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Was depression and mental illness as prominent as it is in modern society back in ancient times? Are there any records of severe depression, schizophrenia, BPD, or any other mental illness that would suggest it was common hundreds and thousands of years ago?(r/AskHistorians)
Any mental illness is both very real and something that is a social construct at some level. It’s real in the sense that it causes real suffering in those who have it – people who commit suicide because of severe depression are not pretending. But a mental illness also a product of a time and a place and a culture: a mind is, practically, all about the relationship between a person and a world, and an illness of the mind is in some way a disordering of that relationship. If that world changes – and obviously it does, or history would be quite boring indeed – mental illnesses are also quite likely to change.
The upshot of this is that it’s unclear whether mental illnesses described by people in the past are the same as the ones today. The modern American psychiatric diagnostic manual – which has been incredibly influential on how English speakers conceptualise mental illness in 2016 – has only existed in its current form since the release of the DSM-III in 1980. In contrast, the way that Sigmund Freud categorises mental illness in books like Introductory Lectures On Psychoanalysis is very different; Freud categorises the illnesses by his perception of their psychological root causes (e.g., by the childhood problems he feels caused the disorders) rather than by groupings of symptoms that often happen together (as the DSM-III does).
It’s therefore often difficult to accurately compare mental illnesses from even 50-60 years ago to today, as psychiatrists and psychologists 50-60 years ago were often looking for very different things when they were making diagnoses (Freud was very influential in American psychiatry in the first two-thirds of the 20th century, though his influence declined rapidly after the 1970s). Reading Freud’s case studies, he goes into quite a lot of detail about his patients, but it’s not always easy to diagnose his patients according to the current DSM-V, because Freud is often focused on very different stuff to what a modern psychiatrist or clinical psychologist would look for.
The most vivid example of this issue is the (mostly female) mental illness that was called ‘hysteria’. Freud wrote extensively about hysteria in works like Introductory Lectures On Psychoanalysis; reading his writing on hysteria in 2016 is interesting, because the peculiar set of symptoms that seemed to characterise hysteria (the physicalisation of psychological distress, a certain sense of over-emotionality that is still seen in the layman’s meaning of the word, etc) are way less common than they seem to have been in Freud’s day. In a book that it should be noted is titled Introductory Lectures On Psychoanalysis Freud actually doesn’t bother to explain in much detail what hysteria is, and in fact clearly states that he doesn’t need to – everybody already knows. Nonetheless, hysteria is not a commonly discussed mental disorder in 2016 (when’s the last time there were frenzied media stories about people with ‘conversion disorder’, which is what psychiatrists now call it?) and seems to be much less frequent than it was. If societal conditions in Freud’s day played a role in the way that its disorder manifested, it seems likely that things like women’s rights and a more sexually open society changed those conditions in a way that reduced its frequency.
Which is to say that it’s difficult to say whether depression is more prominent today than it was in 1366 AD, because we likely have a somewhat different conception of it today than they had in 1366 AD. Even if the symptoms were similar, it might not even be quite the same mental illness in a very real sense, because of the fairly large changes in Western society in the intervening hundreds of years (a mental illness that occurs because of brain state A and social situation X may have very similar symptoms to a mental illness that requires brain state B and social situation Y, but would clearly have different causes despite the similar symptoms).
With all that said: yes, many historical writers have written extensively about mental illness. In terms of thousands of years ago, the modern English word ‘melancholy’ comes from a Greek term ‘melancholia’, a word that originally meant ‘black bile’. Ancient Greek writers appeared to believe that there was a causal relationship between levels of ‘black bile’ in your system and mental illness. It’s not tremendously clear what the ancient Greek physicians meant exactly by ‘melancholia’ – Stanley W. Jackson argued that the term not only included symptoms that sound to us like depression but also symptoms that come across as being indicative of schizophrenia. Whatever it meant, the term was discussed in writings attributed to Hippocrates, Aristotle, and Galen.
In terms of hundreds of years ago, the English writer Robert Burton’s The Anatomy Of Melancholy, first published in 1621 in Latin, discusses a condition that is clearly closer in definition to clinical depression than the Ancient Greek melancholia. There’s an old translation available freely on the web, and a more modern 2001 translation from the Latin currently in stock at Amazon. As you might guess from there being recent translations, it’s a fairly well known literary work; it’s a forbiddingly lengthy book that discourses on the nature and philosophy of the mental condition – going into theology and demonology as well as theories about black bile – and quotes previous authors at length.