What Is Manic Depression?

The Mood Disorder That Became Bipolar Disorder

Upset woman looking at happy reflection in mirror
What is manic depression?. Getty Images/Hristo Shindov

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), is a reference to the sufferer's swings from the manic pole of the illness to the depressive pole. The change from manic depression to bipolar disorder was made in 1980, both to include symptoms such as hypomania (and exclude some others) and 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, thought, and behavior. These disorders all consist of alternating periods of elevated, expansive, or irritable moods, called manic episodes and periods of feeling worthless, lack of concentration, and fatigue called depressive episodes. They differ, however, in the severity of their phases.

Bipolar I disorder refers to patients 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. They just to have "a high potential for painful consequences."

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

Cyclothymia refers to patients 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 patient has had a manic episode. For a patient to be diagnosed with bipolar disorder, he 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 of bipolar disorder allowed for more clarity in diagnosis, which has also provided a clinical term that is less emotionally loaded.

What Are Some of the Symptoms of Mania?

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

  • Grandiosity
  • Decreased need for sleep
  • Pressured speech
  • Racing thoughts
  • Distractibility
  • Tendency to engage in behavior that could have serious consequences, such as spending recklessly or inappropriate sexual encounters
  • Excessive energy

What Are Some of the Symptoms of Major Depression?

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

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

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? The hallmark of bipolar disorder in contrast to major depression is the presence of these episodes of mania or hypomania. Another common question that's asked is "Can depression turn into bipolar disorder?" The answer to that question is no. Depression doesn't later on transition into bipolar disorder. In contrast, when people are diagnosed when they are in the depressive phase they may not recall (or be asked about) symptoms of mania or hypomania. Later on, with more careful questioning, or with the occurrence of a manic or hypomanic phase, the diagnosis then becomes clear.

Diagnosing Bipolar Disorder

For those who are concerned, you can learn more about symptoms of bipolar disorder as well as how bipolar disorder is diagnosed. Thankfully, this stigma surrounding the disorder has been reduced in recent years, and many people—including many celebrities—are talking openly about their journey.


Mason, B., Brown, E., and P.Croarkin. Historical Underpinnings of Bipolar Diagnostic Criteria. Behavioral Sciences. 2016. 6(3):pii E14.

Fountoulakis, K., Vieta, E., Young, A., Yatham, L., Grunze, J., Blier, P., Moller, H., and S. Kasper. 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. International Journal of Neuropsycholpharmacology. 2016 Oct 11. (Epub ahead of print).

Continue Reading