Mania: A Short History of Bipolar Disorder

Johns Hopkins Biographies of Disease

by David Healy

This provocative history of bipolar disorder illuminates how perceptions of illness, if not the illnesses themselves, are mutable over time.

Beginning with the origins of the concept of mania―and the term maniac ―in ancient Greek and Roman civilizations, renowned psychiatrist David Healy examines how concepts of mental afflictions evolved as scientific breakthroughs established connections between brain function and mental illness. Healy recounts the changing definitions of mania through the centuries, explores the effects of new terminology and growing public awareness of the disease on culture and society, and examines the rise of psychotropic treatments and pharmacological marketing over the past four decades. Along the way, Healy clears much of the confusion surrounding bipolar disorder even as he raises crucial questions about how, why, and by whom the disease is diagnosed. Drawing heavily on primary sources and supplemented with interviews and insight gained over Healy's long career, this lucid and engaging overview of mania sheds new light on one of humankind's most vexing ailments.

Genres: Psychology, Mental Health, Nonfiction, History, Psychiatry

320 pages, Hardcover

First published May 22, 2008

About the author

David Healy is a former secretary of the British Association for Psychopharmacology and author of over 120 articles and 12 books, including The Antidepressant Era and The Creation of Psychopharmacology.

Reviews

[Basel · Rating 3 out of 5]

Ever since I was diagnosed with bipolar disorder, I have been on a quest to understand my illness the best way I can. So when I stumbled upon this book by the Irish psychiatrist and psychopharmacologist, David Healy, I knew I had to read, and it did enrich my knowledge not only of the illness, but also of what I live through. Healy builds a biography of the illness that we now know as Bipolar Disorder, tracing the ancient sources and words related to this illness such as mania and melancholy and he presents is with a different historical contrasts of how such traits were perceived. You see, a fundamental aspect of this book is that bipolar disorder (and many other diseases) are actually creations of their times and historical contexts. This is demonstrated by the advent of modern psychopharmacology, which created a rift between modern medicine and ancient medicine. So even though, for instance, a word like mania can be traced back to ancient Greece, the ancient Greek physicians according to Healy described something different than what contemporary physicians would describe, this will eventually completely influence the treatment, if there is a treatment to be had, and the entire perception of the manic person. Society, culture, and industry (pharmaceuticals) all play a rule in defining the disease (with the scientific research, of course). So we are taken on a journey from how different states such as mania and melancholy became the states we know, to how historical links were made between the two as “single illness” called folie circulaire (circular madness), to manic-depressive illness, and eventually to bipolar disorder.

While the book does follow a general chronological order, it isn’t a chronology per se. Healy aims to show how different historical instances in psychopharmacology and general pharmacology were key for the identification of bipolar disorder and mood disorders in general as independent illness from other mental disorders, such as schizophrenia. Sometimes these instances are different contemporary researches influencing each other, sometimes building on the works of the past, and sometimes breakthroughs happening simultaneously at different parts of the world… without the researches and doctors are aware of the others’ breakthroughs. Furthermore, I enjoyed how Healy never hesitated to show how difficult and slow it is for scientific research. The story of lithium and its usage in treatment was really fascinating, and it showed all the hardships researches go through. Yet at the same time, I liked how Healy does not hesitate to take shots, which I personally consider to be legitimate, at big pharmaceutical industries in their illness mongering for profit. Yet at the same time, the rule of such industries cannot be ignored.

Bipolar disorder is still one of the most intriguing, peculiar, and hardest illnesses out there. It combines two extremes, which is one of the main reasons it was and still is hard to identify as a single illness, and work on it is still continuing. Healy’s book was a very interesting read indeed. Nevertheless, it seemed to me that the book is destined more for medical scholars and those with important knowledge of bipolar disorder and psychiatry in general. For instance, if you don’t know what terms such as neuroleptic or a central term to this book, psychopharmacology, then you’ll find it hard to follow. It is a good book to advance your knowledge about the history of the illness and what surrounds it and the illness itself per se.

