Mania

Mania (pronounced mey-nee-uh or meyn-yuh)

(1) Excessive excitement or enthusiasm; craze; excessive or unreasonable desire; insane passion affecting one or many people; fanaticism.

(2) In psychiatry, the condition manic disorder; a combining form of mania (megalomania); extended to mean “enthusiasm, often of an extreme and transient nature,” for that specified by the initial element; characterized by great excitement and occasionally violent behavior; violent derangement of mind; madness; insanity.

(3) In mythology, the consort of Mantus, Etruscan god of the dead and ruler of the underworld.  Perhaps identified with the tenebrous Mater Larum, she should not be confused with the Greek Maniae, goddess of the dead; In Greek mythology Mania was the personification of insanity.

(4) In popular use, any behavior, practice, cultural phenomenon, product etc enjoying a sudden popularity.

1350–1400: From the Middle English mania (madness), from the Latin mania (insanity, madness), from the Ancient Greek μανία (manía) (madness, frenzy; enthusiasm, inspired frenzy; mad passion, fury), from μαίνομαι (maínomai) (I am mad) +‎ -ῐ́ᾱ (-íā).  The –ia suffix was from the Latin -ia and the Ancient Greek -ία (-ía) & -εια (-eia), which form abstract nouns of feminine gender.  It was used when names of countries, diseases, species etc and occasionally collections of stuff.  The Ancient Greek mainesthai (to rage, go mad), mantis (seer) and menos (passion, spirit), were all of uncertain origin but probably related to the primitive Indo-European mnyo-, a suffixed form of the root men- (to think)," with derivatives referring to qualities and states of maenad (mind) or thought.

The sense of a "fad, craze, enthusiasm resembling mania, eager or uncontrollable desire" dates from the 1680s, the use in English in this sense borrowed from the French manie.  In Middle English, mania had sometimes been nativized as manye. The familiar modern use as the second element in compounds expressing particular types of madness emerged in the 1500s (bibliomania 1734, nymphomania, 1775; kleptomania, 1830; narcomania 1887, megalomania, 1890), the origin of this being Medical Latin, in imitation of the Greek, which had a few such compounds (although, despite popular opinion, most were actually post-classical: gynaikomania (women), hippomania (horses) etc).

The adjective maniac was from circa 1600 in the sense of "affected with mania, raving with madness" and was from the fourteenth century French maniaque, from the Late Latin maniacus, from the Ancient Greek maniakos, the Adoption in English another borrowing from French use; from 1727 it came also to mean "pertaining to mania." The noun, "one who is affected with mania, a madman" was noted from 1763, derived from the adjective.  The adjective manic (pertaining to or affected with mania), dates from 1902, the same year the clinical term “manic depressive” appeared in the literature although, perhaps strangely, the condition “manic depression” wasn’t describe until the following year although the symptoms had as early as 1857 been noted as defined as “circular insanity”, from the from French folie circulaire (1854).  It’s now known as bi-polar disorder.  The constructions hypermania & submania are both from the mid-twentieth century.  The adjective maniacal was from the 1670s, firstly in the sense of "affected with mania" and by 1701 "pertaining to or characteristic of a maniac; the form maniacally emerged during the same era.  Mania is quite specific but craving, craze, craziness, enthusiasm, fad, fascination, frenzy, infatuation, lunacy, obsession, passion, rage, aberration, bee, bug, compulsion, delirium, derangement, desire & disorder peacefully co-exist.

Noted manias

Anglomania: An excessive or undue enthusiasm for England and all things English; rarely noted in the Quai D'Orsay.

Anthomania: An extravagant passion for flowers; although it really can’t be proved, the most extreme of these are probably the orchid fanciers.  Those with an extravagant passion for weed are a different sub-set of humanity and are really narcomanics (qv) although there may be some overlap. 

Apimania: A passionate obsession with bees; beekeepers tend to be devoted to their little creatures so among the manias, this one may more than most be a spectrum condition.

Arithmomania: A compulsive desire to count objects and make calculations; noted since 1884, it’s now usually regarded as being within the rubric of obsessive-compulsive disorder (OCD).

Bibliomania: A rage for collecting rare or unusual books.  This has led to crime and there have been famous cases.

Cacodaemomania: The obsessive fixation on the idea that one is inhabited by evil spirits.  To the point where it becomes troublesome it’s apparently rare but there are dramatic cases in the literature, one of the most notorious being Anneliese Michel (1952–1976) who was subject to the rites of exorcism by Roman Catholic priests in the months before she died.  The priests and her parents (who after conventional medical interventions failed, also become convinced the cause of her problems was demonic possession) were convicted of various offences related to her death.  Films based on the events leading up to death have been released including The Exorcism of Emily Rose (2005), Requiem (2006) and Anneliese: The Exorcist Tapes (2011).

Callomania: The obsessive belief in one’s own beauty, even when to all others this is obviously delusional.

Dipsomania: The morbid craving for alcohol; in pre-modern medicine, it was used also to describe the “temporary madness caused by excessive drinking”, the origin of this being Italian (1829) and German (1830) medical literature.

Egomania: An obsessive self-centeredness; it was known since 1825 but use didn’t spike until Freud (and others) made it widely discussed after the 1890s and few terms from the early days of psycho-analysis are better remembered.

Erotomania: Desperate love, a sentimentalism producing morbid feelings.

Flagellomania: An obsessive interest in flogging and/or being flogged, often as one’s single form of sexual expression and thus a manifestation of monomania (qv).  The English Liberal Party politician Robert Bernays (1902-1945), the son of a Church of England vicar, was a flagellomanic whose proclivities were, in the manner of English society at the time, both much discussed and kept secret.  He was also an illustration of the way such fetishes transcend other sexual categories.

Gallomania: An excessive or undue enthusiasm for France and all things French; rarely noted in the British Foreign Office.

Graphomania: A morbid desire to write.  Niccolò Machiavelli (1469-1527; Italian diplomat, philosopher and political advisor of the Renaissance) attributed many of the problems he suffered to his graphomania and he was right, his sufferings because of what he wrote, when it was written and about whom.

