Even though depression has been affecting our wellbeing since prehistoric times, treatment for this mental health issue has, until fairly recently, been fairly basic and, well, rubbish. These days, with better diagnoses and less social stigma, more people than ever are taking care of their emotional wellness and seeking treatment. However, even this isn’t the rosy, sunshiney age for depression sufferers that we’ve been waiting for, as studies show that only 10% of depression patients are getting adequate treatment.
Hippocrates, the father of Western Medicine, was the first to describe depression (which he called melancholia). His 5th century BC definition, which deemed depression to be a condition ‘in which sadness, anxiety, moral dejection, tendency to suicide, aversion to food, despondency, sleeplessness, irritability and listlessness is accompanied by prolonged fear,’ is pretty much the same definition that ended up in psychiatric manuals in the 1950s. Sure, Hippocrates attributed the condition to a build-up of black bile in the spleen, but other than that he was pretty much bang on the money.
However, Hippocrates wasn’t alone in his misdiagnosis of depression. During the Dark Ages, for example, wellness experts at the time believed that depression was a sign of God’s disfavour of you, and so, if you were depressed, you were labelled as a heretic or even a witch. This meant you were either imprisoned – which, I find, really does wonders for lifting the spirits – or you were executed. Apparently the Middle Age-definition of preventative medicine is killing someone before you kill yourself.
When the depression began to be recognised as a clinical condition during the Enlightenment, it paved the way for more humane treatments than, you know, imprisonment or death. Popular cures included ‘the bath of surprise,’ – in which you were submerged in scalding-hot or freezing-cold water to shock their mind ‘back into a normal state’ – and Dutch physician Dr. Hermann Boerhaave’s “gyrating chair” which was designed to achieve a similar effect, but really only served to knock some patients unconscious while causing others to ‘bleed from the mouth, ears and nose.’
It wasn’t until the 1780s that we put the “care” into depression care, when French physician Philippe Pinel took over the Bicêtre insane asylum and forbade the shackling of depressed patients in dungeons – what a guy. Many of Pinel’s patients got better under his regime of sunny rooms and exercise. 15 years later, German doctor Johann Reil first coined the term “psychiatry” and added “psychic” treatments such as massage, opium and flogging to his repertoire existing treatments, which included his own “cannon-fire” edition of the bath of surprise. Still, to get to the “talking cures” that we know today, you have to jump forward to the early 20th century, pioneered by Sigmund Freud, Carl Jung and others.
However, crazy treatments didn’t stop with the 1900s; in 1938, a Portuguese doctor named Antonia Egas Moniz believed he could stop the recurrent thought patterns involved in certain psychoses by surgically separating the nerve fibres that connect your frontal and prefrontal cortex to the thalamus deep in your brain. This lobotomy was championed by American doctor Walter Freeman, the eventual co-founder and president of the American Board of Psychiatry and Neurology – and performer over 3,500 lobotomies – despite admitting that he was ‘uninterested in understanding what was happening in the brain.’ I think I’d rather have a bath of surprise!
Lobotomies went out of fashion with the increasing popularity of drugs in the 1950s, although certain chemicals have been used in the treatment of depression since the late 19th century. The 50s drugs were more than a tool to sedate patients; they were actually created to overcome mental illnesses. However, it wasn’t until 1987 that fluoxetine, better known as Prozac, became the first selective serotonin re-uptake inhibitor (SSRI) approved by the US Food and Drug Administration (FDA), and it remains one of the most widely prescribed drugs ever devised. Still, today many researchers are rethinking their entire approach to depression, and going back in time to agree with Philippe Pinel’s prescription: exercise and sunshine – at least it’s better than lobotomies and an execution.
Comments are closed.