style when I’m writing, and I’ve come to embrace it—so these are my musical muses for the post. Please note, I’m sharing links to the songs for convenience of listening—it’s not about the video element at all.

About the author
Brooke Baron has a BA in English, a minor in philosophy, and a lifelong obsession with language. She is the author of A Beginner's Guide to Being Bipolar. Although born and raised in Alabama, she has been a proud California resident for 10+ years. During a professional stint in Silicon Valley—in both the corporate and private business sectors—she handled internal and external communications, office design and construction, photography and graphic design, executive assistance, and functioning on very little sleep. Brooke now specializes in "New Human Orientation" from her home in the suburbs. She has a young, loving, growing family of five and is fueled by that love and coffee. In addition to caring for the rest of Team Baron, she enjoys writing, reading, researching miscellaneous topics, and funneling manic energy into creative projects. With so many balls in the air—including bipolar II disorder—balancing her life is like balancing two kangaroos on a see-saw. She offers consulting services for the bipolar community at Better Bipolar Balance.
  1. I’ve always known the disorder as bipolar since I was a kid (first in reference to my dad’s diagnosis and then later my own). Manic depression sounds too harsh or old-timey to my ears. I agree that it’s more of a spectrum disorder like autism. I think changing the name could be a way to take the edge off when talking about it with other people. I feel like saying, “I’m on the bipolar spectrum,” sounds better and more true than, “I have bipolar disorder (or manic depression).” That way the other person knows that my bipolar symptoms aren’t necessarily going to manifest in the same way as someone else’s. We definitely need to get rid of the 1, 2, and not otherwise specified thing, at least. I think there’s a weird stigma surrounding the different types. I once had a psych professor insinuate that Type 2 is the “good” kind of bipolar. She said she had a friend with that type who, when she was hypomanic, just got really fun and super productive. Not only was it a problematic description of the symptoms, but it made me wonder why my type was “not otherwise specified” and if I could learn to harness my mania in a way that could help me be more productive, even though that’s not really a thing.

  2. I thought I was the only one who thought this way. I prefer the older term simply because I find it to offer a broader sense of definition. Bipolar is so specific. There are many kinds of mania and depression, not merely one of each. As someone who has a bad history of mixed states, I prefer the spectrum view as well. I refer to it as manic depression, as in the manic depressive spectrum. But that’s just me.

    1. Thanks, Christian! I’m so glad to know there are others like me 😉


      1. I like Manic Depression better with an emphasis on it being on a spectrum. Bipolar sounds so harsh. There is too, much stigma surrounding Mental Illness anyway. I am Bipolar, my Son and my Granddaughter, too. It’s very difficult at times. You would think we would understand each other better, but because of the stigma our family doesn’t understand us. Think it’s an excuse for bad behavior. Oh, see she is being Bipolar!

  3. I often refer to it as a glitch in my brain that prevents me from drinking alcohol (My excuse to friends that want to know why I don’t drink.) I definitely experience both ends of the pole together quit frequently. Energized yet irritable and easily pissed off when I was in a good mood for example. I got mad at the pharmacist for telling me what she gave me was something it was not, and I drove back to the pharmacy and pitched a fit that she cost me $60 for something I won’t take and I was unemployed. Medicine was a life saver for me. I asked the doctor where lithium had been all my life. If I miss even 1 day of my meds I have horrible insomnia. I am in a good mood but I’m very lazy and I don’t know if that is the bipolar or the meds. I had terrible hypersexuality which was cured with meds, but nobody ever talks about it much. It’s the stigma of the stigma of bipolar. Even people with it won’t talk about it in articles about living with bipolar. It’s a shame because that was what made me think, “oh, I guess I do have bipolar disorder. I like some of the names you listed. One of my therapist called it a circadian rhythm disorder.

    1. Thank you for your comment, Michelle!

      Re: discussing hypersexuality — agreed that it’s a subject rarely approached. I think it’s because disclosing that kind of stuff can damage our relationships, our reputations, and our egos. For what it’s worth, I HEAR YOU (if ya know what I mean :)).


  4. This read is exact to the way I feel about living with bipolar2. I also like to refer to it as having a sickness in my brain not a mental illness.

    1. I like Manic Depression better with an emphasis on it being on a spectrum. Bipolar sounds so harsh. There is too, much stigma surrounding Mental Illness anyway. I am Bipolar, my Son and my Granddaughter, too. It’s very difficult at times. You would think we would understand each other better, but because of the stigma our family doesn’t understand us. Think it’s an excuse for bad behavior. Oh, see she is being Bipolar!

    2. I’m so glad it resonated with you! Thanks for the comment.


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