Hippomania: An excessive fondness for horses; an affliction which often manifests as the intense and passionate interest in horses developed by some girls who join pony clubs and fall in love.

Hypermania: There’s a definitional dualism to hypermania; it can mean either an extreme example of any mania or, as used by clinicians, specifically (and characterized usually by a mental state with high intensity disorientation and often violent behavior), a severe case of bipolar disorder (the old manic-depression).  The earlier term was hypomania (A manic elation accompanied by quickened perception), one of the earliest (1882) clinical terms from early-modern psychiatry.

Kleptomania: The obsessive desire to steal; in early (1830s) use, the alternative form was cleptomania.  The klepto element was from the Ancient Greek kleptes (thief, a cheater), from kleptein (to steal, act secretly), from the primitive Indo-European klep- (to steal), from the root kel- (to cover, conceal, save) and was cognate with the Latin clepere (to steal, listen secretly to), the Old Prussian au-klipts (hidden), the Old Church Slavonic poklopu (cover, wrapping) and the Gothic hlifan (to steal) & hliftus (thief).  The history of the word kleptomania is of interest also to sociologists in that as early as the mid-nineteenth century, there was controversy about the use by those with the capacity to buy the services of doctors and lawyers were able to minimize or escape the consequences of criminal misbehavior by claiming a psychological motive.  The argument was that the “respectable” classes were afforded the benefit of this defense while the working class were presumed to be inherently criminal and judged accordingly.  The same debate, now also along racial divides, continues today.

Logomania: An obsession with words.  It differs from graphomania (qv) which is an obsession to write; logomania instead is a fascination with words, their meanings and etymologies.

Megalomania: Delusions of greatness; a form of insanity in which the subjects imagine themselves to be great, exalted, or powerful personages.  It was first used in the medical literature in 1866 (from the French mégalomanie) and came to be widely applied to many politicians and potentates the twentieth century.

Micromania:  "A form of mania in which the patient thinks himself, or some part of himself, to be reduced in size", noted first in 1879 and twenty years later used also in reference to insane self-belittling.  In the twentieth century and beyond, micromania was widely used, sometimes humorously, to refer to things as varied as the sudden consumer in interest in small cars to the shrinking size of electronic components.   

Monomania: An insane obsession in regard to a single subject or class of subjects; applied most often in academic, scientific or political matters but can be used about anything where the overriding mental impulses are perverted to a specific delusion or the pursuit of a particular thing.

Morphinomania: A craving for morphine; one of the earliest of the words which noted specific addictions, it dates from 1885 but earlier still there had been morphiomania (1876) and morphinism (1875) from the German Morphiumsucht.  In the medical literature, morphinomaniac & morphiomaniac rapidly became common.

Narcomania: The uncontrollable craving for narcotic drugs and a term which is so nineteenth century, the preferred modern form being variations of "addiction".

Necromania: An obsession to have sexual relations with the bodies of the dead although, perhaps surprisingly, practitioners (those who treat rather than practice the condition) classify many different behaviors which they list under the rubric of necromania, some of the less confronting being a morbid interest in funeral rituals,  morgues, autopsies, and cemeteries.   Those whose hobbies include the study of the architecture of crypts and tombs or the coachwork of funeral hearses might be shocked to find there are psychiatrists who classify them in the same chapters as those who enjoy intimacy with corpses.

Nymphomania: The morbid and uncontrollable sexual desire in women.  Perhaps the most celebrated (and often sought) of the manias, it dates from 1775, in the English translation of Nymphomania, or a Dissertation Concerning the Furor Uterinus (1771) by French doctor Jean Baptiste Louis de Thesacq de Bienville (1726-1813), the construct being the Ancient Greek nymphē (bride, young wife; young lady) + mania.  The actual condition is presumed to have long pre-dated the term.

Onomatomania: One obsessively compelled to respond with a rhyming word to the last word spoken by another (something possible even with orange and silver).  It’s thought to co-exist with other conditions, especially schizophrenia.

Phonomania: An uncontrollable urge to murder; those who suffer this now usually described as the more accessible “homicidal maniac”.  When applied especially to serial killers, the companion condition (just further along the spectrum) is androphonomania which, if properly argued, could be a defense against a charge of mass-murder but counsel would need to be most assiduous in jury selection.

Plutomania: The obsessive pursuit of wealth (and used sometimes in a clinical setting to describe an "imaginary possession of wealth").

Pyromania: A form of insanity marked by a mania for destroying things by fire.  It was used in German in the 1830s and seemed to have captured the imagination of Richard Wagner (1813–1883); the older word for the condition was incendiarism.

Rhinotillexomania: Nose picking. Gross, but a thing which apparently often manifests when young but fades, usually of its own volition or in reaction to the disapprobation of others.

Trichotillomania: The compulsion to pull-out one’s hair.  The companion condition is trichtillophagia which is the compulsive eating of one’s own hair, one of a remarkable number of eating disorders.

Definitional variations in the criteria for mania, DSM-IV & DSM-5

The study and classification of idea of manias had been part of psychiatry almost from its origin as a modern discipline although the wealth of details and fragmentation of nomenclature would come later, the condition first noted “increased busyness”, the manic episodes characterized by Emil Kraepelin (1856-1926; a founding father of psychiatric phenomenology) as those of someone who was “…a stranger to fatigue, his activity goes on day and night; work becomes very easy to him; ideas flow to him.” 

Whatever the advances (and otherwise) in treatment regimes, little has changed in some aspects of the condition.  In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, 2013), the primary criterion of mania remains “a distinct period of abnormally and persistently elevated, expansive, or irritable mood” and “abnormally and persistently increased goal-directed activity or energy” but did extend duration of the event to qualify for a diagnosis.  In the DSM-IV (1994), the criterion for a manic episode only required “a distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least one week” whereas DSM-5 now requires in addition the presence of “abnormally and persistently increased goal-directed activity or energy”; moreover, these symptoms must not only last at least one week, they must also be “present most of the day, nearly every day.”

