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.
In 1980, the DSM-IIIchanged 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.
“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?
Soundtrack* “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.
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.
Enhanced primary care helps reduce ER visits October 1, 2020, CHAPEL HILL, NC—Integrating primary care services and behavioral health services appears to reduce emergency room visits among people with severe psychiatric conditions such as bipolar disorder, a new study suggests. American researchers, using the customary term “serious mental illness,” noted that individuals with such conditions...
Mixed episodes of mania and depression aren’t easy to spot, but when they hit, they’re among my most exhausting experiences. Not only did I learn how these mood episodes affect me, but I realized the risk they carry—and that is my biggest fear. “Mood Episodes with Mixed Features,” aka Bipolar Mixed Episodes Something that I...
Whether you live with bipolar or love someone who does, you can find comfort, wisdom, and strategies (maybe even a good laugh!) in these inspirational books. We can lose ourselves in the power of the written word, compelled by the raw emotions, deep insights, and humorous takes offered by others like us—people who share our...
This past year has been challenging, and the upcoming holiday season is likely to be no different—especially when we’re feeling isolated. To stay out of the holiday blues or bipolar depression, I am approaching this season proactively, tackling loneliness directly and finding ways to be festive and joyful. Feeling Lonely & Isolated During the Holidays...