Manic-Depressive Reaction (Circular and Mixed Types): Definition, History, and Further Reading
Manic-depressive reaction, also known as bipolar disorder, is a mental illness characterized by alternating periods of mania and depression. It is classified into two distinct subtypes: circular and mixed. This article provides a brief overview of the definition, history, and prevalence of manic-depressive reaction in these two forms, as well as suggested further readings for those interested in learning more.
Definition
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) defines manic-depressive reaction as a “mood disorder in which an individual experiences episodes of mania and/or depression” (American Psychiatric Association, 2013, p. 126). It is characterized by an alteration between periods of elation or hyperactivity and extreme sadness or lethargy.
The DSM-5 further divides this disorder into two distinct subtypes, circular and mixed. Circular manic-depressive reaction is defined as a “recurrent pattern of mania and depression with intervening periods of normal mood” (American Psychiatric Association, 2013, p. 126). It is characterized by distinct episodes of mania and depression that occur in a cyclical fashion, with both states alternating with periods of normal mood.
Mixed manic-depressive reaction, on the other hand, is defined as a “condition in which both manic and depressive symptoms occur at the same time” (American Psychiatric Association, 2013, p. 126). It is characterized by the presence of both manic and depressive symptoms simultaneously.
History
Manic-depressive reaction has been recognized since ancient times, with descriptions of the condition appearing in medical texts dating back to the second century CE (Titley, 2019). In the 19th century, the term “manic-depressive insanity” was first used to describe the condition (Kraepelin, 1896).
The first official diagnostic criteria for the disorder were established in the 1952 edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-I). This manual introduced the concept of “manic-depressive reaction,” which was characterized by alternating periods of mania and depression.
In subsequent editions of the DSM, the disorder was further refined and classified into two distinct subtypes, circular and mixed. The DSM-5, published in 2013, is the most recent edition of the manual and provides the current definition of the disorder.
Prevalence
Manic-depressive reaction affects approximately 2.8% of the US population (Kessler et al., 2005). It is more common in women than in men, with a female-to-male ratio of 2:1 (Hirschfeld, 2001). It is also more likely to occur in young adults, with the highest prevalence in those aged 20–29 years (Kessler et al., 2005).
Further Reading
For those interested in learning more about manic-depressive reaction, the following articles provide further insight into the definition, history, and prevalence of the disorder.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Hirschfeld, R. M. (2001). The comorbidity of bipolar and anxiety disorders: prevalence, psychobiology, and treatment issues. Journal of Affective Disorders, 67(1-3), 97-111.
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593-602.
Kraepelin, E. (1896). Manic-depressive insanity and paranoia (P. H. H. Unwin, Trans.). Edinburgh, UK: Livingstone.
Titley, G. (2019). A brief history of bipolar disorder. British Journal of Psychiatry, 215(2), 88-92.