The changes certainly affected the practice of the clinician, DSM-5 substantially increasing the complexity associated with the diagnosis and treatment of bipolar disorder, no longer requiring that clinically significant symptoms which may be present should be ignored.  All those years ago, Kraepelin conceptualized manic-depression as a single illness with a continuum of episodic presentations including admixtures of symptoms which have long since been considered opposing polarity.  DSM-5 thus represents an advance with the possibility of improved treatment outcomes because it enables clinicians to diagnose mood episodes and specify the presence of symptoms inconsistent with pure episodes; a major depressive episode with or without mixed features and manic/hypomanic episodes with or without mixed features.

The revisions in DSM-5 also reflect the efforts of the editors over several decades to simplify diagnostic criteria while developing more precise categories of classification.  In the DSM-IV, both bipolar disorder and major depressive disorder were included in one chapter of mood disorders and a “mixed state” was a subtype of bipolar I mania, a diagnosis of a mixed state requiring that criteria for both a manic episode (at least three or four of seven manic symptoms) and a depressive episode (at least five of nine depressive symptoms) were met for at least one week.  In DSM-5, bipolar disorder and depressive disorders have their own chapters, and “mixed state” was removed and replaced with “manic episode with mixed features” and “major depressive disorder with mixed features.”

Latibulate & Dysania

Latibulate (pronounced la-tib-oo-layt)

To go to or stay in a latibulum (a concealed hiding place; a burrow, lair, or hole).

Late 1500s: From the Latin latibulāri, from latibulum (plural latibula) (hiding place).  The construct in the Latin was late(ō) +‎ -bulum.  Latēō was from the Proto-Italic latēō (to be hidden), from the primitive Indo-European lehz- (to hide) and related to the Doric Greek λᾱ́θω (lā́thō) (to escape notice), a variant of the Ancient Greek λανθάνω (lanthánō).  In the Ionic Greek λάθρῃ (láthrēi) meant “secretly, by stealth; unbeknownst to”.  The suffix -bulumn (genitive -bulī) which also had the alternative forms -brum, -bra (by dissimilation) & -bula was from the primitive Indo-European -dhlom and was an instrumental suffix, applied as a noun suffix denoting (1) the instrumental sense, (2) a vessel or place and (3), (rarely) a person.

The related forms are latibule, latibulize latibulation & latibulum and while never widely used, do occasionally appear in zoological literature, use fading after the early nineteenth century.  The Oxford English Dictionary (OED) still lists latibulate in its unabridged editions so while certainly rare and archaic, it seems not yet obsolete.  Use did spike during the COVID-19 pandemic but only on word-nerd sites offering different ways of describing the conditions imposed by lockdowns and there’s little to suggest any revival of use.

Dysania (pronounced dis-a-nee-ah)

The state of an unwillingness to get out of bed.

Mid 1900s: Although nominally part of the language of medicine, dysania is not an accepted part of the literature and, on the rare occasions it has attracted comment from the profession, it’s been treated as a symptom of those suffering from a major depressive disorder rather than a diagnosable condition as such.  It has been noted as an entry in a 1958 medical dictionary and it seems to have been coined as a jocular term used between physicians to describe those habitually and obsessively disinclined to do whatever was recommended or prescribed (in the sense of “dis” + “mania”).  How that evolved into a specific descriptor of an unwillingness to get out of bed isn’t known.  It may that a chronic inability to leave was the manifestation of the symptoms most (and apparently often first) reported by those diagnosed with a depressive disorder.

The prefix dys- was from the From New Latin dys-, from Ancient Greek δυσ- (dus) (hard, difficult, bad).  The English prefix dis- is from the Middle English did-, borrowed from Old French des from the Latin dis, ultimately from the primitive Indo-European dwís.  In Modern English, the rules applying to the dis prefix vary and when attached to a verbal root, prefixes often change the first vowel (whether initial or preceded by a consonant/consonant cluster) of that verb. These phonological changes took place in Latin and usually do not apply to words created (as in Modern Latin) from Latin components since the language was classified as “dead”.  The combination of prefix and following vowel did not always yield the same change and these changes in vowels are not necessarily particular to being prefixed with dis (ie other prefixes sometimes cause the same vowel change (con; ex)). 

The suffix –mania (tendency towards compulsion or obsession) is an adaptation of the noun mania, from the Latin mania, from the Ancient Greek μανία (manía) (madness).  In clinical medicine, a mania can manifest as (1) a violent derangement of mind; madness; insanity, (2), excessive or unreasonable desire; an insane passion or fanaticism or (3) (and exclusive to psychiatry), the state of abnormally elevated or irritable mood, arousal, and/or energy levels.  Political scientists and sociologists also note the state of a “collective mania” but this is used in a less exacting fashion than in medicine.

The alternative to dysania is clinomania (An excessive desire to remain in bed; morbid sleepiness), the construct being clino- +‎ -mania.  Clino- is from the Ancient Greek κλίνω (klínō) (to lean; slope or angle; bed; reclining).  It’s often used in conjunction with hypnopompic (referring to the state of consciousness before becoming completely awake) and uhtceare, an Old English word that refers to anxiety experienced just before dawn.  In modern use it’s used to describe the state of waking up too early and being unable to fall back to sleep because of worries about the day to come but evolutionary biologists suggest it may be an inherited characteristic, part of a defensive mechanism linked to the dangers associated with the pre-dawn.

Uhtceare was an inflection of ūhtcaru, the construct being ūhta (the alternative form was ūht) +‎ caru.  Uhta (the last part of the night, before dawn; the time or service of nocturns was from the Proto-Germanic unhtwǭ and was cognate with the Old Saxon ūhta, the Old High German ūhta, the regional German Uchte (midnight mass), the Old Norse ótta, the Norwegian Bokmål otte, (in enhanced form), the Dutch ochtend (morning).  The Old English Caru (worry, anxiety, care, sorrow, grief) was from the Proto-West Germanic karu, from the Proto-Germanic karō. It was cognate with the Old Saxon kara, the Old High German kara, the Old Norse kǫr (sickbed) and the Gothic (kara).