[Peter Ranken · Rating 5 out of 5]

Don't listen to the morons leaving two-star reviews and complaining about big words like "pharmacology". This book is the best book on bipolar since Kraepelin, it's a straight-up masterwork.

This book contains information that is simply non-existent online and barely findable in the medical literature. At first, when I couldn't find information online or at the library to corroborate Healy's claims I began to suspect he was making things up, it took a trip to the state library and the special ordering of some very old books to find to my delight and astonishment that Healy is indeed a consummate historian, reporting on obscurities so rarely discussed he may well be the only modern author to bring them to light.

I think what annoys critics is that Healy uses lived experience perspectives to great effect against scientific dogma while at the same time deploying scientific arguments against subjective dogma. He manages to annoy both the psychiatrists and the anti-psychiatrists. Healy follows history wherever it leads and in the process confuses those who seek a dichotomous, black and white narrative. The only thing confusing about this book is what Healy himself really thinks, but a close reading of the text reveals a mind truly open to all possibilities and opposing sides. Once you understand the history, you will never see things in simple terms again.

[Publius · Rating 4 out of 5]

This book is probably tailored for clinicians and academics rather than the general population. Overall, an interesting, detailed history of Bipolar Disorder and its previous names. The author has some very strong opinions which I don't necessarily agree with, but a good stimulating read nonetheless.

[Zaafira Hasan · Rating 4 out of 5]

This book was very informative as to the history of bipolar disorder and how it came about. Many of the major medical figures were highlighted throughout this book, and the author really pinpointed the major events and development of the illness.

[Rae · Rating 4 out of 5]

FYI there is a base level of medical knowledge that would make this an easier read. I don't have that knowledge but it's still an interesting read.

[William Schrecengost · Rating 4 out of 5]

Fascinating history of Mania and Melancholia in psychiatric diagnosis. Beginning in Ancient Greece and Rome and progressing to now.

[Tia · Rating 2 out of 5]

Long story short, this was a disappointment.

Short story long: the first problem was that I was expecting more of a cultural than a medical history, which is totally on me. Still, I have read multiple books on the history of mental illness and this offered absolutely nothing new. Most of the time it did not focus on bipolar disorder but things around it. I don't think the author did a good job explaining why he was focusing on these topics instead of bipolar disorder itself.

I found that the book lacked depth and focused, predictably, on psychopharmacology and the chokehold this industry has on us. However, he could have discussed the benefits of medication as well, especially when the topic is bipolar disorder. Well, maybe he did, but I lost my interest and focus as the book droned on. The author chose to discuss "science and commerce" when it would have made more sense to focus on science and capitalism.

As per usual, the book was very US-centric despite the author being (apparently) Irish. It would be fantastic to sometimes read about the history of medicine somewhere else, even in Europe, since any euro-american-centric point of view is surely impossible (I'm being sarcastic here; it would be possible but it's just harder and "nobody cares", but ok).

I learned nothing new, which is the worst part, possibly also because as I said, I've alrady read multiple books on history of medicine. However, this book is not the best for understanding bipoalr disorder or mental illness in general. I mean, the name of the book is "Mania", which is just one part of bipolar disorder.

[Kristen Blankenship · Rating 3 out of 5]

This book has an important while disturbing message. I think it is important for people to read especially those who are concerned with their own personal mental health or that of their child. The three star rating was given only because the writing style for me was very labored. It was full of references, but for me it was so much that I got a bit lost. I guess you might say it was somewhat like a text book. Of course, I am sure I will return to this book in the future for that very reason.

[Sian Jones · Rating 3 out of 5]

Perhaps I should have known from the description (and publisher) that this is an academic text that pursues finer points of medical historiography, but I think I was hoping for something along the lines of Peter Kramer's "On Depression". And while I found the parts of the book I read to be intellectually interesting, it didn't provide the practical, contemporary information I was looking for, so I stopped reading.

[Kate · Rating 3 out of 5]

More like a 3.5. Very interesting, especially when it turned into a discussion of randomized controlled trials and their role in modern pharmacology. I will have to find more biographies of disease.