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A Timeline of Bipolar Disorder

Bipolar disorder can literally be considered ancient history. Descriptions and theories about illness can be found in the writings of ancient researchers from many time periods and cultures. However, Aretaeus of Cappadocia is noted for first describing bipolar disorder--though the condition would not be known by that name for centuries.

Early Understanding

Aretaeus is thought to have lived in the first and/or second centuries A.D. His descriptions in “On the Causes and Symptoms of Chronic Disease” provide examples of two states of behavior he describes as melancholy and mania. The descriptions he uses could fit into a modern description of the extreme emotions and behaviors that go with the manic and depressive phases of bipolar disorder. Aretaeus went so far in “Chronic Disease” as to suggest the link between them: “…it appears to me that melancholy is the commencement and a part of mania.”

Other researchers throughout history continued working at defining mental illnesses, including bipolar disorder, through modern times—the 19th and 20th centuries. In this latter period, it was often known as manic depression. The term bipolar disorder is relatively recent and was coined to reflect the distance between the two manifestations  of disease, to show ‘mania’ at one end of the spectrum and ‘melancholia’ at the other end (the polar opposite).

Misconceptions Through the Ages

Theories on what causes mental conditions have changed or become more refined with time. In ancient times, Aretaeus believed the Four Humours played a role in causing the conditions he described. The humours were believed to be four bodily fluids–phlegm, yellow bile, black bile, and blood. How these fluids were balanced in the body determined overall health and personality. This belief lasted for many centuries–well after Aretaeus was dead and gone.

At other times, the mentally ill were thought to be witches and their illness was thought to be caused by demons. Even today, we do not always have all the answers. In the case of bipolar disorder, the cause or causes of the condition remain a mystery, though many avenues are being explored. Treatment, both of the patients and their conditions, has also varied with time. In the past, the mentally ill were often mistreated, marginalized, kept as prisoners, or worse. Unfortunately, it is something that can still happen today.

Evolving Treatment

But bad treatment was not and is not universal. Throughout history, there was also humane care and attempts to effectively treat the mentally ill. Treatments have included religion, bleeding, lobotomy, electroconvulsive (shock) therapy, psychotherapy, and drugs, just to name a few. Some have proved effective, some less so. For bipolar disorder, psychotherapy and electroconvulsive therapy were both early treatments.

The arrival of mood-stabilizing drugs in the mid-twentieth century was a breakthrough for bipolar disorder. These drugs help ease the manic and depressive phases. Among the first mood stabilizers was lithium, which is still widely used now. Other drugs, including antidepressants and antipsychotics, are also used to treat bipolar disorder, often in conjunction with psychotherapies that help bipolar people and their loved ones learn how to better cope with the condition and maintain quality of life.

Electroconvulsive therapy is also still an option for treating bipolar disorder, and it is considered much less dangerous than it was when it came on the scene years ago. It is used when a person’s bipolar disorder is not responding to other forms of treatment, and is most often helpful with the depressive symptoms. This treatment is not a cure, but can help stabilize a person with bipolar so the swings in mood are less volatile and there are fewer of them. 

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