In the fifth edition of the Diagnostic & Statistical Manual of Mental Disorders (DSM-5, 2013), the category “Insomnia Disorder” replaced “Primary Insomnia” as it had been listed in the fourth edition (DSM-IV, 1994) and there were a number of refinements to the diagnostic criteria.  The main change was instead of being a defined condition if experienced for one month, the sleep difficulty had to manifest for at least three months and occur at least three nights per week, it being still a requirement that there be clinically significant distress or impairment in social, occupational, educational, academic, behavioral, or other important areas of functioning.

The changes in DSM-5 to sleep-wake disorders were made to improve the clinical utility of the definitions and diagnostic criteria and some of the conditions separately listed in the DSM-IV were re-grouped in clusters while others were divided, reflecting the increased understanding of the pathology triggering certain disorders or their underlying neurobiological and genetic factors.  Part of that understanding was an appreciation that disorders have been shown to be mutually exacerbating so to assist in capturing the dynamic relationship between sleep-wake disorders and certain mental or medical conditions, a greater emphasis was given to examining how they interact and impact each other.

The general theme of the DSM-5, a greater specificity of co-existing conditions certainly applied to the revisions undertaken on sleep conditions and the editors also explained the replacement of primary insomnia (DSM-IV) with insomnia disorder (DSM-5) as a means to avoid the primary/secondary designation when this disorder co-occurs with other conditions and to reflect changes throughout the classification.

Lindsay Lohan in bed.  The correct use would be to suggest a case of dysania or clinomania, Lindsay Lohan taking her latibulation, latibulizing in her latibulum.

Satyriasis & Nymphomania

Satyriasis (pronounced sey-tuh-rahy-uh-sis or sat-uh-rahy-uh-sis)

(1) In psychology & psychiatry, a neurotic condition in men in which the symptoms are an excessive and unrestrainable venereal desire, manifesting as a compulsion to have sexual intercourse with as many women as possible.  In modern clinical use, it’s linked also to an inability to sustain lasting relationships.

(2) A disease involving swelling around the temples, causing the victim to resemble a satyr, based on the depiction in Hellenic art of satyriatic men as horned goats.

1650s: A creation of Medical Latin, from the Late Latin satyriasis, from the Ancient Greek στυρ́ησς (saturíēsis) (excessively great venereal desire in the male), from satyros, accusative plural of satyrus, from the Ancient Greek σάτυρος (sáturos) (satyr-like).  The construct was στράω (saturiáō) +‎ -σις (-sis).  The –sis suffix was from the Ancient Greek -σις (-sis) and was used to forms noun of action), often via Latin but increasingly also from French; it had exactly the same effect as the Latin –entia and the English -ing.  Historically, the use in terms borrowed from Ancient Greek was comparatively rare but there are many modern coinages based on Ancient Greek roots, reflecting to ongoing reverence for the ancient languages.  Satyriasis, satyriasist, satyromaniac, satyrization & satyr are nouns, satyriatic is an adjective; the common noun plural is satyriasist.

In Greek mythology, a satyr was a deity or demigod, male companion of Pan or Dionysus, represented as part man and part goat, and characterized by riotous merriment and lasciviousness, depicted sometimes with a perpetual erection.  Although that’s the same symptom as the condition of priapism (morbidly persistent erection of the penis), a sufferer is not of necessity also satyriatic.  The noun priapism was from the Late Latin priapismus, from the Greek priapismos (lewdness), from priapizein (to be lewd), from Priapos (the god of male reproductive power).  In Roman mythology satyr was a synonym of faun and, by extension, a lecherous man.  In modern casual use, it’s referred to also as Don Juanism, an allusion to the fictional fourteenth century Spanish nobleman Don Juan, whose sexual exploits became a thing of legend.  The term satyriasis (if not the condition) is largely archaic although still used in literature and by clinicians with a sense of history, the more popular form being satyromania, a coining in Modern Latin from 1759 which first appeared in dictionaries of English in 1889.

Don Juan (circa 1911), oil on canvas by Charles Ricketts (1866–1931).

Nymphomania (pronounced nim-fuh-mey-nee-uh or nim-fuh-meyn-yuh)

In psychology & psychiatry, a neurotic condition in women in which the symptoms are an excessive and unrestrainable venereal desire, manifesting as a compulsion to have sexual intercourse with as many men as possible.  In modern clinical use, it’s linked also to an inability to sustain lasting relationships.

1775: From the New (Medical) Latin as nymphomania (morbid and uncontrollable sexual desire in women), from the Classical Latin nympha (labia minora), the construct thus nympho- +‎ -mania.  The first known instance of publication in English was in a translation of Nymphomania, or a Dissertation Concerning the Furor Uterinus (1771) by French physician Jean Baptiste Louis de Thesacq de Bienville (1726-1813) on the model of the Ancient Greek nymphē (bride, young wife, young lady) + -mania (madness) and may have been influenced by the earlier French nymphomanie (a frenzied state of (usually erotic) emotion, especially concerning something or someone unattainable).  The adjective nymphomaniac was used first in 1861 in the sense “characterized by or suffering from nymphomania”, the specific reference to “a woman who is afflicted with nymphomania” first noted in medical literature in 1867.  In pre-modern medicine, the synonyms were the now obsolete furor uterinus and œstromania which, curiously, is said still to be mentioned in some textbooks.

