Congratulations to Madina who has successfully completed her Masters project “A Historical Analysis of Bipolar Disorder”
Introduction: Bipolar disorder (BD) is a severe mental illness that causes unusual shifts in mood, ranging from extreme highs (mania) to deep lows (depression). Formerly known as manic-depressive illness, BD is a brain disorder that causes unusual shifts in individuals’ mood, energy, and ability to function. According to the National Institute of Mental Health, bipolar disorder affects approximately 5.7 million adult Americans, or about 2.6% of the US population, aged 18 and older. As a chronic illness, BD can lead to cognitive and physical decline leading to functional impairments and reduced quality of life for patients as well as caregivers. Individuals may suffer for years before it is accurately diagnosed and treated.
Method: We analyzed bipolar disorder as it was historically shaped and differentiated from other mental illnesses. To compare manic depression as it was understood at the beginning of the 20th century in America to the current bipolar disorder classification, two case histories were formulated utilizing Dorothea Dix Hospital records between 1880-1920. These two case histories were investigated from the perspective of the course of illness and outcome. Multiple admissions to the hospital while maintaining functional life during remissions are indicative of manic-depressive illness based on Kraepelin’s mental diseases classification. The patients’ information was retrieved from the asylum records located in the NC state archives, such as admission ledgers, general case books (GCBs), and patient interviews. Supplemental information on these patients’ lives outside the hospital stays was obtained through a search of census enumerations, US military enlistment records, and vital statistic records such as marriages, divorces, and death certificates that are collected in Ancestry.com and Newspaper.com.
Discussion: This present study was one of the first to use the Dorothea Dix unique records to explore how the transformational diagnosis of manic-depressive insanity was reflected in asylum administration and practice in the history of American psychiatry. Utilizing a case study-based approach, this project is one of the first to focus specifically on patients with multiple admissions over decades.
Conclusion: The extreme mood alterations known as mania and melancholia have been recognized since ancient times and have shaped the modern concept of bipolar disorder as lifelong extreme mood fluctuations. This review shows that despite scientific advances made to understand BD characteristics, their basic structure did not change over time.