Well paced, judicious, and extremely well researched, Healy's powerful book deserves a wide readership in and far beyond psychiatry.
Mania: A Short History of Bipolar Disorderby 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/i>… See more details below
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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.
If David Healy's intent is to present a cohesive, thorough, integrated and provocative account of the history of the concept of mania and the evolution of what is currently called bipolar disorder, he is tremendously successful.
A powerful political tract. As social history it provides the most detailed available account of the interactions of psychiatry and the world of pharmaceutical manufacturing.
David Healy is indeed an enfant terribleand a very brave man. I doubt he is on Eli Lilly’s or Pfizer’s Christmas card list.
Description: This book, the third in the Johns Hopkins Biographies of Disease series, traces the pedigree of an ancient disorder from Greece to modernity. But it is more than the mere history of a mental disease; it reflects on the human aspects of those who suffered the disorder through different times, places, cultures, and therapeutic milieus.
Purpose: The author's purpose is "to outline how the ways in which we have gone about trying to understand ourselves in the face of morbidity can shed light on the question of who we are." While at least some of the book is dedicated to the process of who discovered what and when in describing and treating bipolar disorder, it is also about how we fit our minds into our brains. It is about the difficulty of identifying a previously obscure mood disorder. It traces the history first from the patient-centered belief that people have bipolar disorder to the disease-centered view that emphasizes the disease and its treatment as an entity unto itself exclusive of the unfortunate patient.
Audience: This is a provocative read. It seems particularly pertinent for medical practitioners who will be familiar with many of the researchers discussed. Its philosophical approach may be of interest to a wider audience of readers with clinical knowledge of bipolar disorder.
Features: The book leads readers through changing perceptions of mania using biographical vignettes to illustrate the interplay of individual physicians and scientists and their ideas. Later chapters concentrate on pharmaceutical competition to discover, produce, and license agents that effectively medicate mania. One chapter, "Branded in the USA", is devoted to a discussion of mood stabilizer drugs. Today, the author believes the driving force in drug therapy of bipolar disorder has shifted to pharmaceutical company marketing departments.
Assessment: For anyone familiar with this author's writings, there are no surprises here. He is known for his views on the psychopharmaceutical industry and drug company marketing (Let Them Eat Prozac: The Unhealthy Relationship Between the Pharmaceutical Industry and Depression (New York University Press, 2004) and The Creation of Psychopharmacology (Harvard University Press, 2002)). However, his historical account of the disorder now called bipolar and how we approach patients is well done.
Healy reminds us that we need to ask ourselves what it means to be ill and what it means to be well.
A learned and polemical volume in the series Biographies of Disease published by the Johns Hopkins University Press... Healy is an intellectual bomb-thrower, a most erudite and clever doctor with an anarchic streak that he cannot quite reconcile with disinterested historical inquiry. He is interesting precisely for the subtle detonations that he sets off in the reader’s mind, rattling the received ideas too comfortably ensconced there.
Provides a probing and challenging commentary on the state of contemporary psychiatry.
Mania is a work that deserves a wide readership.
Well-written and compelling... I encourage you to read this exceptional book.
The book is a scholarly one [and] Healy's wide knowledge of the facts of the history is impressive.
[Healy's] work has enriched our historiographic discourse enormously and social historians of medicine can only greet that as good news.
How did we come to apply such a serious diagnosis to vaguely depressed or irritable adults, to unruly children and to nursing home residents? Is it simply that psychiatric science has progressed and now allows us to detect more easily an illness that had previously been ignored or misunderstood? Healy has another, more cynical explanation: the never-ending expansion of the category of bipolar disorder benefits large pharmaceutical companies eager to sell medications marketed with the disorder in mind.
Read an Excerpt
"That conceptual entity—and thus lived reality—we call bipolar disease today is peculiarly a product of our world. It is a world in which reductionist notions of disease have come to dominate our way of thinking about sickness. It is a world of bureaucratic categories and psychopharmaceutical practice. It is a world created in part by the laboratory’s accomplishments, but it is also a social world shaped in part by mass media and advertising, by corporate strategies and government policies. And, as is illustrated by highly visible contemporary debates over the problematic increase of bipolar diagnoses in children, it is shaped as well by the public contestation of such clinical judgments—decisions that are in theory individual, private, and objective.
"It is in this multidimensional sense that the subject of David Healy’s biography exists outside the bodies and emotions of any particular man, woman, or child. But these aggregated social, cultural, and institutional realities can and do intrude into very real bodies and minds. Healy never lets us forget the men, women, and children who feel emotional pain and incapacity no matter how much such disquieting experience is modified by drugs and ideology, by business plans and bureaucratic rationalities, by professional strategies and rewards. His subject is both timeless and timely, situated in social and cultural space, yet anchored implacably in the idiosyncratic circumstantiality of particular lives."—Charles E. Rosenberg, from the Foreword
What People are saying about this
A distinct and powerful view of the history of psychiatry that arouses controversy in the best sense of the word. Healy's discussion of the role of drug companies is especially right on the mark.
Meet the Author
David Healy is a professor of psychiatry and the director of the North Wales Department of Psychological Medicine at Cardiff University. He is the author of several books on the history of psychopharmaceuticals, including Let Them Eat Prozac, The Antidepressant Era, and The Creation of Psychopharmacology.
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