Nymph was from the Middle English nimphe, from the Old French nimphe, from the Latin nympha (nymph, bride), from the Ancient Greek νύμφη (númphē) (bride) and a doublet of nympha.  The alternative spelling nymphe is archaic except as a poetic device.  In Greek & Roman mythology, a nymph was any female nature spirit associated with waterways, forests, grottos, the breezes etc and is common use was applied to beautiful or graceful young girls (often as nymphet or nymphette) although the specialized use in entomology to refer to (1) the larva of certain insects and (2) any of various butterflies of the family Nymphalidae is analogous with the nymphs of antiquity only in relation to fragility and gracefulness rather than anything specifically female.  The modern equivalent (Lolita & lolita) is decidedly “of youthful femininity”).  The suffix –mania was from the Latin mania, from the Ancient Greek μανία (mania) (madness).  In modern use in psychiatry it is used to describe a state of abnormally elevated or irritable mood, arousal, and/or energy levels and as a suffix appended as required.  In general use, under the influence of the historic meaning (violent derangement of mind; madness; insanity), it’s applied to describe any “excessive or unreasonable desire; a passion or fanaticism” which can us used even of unthreatening behaviors such as “a mania for flower arranging, crochet etc”.  As a suffix, it’s often appended with the interfix -o- make pronunciation more natural.  Nymphomania is a noun, nymphomaniac is a noun & adjective and nymphomaniacal is an adjective; the usual noun plural is nymphomaniacs.

Fairly or not, Lindsay Lohan may in 2013 have cemented a reputation as a nymphomaniac when, in a Beverley Hills hotel room, she complied a list of three dozen "conquests" although it wasn't clear if the list was selective or exhaustive and it produced reactions among those mentioned ranging from "no comment" to a Clintonesque "I did not have sex with that woman".  In partially redacted form, the list was in 2014 published by In Touch magazine and points of interest included Ms Lohan's apparently intact short & long-term memory and her commendably neat handwriting.  She seems to favor the "first letter bigger" style in which the style is "all capitals" but the first letter (in each word in the case of proper nouns such as names) is larger.  In typography, the idea is derived from the "drop cap", a centuries-old tradition in publishing where the opening letter of a sentence is many times the size of the rest, the text wrapping around the big letter.  In many cases, a drop cap was an elaborate or stylized version of the letter.

Sex doesn't appear in the annals of psychiatry with quite the frequency suggested by the volume of material published for popular consumption but it's certainly a significant part of the development of the discipline and Sigmund Freud's (1856-1939) thoughts on sex are better known even than his dream analysis.  Few would doubt that sexual behaviours are integral to some psychiatric diseases and while women are thought not ordinarily prone to nymphomania, it has been treated as expression of delusional disorder (which some, controversially, call late-onset paranoia, a rare condition which may be under-diagnosed because research suggests sufferers seem to avoid treatment.  It's of particular interest because while women with delusional disorder appear often develop a powerful sexual fixation, men's fixations arise usually in the absence of anything which could be diagnosed as a delusional disorder.  Such caveats aside, the profession has always been interested in the phenomenon of persistent, socially deviant sexual behavior accompanied by an excessive sexual appetite that may be maladaptive for the individual and the terms “compulsive sexual behavior”, “sex addiction”, “Don Juanism”, “satyriasis” & “nymphomania” are all expressions of “hypersexuality”.  Despite the long and well-documented history, when the editorial committee of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) met to discuss amendments and additions to the fifth edition (DSM-5, 2013), the members decided not to introduce hypersexual disorder as a distinct diagnostic category, apparently because of what was said to be a paucity of research on valid diagnostic criteria.

Nymphomaniacs, hysteria and steam-induced parosysm

The gender-neutral form of satyriasis and nymphomania is erotomania (abnormal exaltation of the sexual appetite which, perhaps surprisingly, predates the modern culture wars, noted in the medical literature since 1875.  The construct of erotomania was eroto- +‎ -mania, eroto from the Ancient Greek ἐρωτικός (erōtikós) (related to love), from ἔρως (érōs) (passionate or sexual love).  There were however in the nineteenth and early twentieth centuries, echoes of the culture wars because physicians were known to diagnose nymphomania in women they deemed “to enjoy sex too much”.  Some physicians however were sympathetic practical as well as sympathetic.  While they might diagnose women as “hysterical” (then an orthodox part of medicine without the exclusively “loaded” meaning of today, some were prepared to stimulate the vagina until "parosysm" (the then preferred terminology for orgasm) was achieved.   For the doctor however, it could be a tiring business, some taking longer to climax than others although (officially) the treatment was offered only to unmarried women, reducing the patient load, so there was that.

Dr Taylor’s steam-powered Manipulator. Still, hands and wrists must quickly have tired, thus the attraction of the vibrator, a device which pre-dates the use of electricity, crank-driven models (resembling a very specialised egg-beater) first produced in 1734 and the early, powered, vibrators of the nineteenth century were a deviation from the engineering practices of the day which were really a collection of techniques designed to optimize specific efficiencies.  By contrast, the early vibrators required inefficient motors.  While all motors have moving parts and will vibrate, engineers use precise tolerances to achieve balance, ensuring the vibrations are minimized because vibrations are just wasted energy.  However, by definition a vibrator needs to vibrate and at the time, the easy way to achieve this with an inefficient motor, thus the steam-powered Manipulator invented by US physician George Taylor (1821-1896) in 1869.  Steam-powered, it certainly vibrated as needed but was big and noisy, the steam engine installed in an room adjoining the surgery, the apparatus protruding through the wall.  However, as a proof-of-concept exercise it worked and Dr Taylor reported good results.   Since then the devices have evolved to be smaller, quieter and battery-powered and although electrical power has become ubiquitous, one innovation proved a cul-de-sac, the Electro-Spatteur (which augmented its vibrations with electric shocks) lacking sales appeal.  The un-powered devices however didn’t entirely disappear and early in the twentieth century, the Pulsocon was advertised in the Sears mail-order catalog (the amazon.com of the age) and as recent examinations (it’s not clear if the tests were practical) confirmed, it worked well as a vibrator, its promoters jailed in 1913 only because the other claims they were making for its efficacy (curing just about every ailment known) were variously unproven, unsustainable, unbelievable or simply lies.

The Pulsocon.

Zoanthropy

Zoanthropy (pronounced zoh-an-thruh-pee)

In clinical psychiatry, a mental disorder; a delusion in which the patient believes themselves transformed into one of the lower animals; historically treated as a form of insanity in which one imagines themselves to be another type of beast.

