When manic depression was rebranded as bipolar disorder, the new term didn’t sit well with some sufferers of the mental health condition. For some, the verbal juxtaposition of manic depression seemed to capture the texture of the experience; long periods of raging highs, incarceration in locked wards and abysmal lows. “Bipolar” sounded tinnily conceptual by comparison.
Psychoanalyst Darian Leader agrees that a classical definition of manic depression is in order. In his short, essay-length book, Strictly Bipolar, Leader picks apart the rebranding and subdividing of bipolar disorder. Leader’s main problem with the term bipolar is that we are increasingly using is as a lifestyle term, rather than a serious condition that impacts the wellbeing of many. Today, we have become fascinated with mood swings and the “creativity” of mania, as evoked by Claire Danes in Homeland, or Bradley Cooper in Silver Linings Playbook. According to Leader, pop culture and pharmaceutical marketing has turned a categorical psychiatric concept into a dimension of symptoms wide enough to encompass almost anyone who experiences highs and lows.
However, American psychiatry is also to blame, says Leader, as diagnostic subdivisions have proliferated between the third and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders, published in 1980 and this year, respectively. This had allowed for bipolars one, two, three and so on, and Leader argues that when a diagnosis seeks to be both categorical and dimensional — at once a disease and a spectrum of symptoms — it loses the power of definition.
Leader’s definition of manic depression initially advocates the approach of the 19th-century French psychiatrists Jean-Pierre Falret and Jules Baillarger, who first defined ‘double form madness,’ and this makes a significant gesture. By starting prior to Freud, Leader suggests that this is not mere psychoanalytic theory, but he is really using Falret and Baillarger to define manic depression as, principally, a system of thought. If illnesses of the mind exist, medical science has to define the essentials, rather than merely proliferating and subdividing terms. Therefore, if psychiatry fails to rigorously identify categories of this illness, we might as well fall in with the magazine headline: ‘We’re all bipolar now.’
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