The Meaning of Manic Depression

The Mood Disorder That Became Bipolar Disorder

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Manic depression is an older term for what is now referred to as bipolar disorder. Bipolar disorder, which is the official terminology used in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), is a reference to a person's swings from the manic pole of the disorder to the depressive pole.

The change from "manic depression" to "bipolar disorder" was made in 1980. It was done to include symptoms such as hypomania and exclude some others while attempting to reduce the stigma associated with the disorder.

What Is Bipolar Disorder?

Bipolar disorder is actually a group of mood disorders characterized by cyclical disturbances in mood, thoughts, and behavior. These disorders consist of alternating periods of elevated, expansive, or irritable moods, called manic episodes. They also include periods of feeling worthless, a lack of concentration, and fatigue called depressive episodes. The disorders differ in the severity of these two phases.

Bipolar I

Bipolar I disorder is the diagnosis for people who have had at least one episode of mania or mixed episodes (exhibiting symptoms of both depression and mania during the same period of time).

Updates to the DSM specify that a person with mania must present with an elated or irritable mood or both, in addition to increased energy or activity. Also, the "excessive involvement in activities" that are a marker for manic episodes no longer needs to be pleasurable, as in previous versions of the diagnostic criteria.

Bipolar II

Bipolar II disorder is the diagnosis for people who have had both hypomania (a milder form of mania) and major depressive episodes. The old description of "manic depression" did not include hypomania or the consequences that may occur with less than a full manic episode.


Cyclothymia is the diagnosis for people who have had chronic fluctuations between hypomania and milder, subclinical depression for at least two years. In addition, the DSM-5 criteria clarify that hypomanic or depressive symptoms must be present for at least half of the time during the required two-year period.

Bipolar Disorder vs. Manic Depression

A critical point in distinguishing bipolar disorder from major depressive disorder is whether the person has had a manic episode. For someone to be diagnosed with bipolar disorder, they must have had a manic episode lasting for at least one week or a hypomanic episode lasting for at least four days.

Why Did Manic Depression Become Bipolar Disorder?

In the past, "manic depression" was generally used to denote a wide array of mental illnesses. It was also a term that quickly became stigmatized. As classification systems became more sophisticated, the new term bipolar disorder allowed for more clarity in diagnosis, which has also provided a clinical term that is less emotionally loaded.

Symptoms of Mania

The experience of what is known as mania is one part of the symptoms associated with bipolar disorder. It comes with its own set of symptoms, which include:

  • Grandiosity
  • Decreased need for sleep
  • Pressured speech
  • Racing thoughts
  • Distractibility
  • Excessive energy
  • A tendency to engage in behavior that could have serious consequences, such as spending recklessly or unprotected sex

Symptoms of Major Depression

Major depression, on the other hand, is an experience that lives on the other end of the bipolar spectrum. It can also be experienced by people who are not diagnosed with bipolar. Symptoms of major depression include:

  • Decreased energy
  • Severe withdrawal from normal activities
  • Weight loss or gain
  • Despair
  • Irritability
  • Uncontrollable crying
  • Hallucinations and/or delusions
  • Thoughts of, or attempts at, suicide

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Bipolar Disorder vs. Major Depression

You may have heard of people who were first diagnosed with depression but later diagnosed with bipolar disorder, and this can be confusing. How can you tell the difference? Keep in mind that the hallmark of bipolar disorder is the presence of episodes of mania or hypomania. These are not present in major depression.

Another common question that's asked is "Can depression turn into bipolar disorder?" The answer to that question is no, depression doesn't transition into bipolar disorder later on.

However, it is possible for someone to be diagnosed while they are in the depressive phase, which may result in a diagnosis of depression. At the time, they may not recall or be asked about symptoms of mania or hypomania that would lead to a bipolar diagnosis. Later on, with more careful questioning, or with the occurrence of a manic or hypomanic episode, the diagnosis of bipolar may become clear.


The symptoms of bipolar disorder can be quite complex and vary for each person. A doctor, psychiatrist, or psychologist will ask you questions to get a clearer picture of your symptoms and overall mental health. These questions often focus on the type of symptoms you are experiencing, how long you have had these symptoms, and whether you have any family history of related mental conditions.

Your doctor or psychiatrist will also rule out other medical and mental health conditions that may be causing your symptoms, such as hypothyroidism, alcohol or substance use, borderline personality disorder, attention deficit hyperactivity disorder (ADHD), panic disorder, schizophrenia, and other depressive disorders.

As professionals in the field of psychiatry continue to study bipolar disorder, the diagnosis and treatment options are being refined.

It's an ongoing process, but one that many are hopeful will further improve the guidelines that psychiatrists use to help those dealing with the condition.

A Word From Verywell

Bipolar disorder is a complex mental health condition that can be difficult to understand. It can take a toll on the person dealing with it, as well as their family and friends. The good news is that treatment is available, so if you have concerns, speak to your doctor or seek out the help of a psychiatrist.

It's also good to remember that you're not alone. The stigma surrounding the disorder has been reduced in recent years, and many people—including a number of celebrities—are talking openly about their journey.

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7 Sources
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  1. Kaltenboeck A, Winkler D, Kasper S. Bipolar and related disorders in DSM-5 and ICD-10. CNS Spectr. 2016;21(4):318-323. doi:10.1017/S1092852916000079

  2. Phillips ML, Kupfer DJ. Bipolar disorder diagnosis: Challenges and future directions. Lancet. 2013;381(9878):1663-1671. doi:10.1016/S0140-6736(13)60989-7

  3. Angst J, Ajdacic-Gross V, Rössler W. Classification of mood disorders. Psychiatr Pol. 2015;49(4):663-671. doi:10.12740/PP/58259

  4. Culpepper, L. The diagnosis and treatment of bipolar disorder: Decision-making in primary care. Prim Care Companion CNS Disord. 2014;16(3):13r01609. doi:10.4088/PCC.13r01609

  5. Tolentino, JC Schmidt, SL. DSM-5 Criteria and depression severity: Implications for clinical practice. Front Psych. 2018;9:450. doi:10.3389/fpsyt.2018.00450

  6. Vöhringer PA, Perlis RH. Discriminating between bipolar disorder and major depressive disorder. Psychiatr Clin North Am. 2016;39(1):1-10. doi:10.1016/j.psc.2015.10.001

  7. Fountoulakis KN, Vieta E, Young A, et al. The International College of Neuropsychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 4: Unmet Needs in the Treatment of Bipolar Disorder and Recommendations for Future Research. Int J Neuropsychopharmacol. 2017;20(2):196-205. doi:10.1093/ijnp/pyw072

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