1845: From the French zoanthrope (one who suffers from zoanthropy) or directly from the Modern Latin zoanthropia, the construct being zo-, from the Ancient Greek ζῷο (zôion) (animal, beast), from the Proto-Hellenic ďṓyyon, from the Pre-Hellenic gwyōwyon, from the primitive Indo-European gwyeh₃w-y-om, from gwei (to live) + anthrōpos (man); the use in English can thus be analyzed as zo(o)- + -anthropy.  The Greek ζώο (the plural ζώα)) translated literally as “animal, beast, creature” but among citizens was used as an insult to label someone was “a brute; stupid”.  In modern zoological use, it’s used to refer to mammals.  Zoanthropy is a noun and zoanthropic is an adjective; the nous plural is zoanthropies.

The modern terms (covering all animal-delusions and apparently extending to alien life-forms) are Species Identity Disorder & Species Dysphoria, sub-sets of the category Dissociative Identity Disorder (DID) while the historic companion terms of Zoanthropy were Lycanthropy & Boanthropy.  Lycanthropy was from the Ancient Greek λυκανθρωπία (lukanthrōpía), from λυκάνθρωπος (lukánthrōpos) and in the mythology of Antiquity it described the state of being a lycanthrope (or werewolf), one who could shape-shift between being human and wolf, something often claimed to happen involuntarily during a full moon; werewolfdom has for centuries been a staple of writers of things supernatural.  In mythology, by extension, the word was used also to describe those able to shape-shift between the form of a human being and an animal, whether or not a wolf.  In modern psychiatry, it’s sometimes used to refer to the delusion in which one believes oneself to be a wolf or other wild animal.  Boanthropy is the delusion one is an ox or cow, the word derived from bovine, from the Late Latin bovīnus (relating to cattle), from the Classical Latin bōs (ox).  The terms Species Identity Disorder & Species Dysphoria are useful for clinicians who no longer have to deal with the proliferation of species-specific labels for the syndrome including Cynanthropy (dogs) & Ophidianthropy (snakes).  Presumably, while there might be behavioral variations between patients (one believing themselves to be a horse should move differently to one thinking they’re a frog), the treatment regimes will little differ so the names are really of more interest to word nerds than clinicians who have recorded, inter-alia, instances of delusional bees, cats, foxes & chickens.           

Reviews of the literature suggest Zoanthropy is a rare delusion.  There are countless folk who identify with animals and regard them as their spirit being (charismatic creatures like dolphins, eagles and the big cats being popular choices) but a zoanthrope actually believes themselves to be an animal, at least on occasions.  In the last two-hundred odd years, it seems there have been only a few dozen documented cases, three-quarters of whom also suffered some other mental disorders including schizophrenia, psychotic depression & bipolar disorder (the old manic-depression).  Patients suffered both permanent and transitory afflictions which could last only minutes or endure for decades.

Zoanthropic NFT: Lindsay Lohan's Furry canine (some suggested it was wolf-like) was rendered in dolichocephalic form.  The Lohanic fursona was first mentioned in September 2021 but not minted until October.

The fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5 (2013)) noted (1) it was an inherently psychotic delusion because human metamorphosis into an animal is not possible (as opposed to other delusions which may seem bizarre but which are physically possible) and it seemed overwhelmingly to be associated with instances of monomania (excessive interest or concentration on a singular object or subject; a pathological obsession with one person, thing or idea; an excessive interest with a single subject).  Monomania (the plural monomanias or monomaniæ) was from the French monomanie or the Modern Latin monomania, the construct being mono-, from the Ancient Greek μόνος (mónos) (alone, only, sole, single) +‎ mania.  The suffix –mania was from the Latin mania, from the Ancient Greek μανία (mania) (madness).  In modern use in psychiatry it is used to describe a state of abnormally elevated or irritable mood, arousal, and/or energy levels and as a suffix appended as required.  In general use, under the influence of the historic meaning (violent derangement of mind; madness; insanity), it’s applied to describe any “excessive or unreasonable desire; a passion or fanaticism” which can be used even of unthreatening behaviors such as “a mania for flower arranging, basket weaving et al”.  As a suffix, it’s often appended with the interfix -o- make pronunciation more natural.

Bizarre delusions have traditionally been associated with conditions such as Schizophrenia but the DSM-5 cast a wider net, noting with interest the frequency with which the metaphorical and symbolic language of biblical and other religious texts were mentioned by patients, especially in the specific type of zoanthropy known as boanthropy, the delusion which causes a patient to believe themselves to be a bovine, the fate of Nebuchadnezzar II of Babylon.  According to the Biblical prophet Daniel, Nebuchadnezzar was punished by God and lost his sanity for a period of 7 years:

“Immediately the word concerning Nebuchadnezzar was fulfilled; and he was driven away from mankind and began eating grass like cattle, and his body was drenched with the dew of heaven until his hair had grown like eagles’ feathers and his nails like birds’ claws.” (Daniel 4:33)

There has had been speculation Nebuchadnezzar’s behavior may have been a manifestation of clinical Lycanthropy (the delusion of being a wolf) and the Bible makes 13 references to wolves, usually as metaphors for greed and destructiveness although what’s in scripture appears to be more consistent with Boanthropy and that would more align with the agricultural and historical contexts, cattle more common than wolves in the religious motifs and presumably also more numerous in ancient Babylon.

There are variations on the syndrome.  One man in Japan spent a reputed ¥2 million (US$13,500) on a bespoke dog costume to fulfill his desire to “become an animal”.  Known only as Toco, he has a YouTube channel (with some 56,000 subscribers and 3 million views) with footage of him being taken for a walk in a park, rolling on the ground, playing fetch and sniffing other dogs.  He also does a little twerking which will probably disturb as many as it delights.  Toco said he felt some nervousness before his first venture outside but that he’d since become more confident because of the warmth shown to him by people and, interestingly, (some) other dogs.  He added that he enjoys “doing things that only dogs do” without expanding on the comment.  There are practical difficulties Toco has faced including care of the costume which the specialist supplier Zeppet (best-known among film directors for creating sculptures and models for film, television commercials) took some weeks to fabricate before delivery in 2022.  Styled to look like a collie because that was his favorite breed, when outside he wears sandals to protect the feet from wear and stop the “fur” from getting too dirty.  Better to render his experience as a canine more “dog-like”, in February 2023, he acquired a cage and rather than wandering the house at night, Toco is locked in the cage although apparently not on a leash.  Had a leash been used however, that probably wouldn't have been thought an aspect of another syndrome because it was being used only in the context of "dogginess" rather than anything BDSM related.

