Mental illness has a turbulent and complicated history. For most of human history, mental illness was mysterious and misunderstood, leading to the isolation and mistreatment of sufferers. The idea that demonic possession or committing sins caused mental illness to be stigmatized. Unfortunately, despite the huge advances in psychiatry which led to creation of drugs and treatments to help control the diseases, there is no way to prevent or properly cure these afflictions. This means stigma still exists, and the fact that the brain is so complicated means that there are many things we don’t understand about the brain, including the causes of mental illness.
In the Classical period, the mentally ill were often considered to be prophets. Examples of this phenomenon include John the Baptist. With their limited medical knowledge, writers came to the conclusion that the behaviours displayed by the ‘insane’ were caused by psychological or emotional impacts on the individual. They also looked to the theory of the humours to explain the conditions, with too much of one humour causing the illness. Despite, the fact that Classical doctors did not properly understand brain function some of their treatments for the mentally ill would have been fairly effective. These include diets, baths, ointments, drugs and perhaps most importantly rest.
However, the mentally ill were persecuted, with laws being created to protect people from the insane. This resulted in the so-called insane people being feared, ignored and isolated from the rest of the population. During the Middle Ages, the first institutions created for the care of the mentally ill were the Islamic mauristans which were located in cities such as Baghdad, Cairo, Fez and Damascus. Islam believed that the insane were inspired by God. This meant that they were considered holy and therefore they were treated appropriately. It has been said that mauristans were luxurious. However, in the rest of Europe people who exhibited strange behaviour were thought to have been possessed by demons. The treatment of those who were deemed to have been possessed included beating, whipping, expulsion and execution. Often the luckiest patients were the ones who were simply neglected as they were less likely to be executed. Another consequence of negative attitudes towards mental health was the burning of a huge number of women who were accused of witchcraft. Ironically, the perpetrators of these witch hunts seem to have been the victims of mass hysteria themselves.
Hospitals created to treat the mentally ill tended to evolve into horrific places. A wide range of people were placed in them, often including those who were not ‘insane’ but were instead seen as a risk to society. These people included criminals, beggars, the poor, the chronically ill, and also some mad people. The conditions are thought to have been awful in these hospitals and the care was no better. The treatments administrated in these hospitals were no different from early cruel treatments and included attempts to shock or humiliate the inmates into behaving in a socially acceptable manner.
By the early modern period, the ideas of what caused mental illness began to change. Doctors now thought they were disorders of the brain, and not of the soul. At the end of the 19th century, Emil Kraeplin (a German psychiatrist) defined the two main psychoses as manic depression (which is now called bipolar) and dementia praecox. Dementia praecox later became known as schizophrenia.
During the early 20th century, the psychosomatic approach emerged. This movement started to research the physical effects of strong emotions. One of the most famous proponents of this medical movement was Hans Selye (a Canadian doctor) studied the physical effects of prolonged stress on the human body. Another theory which emerged about the brain was the idea that some personality traits meant people were more predisposed to contract certain diseases. An example of this theory in practise is the fact that having a Type A personality may mean one would be more likely to get stomach ulcers and/or coronary heart disease. One treatment which emerged during the 20th century was the removal of the ovaries in order to prevent (or control) mental illness in women.
To conclude, attitudes and treatment of the mentally ill has only improved dramatically in the last two hundred years. Before then they were often considered to be demoniacal possessed and therefore were ignored or mistreated due to fear they would affect other people. This led to the stigma which exists around mental health, which unfortunately still exists to a lesser extent today.
Duffin, J., History of Medicine: A Scandalously Short Introduction (Toronto, 1999)