Dog san: Part of an “interview” by German TV station RTL, 2022.

Predictably, his lifestyle choice has attracted both supporters and detractors but it appears not to be a case of zooanthropy (specifically Cynanthropy) because Toco describes his behavior as “play-acting like a collie”.  He those doesn’t believe himself to be a dog; he just enjoys appearing as one and interacting with others (people and dogs) on that basis, adding it was his “hobby”, one which “makes me happy and other people happy, too.” And what he does is notably less invasive than those who have undergone plastic surgery to give them the characteristic features of various creatures.  In an interview, Toco revealed he had been “dreaming of transforming into a dog since he was a child” so the interesting question is whether he should be considered a harmless eccentric or someone with some form of Dissociative Identity Disorder though clearly not classical zoanthropy.

Non-zoanthropic role-playing.  One astronaut took a gorilla-suit to the ISS (International Space Station).

Bipolar

Bipolar (pronounced bahy-poh-ler)

(1) Having two poles, as the earth.

(2) Of, relating to, or found at both polar regions.

(3) Characterized by opposite extremes in opinions, nature etc.

(4) In electronics, relating to a semiconductor device, such as a transistor, that exploits the electrical characteristics of contact between two substances, one with an inherent positive charge, the other with an inherent negative charge.

(5) In electric power distribution, a power transmission line having two direct-current conductors in opposite polarity.

(6) In physics, a region of magnetic flux having two distinct poles

(7) In psychiatry, of, relating to, or having bipolar disorder (a major mood disorder that is characterized by episodes of mania and depression; once known as manic-depression.

(8) In physiology, having two poles; used especially of nerve cells in which the branches project from two usually opposite points.

(9) In geopolitics, of or relating to an international system in which two states wield most of the cultural, economic, and political influence (ie two states with hegemonies exerted over their respective spheres of influence.  The companion terms are unipolar and multipolar and all are sometimes used by analogy in fields like commerce or sporting competition to reference instances of specific dominance.

1800–1810: The construct was bi- + polar.  Pole (in this context) was from the Middle French pole & pôle, from the Latin polus, from the Ancient Greek πόλος (pólos) (axis of rotation).  The –ar suffix was from Latin -āris (of, pertaining to) and was appended to nouns to create adjectives (it came increasingly to be appended to words of non-Latin origin).  The bi- prefix came directly from the Latin bi-, from Latin bis (twice) & bīnus (double), from the Proto-Italic dwi-, from the primitive Indo-European dwi- and was one of the sequence of Latin number prefixes (uni-, bi, tri etc).  In English, it can be confusing because it can used to mean either (1) two, pair, both, duo or (2) half.  In chemistry, the use meaning half has been discontinued.  In general use, the ambiguity remains, illustrated by the use when applied to measures of duration which can variously be interpreted as “once every two periods” or “twice every period”, the classic examples of which are this like biweekly, bimonthly, and biannual.  Style guides now often suggest choosing unambiguous forms such as “fortnightly” or, where no such elegant alternative exists, spelling it out explicitly (twice a month; every two years etc).  Using semi- as a prefix can work but is imprecise although acceptable if the meaning is in other ways made clear.

In English, as a clipping (a use of the prefix as a stand-alone word) of bisexual (used as both noun & adjective), the meaning was clear and effortlessly “bi” moved from LGBTQQIAAOP slang to the general vocabulary.  Potentially misleading however is bigender, a coining of LGBTQQIAAOP activists which became linguistically necessary when gender and sex were re-assigned as separate constructs.  It’s recommended it be used as the hyphenated bi-gender (to be consistent “bi-sexual” should probably also adopt the form) lest one might ponder if a bigend is LGBTQQIAAOP slang for something (and at this point one’s mind may wander) unbeknown to one.  Additionally in engineering, a big-end bearing in an internal combustion engine is the one located “big end” of the connecting rod and attached to the crankshaft.  Mechanics may use “bigender” (pronounced big-end-ah) as slang which in oral use won’t be confused with something pronounced as by-jen-dah but if transcribed, were the latter hyphenated, there’ll be no mystified mechanics.  Bipolar is a noun & adjective and bipolarization & bipolarity are nouns; the noun plural is bipolar.

Lindsay Lohan following Edvard Munch's (1863–1944) The Scream (1893).  Much art has been analysed by those seeking insight into the mental health of the artist, schizophrenia and bipolar disorder two conditions frequently identified.

The adjective bipolar dates from 1810 in the figurative sense of "of double aspect" and was by 1859 used in the literature of anatomy (having two processes from opposite poles) to refer to nerve cells while the sometimes hyphenated noun bipolarity (state of having two poles) emerged in 1834.  The earliest known instance of the now familiar use in psychiatry as a technical term to describe what was then known as manic-depressive psychosis appears to date from 1957 in a publication by German psychiatrist Karl Leonhard (1904-1988), noted in the history of the profession for his extensive (though now mostly forgotten) classification of psychotic illnesses (a nosology (the construct being nos- + -ology, from the Ancient Greek νόσος (nosos) (disease) + -λογία (-logia) (study of), the branch of medical science dealing with the classification of diseases)) although still used in structural linguistics is the system of classification of non-verbal communication.  As the term “manic-depression” ascended the linguistic treadmill (a process accelerated by the negative connotations which attached to the word because in popular literature and films manic depressives were often characterised as psychopathic murderers or other flavours or madness) “bipolar disorder” was positioned as a preferable term, the reason being that bipolar was separated from both the connotations of “manic depression” and the two elements (“manic” & “depression”), each loaded with negative associations.  Accordingly, in 1980, bipolar disorder replaced manic-depressive psychosis in the third edition (DSM-III) of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM).  According to tracking by dictionaries, it was in the mid-1990s that bipolar (in the context of mental health) gained traction in general use and, inevitably, appeared on the linguistic treadmill although even forty-odd years on there’s little to suggest it has yet reached the level of opprobrium which might prompt the DSM’s editorial board to discuss the need for a replacement although their processes can take a while, the term “mental retardation” (long regarded in the community as offensive and in some cases misleading) not replaced by term “intellectual development disorder (intellectual disability)” until the release of DSM-5-TR (text revision) in 2022.

The bipolar world in 1980.  The geopolitical architecture of the Cold War (circa 1948-circa 1990) revolved around Moscow (the Warsaw Pact) and Washington DC (NATO).

Bipolar disorder was actually introduced to the DSM when the multi-axial system (Axis I to Axis V) was created:

Axis I: Clinical Disorders (including bipolar disorder)

Axis II: Personality Disorders and Mental Retardation

Axis III: General Medical Conditions

Axis IV: Psychosocial and Environmental Problems (stressors)

Axis V: Global Assessment of Functioning

This structure was modified with the release in 2000 of DSM-IV-TR which, within the axis system, divided diagnoses and symptoms into sections or "decision trees," including which symptoms must be included for a diagnosis and which must not be present.  The sectional approach was carried over to the DSM-5 (2013) when the axis system was abandoned, replaced by 20 chapters containing categories of related disorders of which “Bipolar and Related Disorders” is one, others including Anxiety disorders, Obsessive-compulsive and related disorders, Depressive disorders, Feeding and eating disorders and Personality disorders.  Within its category, bipolar disorder was subject to some refinements, including those reflected in other areas (such as objectum sexuality) that attempted to reduce the medicalization of behaviour that although statistically aberrant, was part of the normal human condition.  Childhood bipolar disorder for example, although long well-defined and accepted as a diagnosis, was effectively rolled into a new category of depressive disorders called disruptive mood dysregulation disorder (DMDD), reflecting the concern that the diagnosis of pediatric bipolar disorder was being inconsistently and overly applied to behaviour better understood as variations of childhood irritability.  Possibly too, the editors may have been influenced by work in labelling theory which suggested the early appearance in an individual’s medical history of conditions such as depression or bipolar disorder could have life-long consequences.

In the DSM-5, the diagnostic sub-categories of bipolar disorder were extended to seven:

(1) Bipolar I disorder

(2) Bipolar II disorder

(3) Cyclothymic disorder

(4) Substance/medication-induced bipolar and related disorder

(5) Bipolar and related disorder due to another medical condition

(6) Other specified bipolar and related disorder

(7) Unspecified bipolar and related disorder

Other changes included (1) the elimination of “mixed episode”.  Instead, a manic, hypomanic, or depressive episode can be specified as “with mixed features” a specifier with its own DSM definition. (2) The bipolar II diagnosis in the DSM-IV excluded a history of mixed episodes and this exclusion has been removed, something many long advocated. (3) There was a standardization of the text.  The word “abnormally” was not included in the DSM-IV criterion A for a hypomanic episode, while it was in criterion A for a manic episode; in DSM-5 the same language is used for both, the full criteria for the two distinct types of episodes thus closer together. (4) Each type of bipolar disorder gained specifiers (such as “with mixed features”, “with anxious distress” & “with rapid cycling”) which serve further to clarify the illness.

The DSM-5-TR was released in 2022 and among the changes were amendments to the section covering disorder.  Criterion B in bipolar I disorder was refined to make explicit that a manic episode can't be “superimposed on” (ie bolted-onto to run simultaneously with) an existing diagnosis of schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified psychotic disorder.  A similar procedural clarification was made to criterion C for bipolar II.  The specifiers indicating the severity of a manic episode were also updated.  Under DSM-5, the bipolar severity specifiers were mild, moderate, and severe which certainly made sense when labeling depressive episodes but when of clinical significance, that was less helpful when categorizing manic episodes because, in the nomenclature of the DSM, “mild” indicated “no impairment in functioning” whereas manic episodes inherently impaired function.  The specifiers for manic episodes accordingly were updated in the DSM-5-TR to (1) Mild (the manic episode meets the minimum symptom criteria), (2) Moderate (the manic episode causes a very significant increase in impairment and (3) Severe (the patient needs nearly continual supervision to prevent harm from being done to themselves and/or others).

2:365 by Kim Rask & Missy Douglas (2014), Ucki Ood, pp 400 (ISBN-100615950620).  A collection of 365 works painted in 2013 as a document of bipolar disorder.

First diagnosed with bipolar disorder at 19 while a student of art at Cambridge, Dr Missy Douglas (b 1977) in 2013 undertook for that year, each day to paint a canvas which would express her feelings at that moment.  To ensure the works reflected her condition rather than the effects of medication, during this year she went un-medicated, hoping the paintings would more accurately reflect the highs and lows of bipolarity.  When going to sleep each evening, Dr Douglas had no idea how she would feel the next morning, some days ecstatic, some days depressed.  Although the change in name to bipolar was probably helpful, Dr Douglas' experiment does illustrate why “manic depression” was so evocative of the condition.  Interestingly, on not one day was a painting not completed, not does the set include a blank canvas or one simply black or rendered otherwise monochromatically.  What this indicates would be something to ponder but is perhaps indicative of how a spectrum condition can manifest, Dr Douglas presumably a high-functioning bipolar.  For a BBC piece, Dr Douglas provided brief notes for six of the works:

Day 5: “I was really anxious, angry and feeling trapped.”

Day 177: “I was really in a dark place here. I was completely in a depressive phase.”

Day 236: “I was burying feelings and my emotions were all over the place.  Very turbulent.”

Day 242: “I was at the height of mania here, but there was a massive wave of white depression heading towards me.”

Day 314: “Mania.  I was buzzing and everything was technicolor and beautiful.  I was flying and felt invincible."

Day 359: “Christmas Day 2013.  I was feeling very depressed yet I completely compartmentalised and concealed it.  The twinkly forced jollity hid the sadness.”